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Kanning M, Bollenbach L, Schmitz J, Niermann C, Fina S. Analyzing Person-Place Interactions During Walking Episodes: Innovative Ambulatory Assessment Approach of Walking-Triggered e-Diaries. JMIR Form Res 2022; 6:e39322. [PMID: 36427231 PMCID: PMC9736755 DOI: 10.2196/39322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 09/01/2022] [Accepted: 10/08/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Walking behavior is positively associated with physiological and mental health as much evidence has already shown. Walking is also becoming a critical issue for health promotion in urban environments as it is the most often used form of active mobility and helps to replace carbon dioxide emissions from motorized forms of transport. It therefore contributes to mitigate the negative effects of climate change and heat islands within cities. However, to promote walking among urban dwellers and to utilize its health-enhancing potential, we need to know more about the way in which physical and social environments shape individual experiences during walking episodes. Such person-place interactions could not adequately be analyzed in former studies owing to methodological constraints. OBJECTIVE This study introduces walking-triggered e-diaries as an innovative ambulatory assessment approach for time-varying associations, and investigates its accuracy with 2 different validation strategies. METHODS The walking trigger consists of a combination of movement acceleration via an accelerometer and mobile positioning of the cellphone via GPS and transmission towers to track walking activities. The trigger starts an e-diary whenever a movement acceleration exceeds a predetermined threshold and participants' locations are identified as nonstationary outside a predefined place of residence. Every 420 (±300) seconds, repeated e-diaries were prompted as long as the trigger conditions were met. Data were assessed on 10 consecutive days. First, to investigate accuracy, we reconstructed walking routes and calculated a percentage score for all triggered prompts in relation to all walking routes where a prompt could have been triggered. Then, to provide data about its specificity, we used momentary self-reports and objectively assessed movement behavior to describe activity levels before the trigger prompted an e-diary. RESULTS Data of 67 participants could be analyzed and the walking trigger led to 3283 e-diary prompts, from which 2258 (68.8%) were answered. Regarding accuracy, the walking trigger prompted an e-diary on 732 of 842 (86.9%) reconstructed walking routes. Further, in 838 of 1206 (69.5%) triggered e-diaries, participants self-reported that they were currently walking outdoors. Steps and acceleration movement was higher during these self-reported walking episodes than when participants denied walking outdoors (steps: 106 vs 32; acceleration>0.2 g in 58.4% vs 19% of these situations). CONCLUSIONS Accuracy analysis revealed that walking-triggered e-diaries are suitable to collect different data of individuals' current experiences in situations in which a person walks outdoors. Combined with environmental data, such an approach increases knowledge about person-place interactions and provides the possibility to gain knowledge about user preferences for health-enhancing urban environments. From a methodological viewpoint, however, specificity analysis showed how changes in trigger conditions (eg, increasing the threshold for movement acceleration) lead to changes in accuracy.
