Research Square · Oct 28, 2026
Grip strength and mental health in institutionalized older adults: A multicenter observational cross-sectional study
By Zambrano JL, Zurita-Pinto D, Hermo-Rebollido L
Background Grip strength is a widely used functional marker in geriatrics and has been linked to various domains of mental health. However, there is limited evidence regarding which of these dimensions maintains an independent association with grip strength when analyzed simultaneously, particularly among institutionalized older adults. Methods A cross-sectional observational study was conducted among 105 institutionalized older adults. Grip strength was assessed using a hand dynamometer. Perceived stress, anxiety, depression, and sleep quality were measured using validated scales (PSS-10, HADS, and PSQI). Descriptive and bivariate analyses were performed. The main analysis consisted of a multivariate linear regression with grip strength as the dependent variable, simultaneously including perceived stress, anxiety, depression, and sleep quality as continuous predictors, adjusted for age and sex. Inference was based on robust standard errors. A sensitivity analysis was performed excluding outliers. Results In the bivariate analyses, grip strength showed differences according to anxiety and depression categories, an inverse correlation with perceived stress, and a tendency toward higher values in those with good sleep quality, although this latter association did not reach statistical significance. In the adjusted multivariate model, only perceived stress and sex were independently associated with grip strength. Higher perceived stress was associated with lower grip strength, and women had lower values compared to men. These findings were maintained in the sensitivity analysis. Conclusions In institutionalized older adults, perceived stress and sex are independently associated with grip strength. Grip strength may provide clinically useful information not only regarding muscle status but also regarding biopsychosocial vulnerability in residential settings.