Previous studies reported that depressive symptoms were associated with a high risk of all-cause mortality. However, the effect of different long-term depressive symptom trajectory patterns on the risk of all-cause mortality has not been evaluated. Our research aimed to explore the association between different depressive symptom trajectories and the risk of all-cause mortality in Chinese adults. The data we used were from the China Health and Retirement Longitudinal Study. In total, 13,624 subjects aged over 45 years were ultimately included in the analysis. Group-based trajectory modeling was used to identify the different trajectories of depressive symptoms. The multivariable Cox regression model was used to examine the association between long-term depressive symptom trajectories and all-cause mortality. The results show that a total of five depressive symptom trajectories were identified in our study, including stable-low, stable-moderate, increasing, decreasing and stable-high. Compared with individuals in the stable-low depressive symptom trajectories group, those in the increasing and stable-high trajectory groups possessed a greater mortality rate, with a multivariable-adjusted hazard ratio (95% CIs) for mortality were 1.30 (1.06, 1.60) and 1.59 (1.26, 2.02), respectively. In addition, we have not identified the significant risk of all-cause mortality in people with decreased and stable-moderate symptom trajectories. Moreover, the risk of all-cause mortality had an increasing trend among the different trajectory groups. In the sensitivity analysis, the association was robust in most of the subgroups. In conclusion, people with increasing and persistent higher depressive symptom trajectories were associated with an increased risk of all-cause mortality.

Objective: Although handgrip strength (HGS) has been shown to be associated with various health outcomes, its relationship with visceral obesity and low appendicular skeletal muscle mass (ASM) has rarely been examined. This study aimed to investigate the independent associations between HGS and the risk of visceral obesity, low ASM, and their co-occurrence in the Chinese population. Methods: The data we used were obtained from individuals who attended the health checkup program at the health management center of Yancheng First People’s Hospital from March 2023 to November 2024. The odds ratio (OR) and 95% confidence interval (CI) for visceral obesity, low ASM, and their co-occurrence were calculated using a logistic regression model with the lowest HGS group serving as the reference category. Results: After adjusting for BMI, age, sex and other covariates, subjects in the highest quartile of HGS were significantly associated with a lower risk of visceral obesity (OR: 0.14, 95% CI: 0.08-0.27, p < 0.001), low ASM (OR: 0.10, 95% CI: 0.05-0.18, p < 0.001), and their co-occurrence (OR: 0.09, 95% CI: 0.04-0.22, p < 0.001). For visceral obesity, HGS showed an L-shaped, nonlinear association in females, characterized by a sharp reduction in risk at lower HGS levels, followed by a plateau at higher HGS levels ( p for nonlinearity < 0.05). Meanwhile, the area under the curve (AUC) values for low ASM, visceral obesity, and their co-occurrence were 0.88 (0.86, 0.89), 0.93 (0.92, 0.94), and 0.72 (0.67, 0.76), respectively. Conclusion: Higher HGS was associated with a lower risk of visceral obesity, low ASM, and their co-occurrence.