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Affiliation(s)
- Martina Kanning
- Department of Sport Science, University of Konstanz, Konstanz, Germany
| | - Lukas Bollenbach
- Department of Sport Science, University of Konstanz, Konstanz, Germany
| | - Julian Schmitz
- Faculty of Architecture and Civil Engineering, University of Applied Sciences Augsburg, Augsburg, Germany
| | - Christina Niermann
- Institute of Interdisciplinary Exercise Science and Sports Medicine, Medical School Hamburg, Hamburg, Germany
| | - Stefan Fina
- Faculty of Architecture and Civil Engineering, University of Applied Sciences Augsburg, Augsburg, Germany
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Cross-sectional associations of personal efforts and beliefs and depressive symptoms among older adults in India. Sci Rep 2022; 12:13194. [PMID: 35915137 PMCID: PMC9343383 DOI: 10.1038/s41598-022-17578-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 07/27/2022] [Indexed: 11/21/2022] Open
Abstract
Whilst there is growing evidence on the increased vulnerability of older adults to depression, there is limited research on potentially mitigative factors against symptoms of depression at a population level. This research examined associations of possible protective factors (personal efforts and beliefs) and depressive symptoms among older adults in India. This cross-sectional study used data from the Longitudinal Aging Study in India with 31,464 respondents aged 60 years and above. Depressive symptoms were assessed using the 10-item Centre for Epidemiologic Studies Depression Scale. Multivariable linear regression was used while exploring the associated factors of depressive symptoms. The mean score of depressive symptoms was 2.94 (CI 2.92, 2.96). Older adults who engaged in moderate [aCoef: −0.11, CI −0.18, −0.05], vigorous [aCoef: −0.09, CI −0.16, −0.03], or both types of physical activity [aCoef: −0.10, CI −0.19, −0.02] had lower likelihood of depressive symptoms in comparison to those who were physically inactive. Older adults who participated in social activities were less likely to have depressive symptoms [aCoef: −0.44, CI −0.50, −0.39] compared to their socially inactive counterparts. Further, older adults who perceived religion as very important [aCoef: −0.29, CI −0.41, −0.17], who had high life satisfaction [aCoef: −0.78, CI −0.82, −0.73], who had good self-perceived health [aCoef: −0.29, CI −0.33, −0.25] and those who had high self-perceived social standing [aCoef: −0.39, CI −0.47, −0.31] had lower likelihood of depressive symptoms in comparison to their respective counterparts. Physical activity, social participation, voluntary work and financial contribution to family, religiosity, life satisfaction, self-perceived health and self-perceived social standing are associated with lower likelihood of depressive symptoms among community-dwelling older adults in this study. Future longitudinal studies should explore these factors that can guide interventions against depression in old age.
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Guo Z, Li R, Lu S. Leisure-time physical activity and risk of depression: A dose-response meta-analysis of prospective cohort studies. Medicine (Baltimore) 2022; 101:e29917. [PMID: 35905243 PMCID: PMC9333473 DOI: 10.1097/md.0000000000029917] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND There has never been a dose-response meta-analysis of the relationship between physical activity and the risk of depression. Hence, we aimed to explore the dose-response relationship between leisure-time physical activity (LTPA) and the risk of depression through a meta-analysis to provide a basis for the prevention of depression. METHODS PubMed and Web of Science databases were searched using a computer to collect prospective cohort studies on the relationship between LTPA and depression between January 1997 and July 2021. A dose-response meta-analysis was performed using the Stata 14 software to calculate the combined effect size relative risk (RR and 95% confidence interval CI). RESULTS Twelve cohort studies included 310,359 subjects who met the inclusion criteria. The categorical dose-response analysis results showed that the risk of incident depression was 27%, 17%, and 8% lower for the light, moderate, and highest dose LTPA participants, respectively (RR: 0.73, 95% CI: 0.64-0.82; RR: 0.83, 95% CI: 0.78-0.87; RR: 0.92, 95% CI: 0.86-0.99), compared with the lowest LTPA category. Continuous dose-response analysis showed a nonlinear relationship between LTPA and the risk of incident depression (P = .04). The risk of incident depression was reduced by 3% (RR: 0.97, 95% CI: 0.95-0.98) for every 5 MET-h/week increase in LTPA < 25 MET-h/week; when LTPA was higher than 25 MET-h/week, a 4% increase in the risk of depression for every 5 MET-h/week increase was observed (RR: 1.04, 95% CI: 1.02-1.05). CONCLUSIONS There was a nonlinear relationship between LTPA and the risk of incident depression. Moderate and low doses of LTPA were protective factors in preventing the risk of incident depression, while high doses of LTPA may increase the risk of incident depression.
