Association between muscle mass and depression symptoms

Melissa Smith

I.

Do depression symptoms have any effect on the aging body?

The researchers who performed this study hypothesized that there is a correlation between

depression symptoms and learn muscle mass. Depression symptoms decrease the drive to
workout and can also increase inflammation so identifying at risk individuals could be beneficial
to the health care system and the patient because help will be more readily available.
Sarcopenia in the older population accounts for 18.5 billion dollars in healthcare costs as
of the year 2000 and because of its association with diabetes, mortality, and frailty among the
elderly, finding out who falls into high risk groups is necessary to help prevent the development
or worsening of these conditions. The progression of sarcopenia is worsened by lack of physical
activity and depression symptoms may cause less motivation to be active. Inflammation may also
be related to depression symptoms which can further attribute to muscle loss. Although there
have been other studies showing the relationship between depression and muscle loss,
researchers now believe sex and ethnicity may also be factors. Studies have shown that women
are more sensitive to adrenal cortex stimulation which could lead to more inflammation than
men, but they have also shown higher cortisol responses in men which could lead to increased
inflammation as well. Because of all the unknowns it is necessary to study the relationship
between depression in men and women and muscle deterioration.
II.

Studying symptoms of depression in different Races

Men with depression have been shown to consume higher amounts of alcohol then other
men which can increase their risk for alcohol induced myopathy which will then lead to

decreased physical activity and lower muscle mass. Whites tend to drink more alcohol than
blacks and Asians which could put this minority group at lower risk for myopathy. Race and
ethnic differences may also contribute to the relationship between depressive symptoms and
muscle mass. Depression induced stress can cause inflammation, this response has been
shown to be more prevalent among Black than White women. In comparison to white people
blacks and Hispanics are less active during their leisure time, therefore in the presence of
depression these ethnic minorities may go through faster muscle atrophy because of low
baseline physical activity.

III.

Effects of depression on the brain

Computed tomography scans were done during visits 2 or 3 on a subset of 1,968 people
who enrolled in an ancillary study to determine the presence and extent of calcified
atherosclerosis in the abdominal aorta. Six selected slices from the L2-L5 vertebral spaces
were taken to measure the amount of abdominal lean muscle mass. In addition to being
assessed as a whole, muscle mass was classified as stabilization/ posture to explore whether
or not increased depression symptoms were related to how functional a muscle group is.
Depression symptoms were assessed during the third visit using the Center for

Epidemiologic Studies Depression scale which is a 20-item questionnaire developed to check the
past weeks depression symptoms among the participants. Although the CESD is not an
assessment of clinical depression, a score of less than 16 has been found to be indicative of at
least mild-to-moderate depression. The use of anti-depressants also indicates the presents of
more severe depression that would not be measured by this questionnaire. Covariates were also

collected such as height, weight, and sociodemographic, along with other inflammatory markers
like smoking and alcohol consumption. After factoring in the different variables the participants
were weighed and total intentional physical activity was calculated.
IV.

Conclusion and results

Overall, 18.4 % of the sample had depression symptoms, with a median CESD score of

18.0 . Among those with depression symptoms, 45.2 % utilized antidepressants. They were
also, on average, younger, more likely to be women, of Hispanic descent and single, and
were less educated. Depression symptoms were also significantly associated with shorter
stature, greater prevalence of overweight/obesity based on both waist circumference and
BMI, and lower lean muscle mass. Evaluating the overall sample population, depression
symptoms were inversely associated with lean muscle mass after adjustment for age, height
and BMI. Additional adjustment for sociodemographics reduced the findings to about half of
what was originally estimated. Fully-adjusted, participants with depression symptoms had
8.0 cm2 lower lean muscle mass compared to those without depression. The relationship
between depression and lean muscle mass varied by sex and race/ethnicity, which was driven
by the difference comparing the results between White and Chinese participants.
The results provide evidence that depressive symptoms are most definitely related to lean
muscle mass and that these associations vary by sex and race/ethnicity. Although long term
assessments are necessary to determine association direction, our findings provide support
for sex- and race/ethnic-specific interventions when people of high risk are exhibiting signs
of behavior that could decrease muscle mass, targeting men and Chinese-Americans. The
hypothesis was not completely correct but for the most part researchers knew what to expect
from this study I believe.