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BACKGROUND The longitudinal associations between handgrip strength (HGS) and depressive symptoms remain unclear, especially in developing countries. The aim of this cohort study was to explore the associations between HGS and the incidence of depressive symptoms in China. METHODS This prospective cohort study enrolled 8470 participants living in 450 urban communities and rural villages within 28 provinces of China. Depressive symptoms were assessed using the 10-item Center for Epidemiological Studies Depression Scale. Cox proportional ha