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Affiliation(s)
- ZhiGuang Guo
- School of Sports Health, HuBei University of Chinese Medicine, Wuhan, China
| | - Rui Li
- School of Physical Education, Central China Normal University, Wuhan, China
- Institute of Physical Education, Kashgar University, Kashi, China
| | - Songtao Lu
- School of Physical Education, Central China Normal University, Wuhan, China
- School of Sports, Wuhan University of Science and Technology, Wuhan, China
- *Correspondence: Songtao Lu, MD, School of Sports, Wuhan University of Science and Technology, No.16, Huangjiahu West Road, Hongshan District, Wuhan 430065, Hubei Province, China (e-mail: )
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Yatsugi H, Chen T, Chen S, Liu X, Kishimoto H. The Associations between Objectively Measured Physical Activity and Physical Function in Community-Dwelling Older Japanese Men and Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010369. [PMID: 35010628 PMCID: PMC8744806 DOI: 10.3390/ijerph19010369] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 12/20/2021] [Accepted: 12/28/2021] [Indexed: 01/06/2023]
Abstract
Objective: The relationships between physical activity (PA) and physical function (PF) among older Japanese adults have been examined before, with some studies reporting that moderate-to-vigorous physical activity (MVPA) is positively associated with PF. However, it is unclear whether the observed associations differ between men and women. In this study, we investigated the associations of objectively measured MVPA, light physical activity (LPA), and sedentary time (ST) with different PF levels in older Japanese men and women. Subjects and Methods: A total of 810 community-dwelling subjects aged 65–75 years were investigated (52.1% women, 47.9% men). The PF variables included grip strength, one-leg standing, usual and maximum walking speeds, and chair-standing time. PA (MVPA, LPA, and ST) and the number of steps taken daily were assessed for seven consecutive days by a tri-axial accelerometer. We determined the sex-specific quartiles of MVPA, LPA, and ST and analyzed their associations with physical function in separate models for each exposure measure. Results: In the crude analysis, MVPA was significantly associated with all PF variables in the men, and with the usual walking speed, max. walking speed, and chair-standing time in the women. Neither LPA nor ST was significantly associated with any PF variables. After adjusting potential confounding factors, significant associations between MVPA and usual walking speed remained in the men and women. Conclusions: Only greater moderate-to-vigorous physical activity (MVPA) was significantly associated with higher levels of PF variables in both men and women. Thus, time spent in moderate-to-vigorous physical activity (MVPA) can help older adults maintain or improve their physical function.
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Affiliation(s)
- Harukaze Yatsugi
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, 744 Motooka Nishi-ku, Fukuoka 819-0395, Japan; (H.Y.); (X.L.)
| | - Tao Chen
- Sports and Health Research Center, Department of Physical Education, Tongji University, Shanghai 200092, China;
| | - Si Chen
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, 44 West Wenhua Road, Jinan 250012, China;
| | - Xin Liu
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, 744 Motooka Nishi-ku, Fukuoka 819-0395, Japan; (H.Y.); (X.L.)
| | - Hiro Kishimoto
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, 744 Motooka Nishi-ku, Fukuoka 819-0395, Japan; (H.Y.); (X.L.)
- Faculty of Arts and Science, IC15, Kyushu University, 744 Motooka Nishi-ku, Fukuoka 819-0395, Japan
- Correspondence:
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Ejiri M, Kawai H, Kera T, Ihara K, Fujiwara Y, Watanabe Y, Hirano H, Kim H, Obuchi S. Exercise as a coping strategy and its impact on the psychological well-being of Japanese community-dwelling older adults during the COVID-19 pandemic: A longitudinal study. PSYCHOLOGY OF SPORT AND EXERCISE 2021; 57:102054. [PMID: 34512181 PMCID: PMC8416690 DOI: 10.1016/j.psychsport.2021.102054] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 09/02/2021] [Accepted: 09/03/2021] [Indexed: 05/17/2023]
Abstract
This study aimed to examine the prevalence of exercise as a coping strategy among Japanese community-dwelling older adults and its impact on their psychological well-being during the COVID-19 pandemic. In October 2019 (baseline [BL]), 720 community-dwelling older adults living in an urban area in Japan participated in a comprehensive health survey. Of these, 618 responded to a mail survey (follow-up [FL]) in June 2020, after the first state of emergency was lifted. Their psychological well-being was assessed using the WHO-5 Well-Being Index (WHO-5). Exercise as a coping strategy during the stay-at-home period was determined at FL by asking respondents whether they had engaged in 1) walking and 2) at-home exercise and strength training to maintain their physical and mental health. Each type of exercise's impact and the effective exercise combinations were examined. Time and group interaction effects on the WHO-5 scores were investigated using a two-way analysis of covariance. Of the final sample, 65.1% engaged in walking. The WHO-5 mean scores at BL and FL were 16.7 and 15.4 for the walking group and 16.7 and 14.5 for the non-walking group, respectively; interaction for time and group was significant. Additionally, 56.4% of the participants engaged home training. The WHO-5 mean score at BL and FL were 17.5 and 15.5 for the home training group and 15.7 and 14.5 for the no home training group, respectively; there was no significant interaction. Older adults who engaged in both walking and home training received higher score on the WHO-5 than those who engaged in only one activity at FL. The decline in psychological well-being was most attenuated in the walking only group compared to the at-home exercise and strength training groups. Exercise as a coping strategy during the stay-at-home period was associated with psychological well-being, with different impacts observed depending on the type of activity.
