Background: Originally, sarcopenia meant ‘poverty of flesh’, but recent operational definitions have brought measures of poor muscle performance to the fore. None has considered psychological wellbeing. We aimed to compare the muscle performance components of EWGSOP2, FNIH and SDOC algorithms for women with and without depressive and anxiety symptoms.
Methods: This cross-sectional study involved 348 women (ages 60-94 years) from the Geelong Osteoporosis Study. Hospital Anxiety and Depression Scale scores for depression (HADS-D) and anxiety (HADS-A) >=8 indicated depressive and anxiety symptoms, respectively. Handgrip strength (HGS) was measured by dynamometry and physical performance by timed up-&-go (TUG; n=320). Measures of gait speed were not available. According to EWGSOP2, low-HGS <16kg; for FNIH, low-HGS <16kg and low-HGS/BMI <0.56; for SDOC low-HGS <20kg. Slow-TUG (3m) was >20s (EWGSOP2). Chi-squared test (applying Fisher’s exact test for cell counts<5) identified differences in proportions and logistic regression models identified poor muscle performance in association with depressive symptoms.
Results: Twenty-nine (8.3%) women had depressive and 83 (23.9%) had anxiety symptoms. Proportions with low-HGS were greater for those with depressive symptoms according to different criteria [EWGSOP2 11/29(37.9%) vs 34/319(10.7%), p<0.001], [FNIH 11/29(37.9%) vs 34/319(10.7%), p<0.001] and [SDOC 15/29(51.7%) vs 85/319(26.7%), p=0.006]; and low-HGS/BMI [FNIH 13/29(44.8%) vs 50/319(15.7%), p<0.001]. Slow-TUG [EWGSOP2 3/24(12.5%) vs 4/296(1.4%), p=0.011]. No differences were detected for those with and without anxiety symptoms.
In multivariable models adjusted for age, women with depressive symptoms were 2-5 fold more likely to have low-HGS [EWGSOP OR 4.77 (95%CI 1.83-12.45) p=0.001] and [FNIH OR 4.77 (95%CI 1.83-12.45) p=0.001] and [SDOC OR 2.59 (95%CI 1.10-6.07) p=0.029], and low-HGS/BMI [FNIH OR 3.92 (95%CI 1.69-9.07) p=0.001]; and 11-fold more likely to have a slow-TUG [EWGSOP OR 10.99 (95%CI 2.03-59.7) p=0.005]. No interactions were detected.
Conclusion: Operational definitions should consider depressive symptoms at the time of evaluation when assessing muscle performance in women.