title: Associations of Blood Cadmium Levels With Depression and Lower Handgrip Strength in a Community-Dwelling Elderly Population: A Repeated-Measures Panel Study.
abstract: Although biologically plausible, few studies have linked cadmium exposure to depression or muscle strength. Herein, we hypothesized that blood cadmium concentrations are associated with depression and lower handgrip strength in a community-dwelling elderly population.
  
  
  
  Data from 983 elderly participants who completed up to 3 surveys between 2012 and 2015 were analyzed. At every survey, we assessed depressive status using the Korean version of the Geriatric Depression Scale-Short Form (SGDS-K) and measured handgrip strength and blood cadmium levels (mean, 1.24 μg/L). We evaluated the associations of cadmium with depression using generalized linear mixed models, and handgrip strength using linear mixed models. All models were adjusted for sociodemographic factors, lifestyle factors including active and passive smoking, weight, height, and comorbidity status.
  
  
  
  Interquartile-range increase (0.645 μg/L) in blood cadmium levels was associated with depression defined as SGDS-K score ≥8 (odds ratio = 1.27, 95% confidence interval: 1.06, 1.52) and lower handgrip strength (right hand: β = -0.40, 95% confidence interval: -0.75, -0.09; left hand: β = -0.36, 95% confidence interval: -0.69, -0.04). The association between cadmium levels and handgrip strength was robust after further adjustment for depressive status, although it attenuated in size by 14.7%-18.0%.
  
  
  
  After adjusting for potential confounders, blood cadmium concentrations were associated with depression and lower handgrip strength in an elderly population. The participants' depressive status partially mediated the association between cadmium levels and handgrip strength.
authors.affiliation: Department of Preventive Medicine, Seoul National University College of Medicine, South Korea.
authors.forename: Kyoung-Nam
authors.initials: KN
authors.lastname: Kim
authors.affiliation: Department of Preventive Medicine, Seoul National University College of Medicine, South Korea.
authors.forename: Mee-Ri
authors.initials: MR
authors.lastname: Lee
authors.affiliation: Department of Preventive Medicine, Gachon University Graduate School of Medicine, Incheon, South Korea.
authors.forename: Yoon-Hyeong
authors.initials: YH
authors.lastname: Choi
authors.affiliation: Environmental Health Research Division, Environmental Health Research Department, National Institute of Environmental Research, Incheon, South Korea.
authors.forename: Bo-Eun
authors.initials: BE
authors.lastname: Lee
authors.affiliation: Department of Preventive Medicine, Seoul National University College of Medicine, South Korea. ychong1@snu.ac.kr.|Institute of Environmental Medicine, Seoul National University Medical Research Center, South Korea.|Environmental Health Center, Seoul National University College of Medicine, South Korea.
authors.forename: Yun-Chul
authors.initials: YC
authors.lastname: Hong
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D002104:Cadmium / Q000097:blood*; D003863:Depression / Q000097:blood*; D005260:Female; D015577:Geriatric Assessment; D018737:Hand Strength; D006801:Humans; D057187:Independent Living; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea; D011795:Surveys and Questionnaires
chemical_list: D002104:Cadmium
keywords: Blood cadmium; Depression; Handgrip strength; Repeated-measures panel