Associations of Blood Cadmium Levels With Depression and Lower Handgrip Strength in a Community-Dwelling Elderly Population: A Repeated-Measures Panel Study

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 mu g/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 mu g/L) in blood cadmium levels was associated with depression defined as SGDS-K score a parts per thousand yen8 (odds ratio = 1.27, 95% confidence interval: 1.06, 1.52) and lower handgrip strength (right hand: beta = -0.40, 95% confidence interval: -0.75, -0.09; left hand: beta = -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.