CoChat
Sign Up
Cited by 94Physical Activity and HealthDementia and Cognitive Impairment ResearchSchizophrenia research and treatment

Association Between Muscular Strength and Cognition in People With Major Depression or Bipolar Disorder and Healthy Controls

Open access
Firth, Joseph, Firth, Josh A., Stubbs, Brendon, Vancampfort, Davy, Schuch, Felipe B., Hallgren, Mats, Veronese, Nicola, Yung, Alison R. +1 more·2018·JAMA Psychiatry
DOI 10.1001/jamapsychiatry.2018.0503PMC PMC6145677
Open this paper in CoChat — free accountOpen PDF

Abstract

Importance: Objective physical fitness measures, such as handgrip strength, are associated with physical, mental, and cognitive outcomes in the general population. Although people with mental illness experience reduced physical fitness and cognitive impairment, the association between muscular strength and cognition has not been examined to date. Objective: To determine associations between maximal handgrip strength and cognitive performance in people with major depression or bipolar disorder and in healthy controls. Design, Setting, and Participants: In a multicenter, population-based study conducted between February 13, 2005, and October 1, 2010, in the United Kingdom, cross-sectional analysis was conducted of baseline data from 110 067 participants in the UK Biobank. Data analysis was performed between August 3 and August 18, 2017. Invitations were mailed to approximately 9.2 million UK homes, recruiting 502 664 adults, all aged 37 to 73 years. Clinically validated measures were used to identify individuals with major recurrent depression (moderate or severe) or bipolar disorder (type I or type II) and healthy controls (those with no indication of present or previous mood disorders). Main Outcomes and Measures: Handgrip dynamometry was used to measure muscular function. Cognitive functioning was assessed using computerized tasks of reaction time, visual memory, number memory, reasoning, and prospective memory. Generalized linear mixed models assessed the association between handgrip strength and cognitive performance, controlling for age, educational level, sex, body weight, and geographic region. Results: Of the 110 067 participants, analyses included 22 699 individuals with major depression (mean [95% range] age, 55.5 [41-68] years; 7936 [35.0%] men), 1475 with bipolar disorder (age, 54.4 [41-68] years; 748 [50.7%] men), and 85 893 healthy controls (age, 53.7 [41-69] years; 43 000 [50.0%] men). In those with major depression, significant positive associations (P < .001) between maximal handgrip strength and improved performance on all 5 cognitive tasks were found, including visual memory (coefficient, -0.146; SE, 0.014), reaction time (coefficient, -0.036; SE, 0.002), reasoning (coefficient, 0.213; SE, 0.02), number memory (coefficient, 0.160; SE, 0.023), and prospective memory (coefficient, 0.341; SE, 0.024). Similar results were found in healthy controls. Among participants with bipolar disorder, handgrip strength was positively associated with improved visual memory (coefficient, -0.129; SE, 0.052; P = .01), reaction time (coefficient, -0.047; SE, 0.007; P < .001), prospective memory (coefficient, 0.262; SE, 0.088; P = .003), and reasoning (coefficient, 0.354; SE, 0.08; P < .001). Conclusions and Relevance: Grip strength may provide a useful indicator of cognitive impairment in people with major depression and bipolar disorder. Future research should investigate causality, assess the functional implications of handgrip strength in psychiatric populations, and examine how interventions to improve muscular fitness affect neurocognitive status and socio-occupational functioning.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1001/jamapsychiatry.2018.0503

Cites

37 of 37 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • There is a clear association between increased muscular strength and cognition in people with major depression, bipolar disorder and schizophrenia.

    “Future interventions should also examine the role of resistance training for improving cognition in serious mental illness, since there is a clear association between increased muscular strength and cognition in people with major depression, bipolar disorder and schizophrenia [108, 109] and evidence from the general population indicates resistance training can improve cognition [110, 111].”

    From Exercise as Medicine for Mental and Substance Use Disorders: A Meta-review of the Benefits for Neuropsychiatric and Cognitive Outcomes (2020) · cites this paper as [108]

    The Associations Between Handgrip Strength and Cognitive Functioning section reports that greater handgrip strength was associated with better cognitive performance in people with major depression and, across several domains, bipolar disorder. The study did not examine the claimed strength–cognition association in people with schizophrenia; its Discussion mentions only a separate, mixed-diagnosis weight-training study. (LLM, conf=0.91)

    Experimental — accuracy not yet measured

  • There is encouraging evidence for resistance training in people with elevated mental health symptoms.

    “There is encouraging evidence for resistance training in people with elevated mental health symptoms [108-114], but this requires further testing in those with mental disorders.”

    From Exercise as Medicine for Mental and Substance Use Disorders: A Meta-review of the Benefits for Neuropsychiatric and Cognitive Outcomes (2020) · cites this paper as [108]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

3 of the 40 references couldn’t be matched to a known paper.

Cited by

Sorted by citations

Related

Authors
Firth, J., Firth, J. A., Stubbs, B., Vancampfort, D., Schuch, F. B., Hallgren, M., Veronese, N., Yung, A. R., & Sarris, J.
Affiliations
  • University of Manchester (GB)
  • King's College London (GB)
  • KU Leuven (BE)
  • Hospital de Clínicas de Porto Alegre (BR)
  • Karolinska Institutet (SE)
  • National Research Council (IT)
  • National Health Service (GB)
  • The University of Melbourne (AU)
Corresponding author
Firth, Joseph
ORCID
Venue
JAMA Psychiatry
Publisher
American Medical Association (AMA)
Published
2018-07-01
Volume
75
Issue
7
Pages
740
ISSN
2168-622X (ISSN-L)
DOI
10.1001/jamapsychiatry.2018.0503
PMC
PMC6145677
OpenAlex
W2799332621
Semantic Scholar
fd6d4ec2d89ab1ec8174052fd4ac23d8ba54a693
Cited by
94
References
40
Citations by year
2026: 6 · 2025: 14 · 2024: 12 · 2023: 13 · 2022: 14 · 2021: 14 · 2020: 7 · 2019: 10 · 2018: 4
FWCI
6.00
Type
journal article
Language
en
Open access
Locations
  • JAMA Psychiatry (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Deakin Research Online (Deakin University) (submittedVersion)
  • Figshare (submittedVersion, cc-by)
  • Nova Science Publishers (Nova Science Publishers, Inc.) (submittedVersion)
  • Research Portal (King's College London) (submittedVersion)
  • Lirias (submittedVersion)
  • Research Explorer (The University of Manchester) (submittedVersion)
Funders
  • National Institute for Health and Care Research (APP1125000, NF-SI-0617-10047, ICA-CL-2017-03-001, NIHR-INF-0685)
  • King's College London
  • Medical Research Council (MC_PC_17228, P117413F07)
  • National Health and Medical Research Council (1125000)
Topics
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
Keywords
major depressive disorder, bipolar disorder, grip strength, muscle strength, cognitive function, physical fitness, cognitive impairment, mood disorders, reaction time, visual memory, prospective memory, UK Biobank, handgrip dynamometry, physical activity and cognition, healthy controls comparison, sex differences, age differences, educational level differences
MeSH terms
Adult, Aged, Bipolar Disorder, Cognition, Cross-Sectional Studies, Major Depressive Disorder, Female, Humans, Male, Middle Aged, Physical Fitness, Case-Control Studies, Hand Strength, Muscle Strength, Muscle Strength Dynamometer, Cognitive Dysfunction, Healthy Volunteers

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review