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Participants were selected using a multistage cluster-stratified sampling approach. Assessments included HGS measured with a dynamometer, the Montreal Cognitive Assessment (MoCA) for cognition, and the Geriatric Depression Scale (GDS) for depressive symptoms. Restricted cubic splines revealed a positive association between dominant HGS and MoCA scores, indicating better cognitive performance, and a negative association with GDS scores, suggesting fewer depressive symptoms. The association between the HGS ratio and MoCA scores and the HGS ratio and GDS scores varied by sex. Women with HGS weakness alone (odds ratio (OR)\u2009=\u20092.00, 95% confidence interval (CI)\u2009=\u20091.17\u20133.37), asymmetry alone (OR\u2009=\u20091.93, 95% CI\u2009=\u20091.14\u20133.29), or weakness and asymmetry together (OR\u2009=\u20092.57, 95% CI\u2009=\u20091.48\u20134.46) had a significantly increased risk of cognitive impairment. However, no such associations observed in men. These findings suggest that HGS weakness and asymmetrical HGS may be associated with a higher risk of cognitive decline and depressive symptoms, particularly in women. This study emphasizes the need for sex-specific assessments and prevention strategies to address cognitive and mental health issues among older adults.<\/jats:p>","DOI":"10.1038\/s41598-025-93573-6","type":"journal-article","created":{"date-parts":[[2025,3,21]],"date-time":"2025-03-21T12:49:19Z","timestamp":1742561359000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Association of handgrip strength weakness and asymmetry with cognitive impairment and depressive symptoms in older Chinese adults"],"prefix":"10.1038","volume":"15","author":[{"given":"Nazhakaiti","family":"Abudukelimu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Du","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yupei","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanyan","family":"Mao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Difei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qianxi","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,3,21]]},"reference":[{"key":"93573_CR1","doi-asserted-by":"publisher","first-page":"758","DOI":"10.1093\/ageing\/afaa112","volume":"49","author":"J Thillainadesan","year":"2020","unstructured":"Thillainadesan, J., Scott, I. 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