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Affiliation(s)
- Manami Ejiri
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo, 173-0015, Japan
| | - Hisashi Kawai
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo, 173-0015, Japan
| | - Takeshi Kera
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo, 173-0015, Japan
- Department of Physical Therapy, Takasaki University of Health and Welfare, 37-1 Nakaorui-machi, Takasaki-shi, Gunma, 370-0033, Japan
| | - Kazushige Ihara
- Department of Social Medicine, Hirosaki University School of Medicine, 5 Zaifu-cho, Hirosaki City, Aomori, 036-8560, Japan
| | - Yoshinori Fujiwara
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo, 173-0015, Japan
| | - Yutaka Watanabe
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Nishi-7, Kita-13, Kita-ku, Sapporo, Hokkaido, 060-8586, Japan
| | - Hirohiko Hirano
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo, 173-0015, Japan
| | - Hunkyung Kim
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo, 173-0015, Japan
| | - Shuichi Obuchi
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo, 173-0015, Japan
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Yatsugi H, Chen T, Chen S, Narazaki K, Nagayoshi S, Kumagai S, Kishimoto H. Normative Data of Objectively Measured Physical Activity and Sedentary Time in Community-Dwelling Older Japanese. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073577. [PMID: 33808283 PMCID: PMC8037252 DOI: 10.3390/ijerph18073577] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 03/19/2021] [Accepted: 03/26/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND The amounts of moderate-to-vigorous-intensity physical activity (MVPA), light-intensity physical activity (LPA), and sedentary time (ST) by sex, age, and body mass index (BMI) in older Japanese adults have not been known. We conducted this study to determine the actual physical activity (PA) and ST in this population. SUBJECTS AND METHODS A total of 3998 community-dwelling Japanese adults aged ≥65 years were investigated. Their levels of PA and ST and number of steps taken daily were assessed for seven consecutive days by a tri-axial accelerometer. Normative values of daily PA and ST were analyzed by age and BMI groups in the men and the women and are presented as mean, median, or decile. RESULTS The subjects generally adhered to the PA guideline, i.e., ≥10 metabolic equivalents (METs)·hour MVPA per week. Older age was associated with lower adherence to the PA guideline. CONCLUSIONS Normative values (mean, median, or decile) were yielded for MVPA, LPA, and ST based on accelerometer readings in a large sample of older community-dwelling Japanese adults. One-half of the subjects' waking time was spent being sedentary, and >70% of the subjects met the current PA guideline by engaging in MVPA.
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Affiliation(s)
- Harukaze Yatsugi
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, 744 Motooka Nishi-ku, Fukuoka City, Fukuoka 819-0395, Japan; (H.Y.); (S.N.)
| | - Tao Chen
- Sports and Health Research Center, Department of Physical Education, Tongji University, Shanghai 200092, China;
| | - Si Chen
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, 44 West Wenhua Road, Jinan 250012, China;
| | - Kenji Narazaki
- Faculty of Socio-Environmental Studies, Fukuoka Institute of Technology, 3-30-1 Wajiro-higashi, Higashi-ku, Fukuoka City, Fukuoka 811-0295, Japan;
| | - Sho Nagayoshi
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, 744 Motooka Nishi-ku, Fukuoka City, Fukuoka 819-0395, Japan; (H.Y.); (S.N.)
