Interplay of Physical Activity, Muscle Strength, and Depression in Cognitive Impairment among Korean Older Adults: A Cross-sectional Study
Youngyun Jin, Taewan Kim, Jinkyung Cho
Department of Sport Science, Sungkyunkwan University, Suwon, Korea
Correspondence to: Jinkyung Cho
Department of Sport Science, Sungkyunkwan University, 2066, Seobu-ro, Jangan-gu, Suwon 16419, Korea
E-mail: skkucjk81@skku.edu
ORCID: https://orcid.org/0000-0002-4500-3622
Received: September 2, 2024; Revised: November 19, 2024; Accepted: December 25, 2024; Published online: January 17, 2025.
© The Korean College of Neuropsychopharmacology. All rights reserved.

Abstract
Objective: The present study was to investigate the association of physical activity (PA), relative-handgrip strength (RHGS), depressive symptoms, and cognitive impairment in Korean older adults.
Methods: This study included 512 community-dwelling Korean older adults (417 female, 95 male) aged ≥ 65 years (74.8 ± 5.4 years). PA and RHGS were assessed using an accelerometer and dynamometer, respectively. Depressive symptoms were evaluated by the Korean form of the Center for Epidemiologic Studies Depression (CES-D) Scale. Cognitive impairment was assessed through the Mini-Mental State Examination for Dementia Screening (MMSE-DS).
Results: Multiple logistic regression analysis revealed that depressive symptoms (odds ratio [OR] = 2.676, 95% confidence interval [CI]: 1.594−4.492, p < 0.001) showed a significant association with increased odds of cognitive impairment compared with normal depression status (OR = 1). Depressive symptoms had both direct and indirect effects on cognitive impairment. Both PA and RHGS partially mediated the relationship between depressive symptoms and cognitive impairment (PA: effect [B] = −0.017, 95% CI: −0.028 to −0.009, p < 0.001; RHGS: B = −0.005, 95% CI: −0.007 to −0.003, p < 0.001). Serial mediation analysis further indicated that the association between depressive symptoms and cognitive impairment was sequentially mediated by PA and RHGS (B = −0.004, 95% CI: −0.006 to −0.002, p < 0.001).
Conclusion: Promoting PA among older adults may be crucial, as this helps improve and maintain muscular strength and mitigates the negative impact of depressive symptoms on cognitive impairment.
Keywords: Cognitive dysfunction; Depression; Muscle strength; Physical activity


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