Association between handgrip strength and incident depression: a meta-analysis of prospective cohort studies

A number of individual studies have suggested that higher handgrip strength is associated with a lower risk of depressive symptoms but the totality of the evidence remains inconclusive. This study aimed to investigate the association between handgrip strength and the incidence of depressive symptoms or depression and explore potential moderators of this association. We searched major databases (PubMed, Web of Science, PsycINFO, EMBASE, and SportDiscus) from inception to February 4, 2025, for prospective cohort studies evaluating the risk of incident depressive outcomes according to handgrip strength. Effect sizes extracted were the most adjusted model containing odds ratios (ORs) or relative risks (RRs) from individual studies. Random-effects meta-analyses were conducted for ORs and RRs separately, and potential moderators were explored through meta-regressions (% women, sample size, % smokers, age, number of adjustment variables, follow-up time, and person-years). Methodological quality was assessed using the Newcastle-Ottawa Scale. Twelve unique cohorts were included (N = 497,336, person-years = 3,442,910). Individuals with lower handgrip strength had higher odds of incident depressive outcomes (OR = 1.42, 95% CI = 1.14-1.78, p < 0.001). Follow-up time (β = 0.0089, 95% CI = 0.0082-0.0096, R² = 1.00) and person-years (β = 0.00000057, 95% CI = 0.00000028-0.00000086, R² = 0.91) were identified as statistically significant moderators of this association, with studies showing slightly stronger associations, although the magnitude of these effects was small. The average methodological quality score of the studies was 8 (SD = 0.63), indicating overall high quality. This meta-analysis demonstrates a statistically significant but clinically small association between handgrip strength and the incidence of depressive outcomes. These findings suggest that handgrip strength may represent a convenient marker of overall health and functional resilience associated with depression risk.