- Development Center, Clinical Development Department, Technology Development HQ, Omron Healthcare Co., Ltd., 53 Kunotsubo, Terado-cho, Muko, Kyoto 617-0002, Japan
| | - Shuzo Kumagai
- Institute of Covergence Bio-Health, Dong-A University, B08-0302, 37 Nakdong-daero 550 Beon-gil, Saha-gu, Busan 49315, Korea;
| | - Hiro Kishimoto
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, 744 Motooka Nishi-ku, Fukuoka City, Fukuoka 819-0395, Japan; (H.Y.); (S.N.)
- Faculty of Arts and Science, IC15, Kyushu University, 744 Motooka Nishi-ku, Fukuoka City, Fukuoka 819-0395, Japan
- Correspondence: ; Tel./Fax: +81-92-802-6071
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The Impact of Health Consciousness on the Association Between Walking Durations and Mental Health Conditions After a Disaster: a Cross-Sectional Study. SPORTS MEDICINE-OPEN 2020; 6:30. [PMID: 32676856 PMCID: PMC7366311 DOI: 10.1186/s40798-020-00259-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Accepted: 07/03/2020] [Indexed: 11/20/2022]
Abstract
Background In communities affected by a disaster, walking can be a feasible form of physical exercise to improve physical and mental health conditions. However, there is limited evidence to support relationships between walking habits and mental health conditions in post-disaster settings. Cross-sectional epidemiological data obtained from a questionnaire survey (conducted in October 2017) of a community affected by the 2011 Great East Japan Earthquake (GEJE) was analyzed to evaluate the relationships. Methods Participants included individuals over 20 years of age (N = 718) from Shichigahama town in Miyagi prefecture, whose houses were significantly damaged by the GEJE. Their mental health conditions were assessed by the Kessler Psychological Distress Scale (K6), the Center for Epidemiologic Studies Depression Scale (CES-D), and the Impact of Event Scale-Revised (IES-R). Additionally, the questionnaire asked the participants spent duration walking on average and their walking purpose by the following items: (1) longer than 60 min per day, (2) between 30 and 60 min per day, or (3) less than 30 min per day, and whether they walked to maintain healthy living habits (health-conscious walkers) or merely for transportation without considering health consequences (non-health-conscious walkers). These information and mental health indicators were analyzed using analysis of covariance (ANCOVA). Results Among the three walking duration groups of health-conscious walkers, there were significant differences in CES-D and K6 scores (p = 0.01 and p = 0.04), but not in IES-R scores, considering age, gender, and alcohol drinking habits as covariates. CES-D score was significantly higher among short walkers (p = 0.004). Among the three walking duration groups of non-health-conscious walkers, there were significant differences in avoidance symptoms, the subdomain of IES-R (p = 0.01), but not in CES-D, K6, and total IES-R scores, considering the variants. Conclusion Our study suggests that walking durations may positively affect mood, but not PTSR, only when walking is performed with the purpose of maintaining healthy living habits. Walking durations were negatively associated with avoidance symptoms among non-health-conscious walkers in the community affected by the GEJE, indicating that the disaster may have had a long-lasting impact on walking habits.
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Özsungur F. Successful Aging of Men with Various Chronic Health Conditions Residing in Nursing Homes. AGEING INTERNATIONAL 2020. [DOI: 10.1007/s12126-020-09378-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Active Commuting and Depression Symptoms in Adults: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17031041. [PMID: 32041331 PMCID: PMC7037710 DOI: 10.3390/ijerph17031041] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 02/04/2020] [Accepted: 02/05/2020] [Indexed: 12/13/2022]
Abstract
Physical activity (PA) is suggested to have a protective effect against depression. One way of engaging in PA is through active commuting. This review summarises the literature regarding the relationship between active commuting and depression among adults and older adults. A systematic review of studies published up to December 2019, performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, was conducted using three databases (PubMed, Scopus, and Web of Science). A total of seven articles were identified as relevant. The results from these studies were inconsistent. Only two presented a significant relationship between active commuting and depression symptoms. In those two studies, switching to more active modes of travel and walking long distances were negatively related to the likelihood of developing new depressive symptoms. In the other five studies, no significant association between active travel or active commuting and depression was found. The relationship between active commuting and depression symptoms in adults is not clear. More studies on this topic are necessary in order to understand if active commuting can be used as a public health strategy to tackle mental health issues such as depression.
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Lim S, Mohaimin S, Min D, Roberts T, Sohn YJ, Wong J, Sivanesathurai R, Kwon SC, Trinh-Shevrin C. Alzheimer's Disease and its Related Dementias among Asian Americans, Native Hawaiians, and Pacific Islanders: A Scoping Review. J Alzheimers Dis 2020; 77:523-537. [PMID: 32675416 PMCID: PMC8638681 DOI: 10.3233/jad-200509] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND The Asian American, Native Hawaiian, and Pacific Islander (AANHPI) aging population is rapidly growing and the burden of Alzheimer's disease and its related dementias (ADRD) will likely mirror this demographic growth. AANHPIs face significant barriers in obtaining timely ADRD diagnosis and services; yet little is known about ADRD in this population. OBJECTIVE The study objective is to conduct a systematic review on the published literature on ADRD among AANHPIs to identify gaps and priorities to inform future research and action plans. METHODS The systematic review was conducted following the PRISMA Protocol for Systematic Reviews. Co-author (TR), an experienced Medical Librarian, searched PubMed, EMBASE, PsycINFO, Cochrane Central of Clinical Trials, Ageline, and Web of Science for peer-reviewed articles describing ADRD among AANHPIs. The search was not limited by language or publication date. Each citation was reviewed by two trained independent reviewers. Conflicts were resolved through consensus. RESULTS The title/abstract and full texts of 1,447 unique articles were screened for inclusion, yielding 168 articles for analysis. Major research topics included prevalence, risk factors, comorbidities, interventions and outreach, knowledge and attitudes, caregiving, and detection tools. A limited number of studies reported on national data, on NHPI communities generally, and on efficacy of interventions targeting AANHPI communities. CONCLUSION To our knowledge, this is the first systematic review on ADRD among AANHPI populations. Our review provides a first step in mapping the extant literature on ADRD among this underserved and under-researched population and will serve as a guide for future research, policy, and intervention.
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Affiliation(s)
- Sahnah Lim
- Department of Population Health, New York University Grossman School of Medicine
| | - Sadia Mohaimin
- Department of Population Health, New York University Grossman School of Medicine
| | - Deborah Min
- Department of Population Health, New York University Grossman School of Medicine
| | - Timothy Roberts
- Health Science Library, New York University Grossman School of Medicine
| | - Young-Jin Sohn
- Department of Population Health, New York University Grossman School of Medicine
| | - Jazmine Wong
- Department of Population Health, New York University Grossman School of Medicine
| | | | - Simona C. Kwon
- Department of Population Health, New York University Grossman School of Medicine
| | - Chau Trinh-Shevrin
- Department of Population Health, New York University Grossman School of Medicine
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Yang R, Liu Y, Wang H, Du Y. Leisure-Time Daily Walking and Blood Pressure Among Chinese Older Adults: Evidence From the China Health and Retirement Longitudinal Study (CHARLS). Res Gerontol Nurs 2019; 12:248-258. [PMID: 31283832 DOI: 10.3928/19404921-20190702-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 03/08/2019] [Indexed: 11/20/2022]
Abstract
This descriptive, cross-sectional study aimed to describe the characteristics of participants who engaged in leisure-time daily walking (LTDW) and examine the relationship between LTDW and blood pressure (BP) in Chinese older adults in general, and specifically among Chinese older adults with hypertension. Participants included 780 adults who were 65 and older from the China Health and Retirement Longitudinal Study (CHARLS). Participants self-reported their LTDW time, and BP was measured three times using an Omron HEM-7200 Monitor. Multiple linear regression models and ordinal logistical models were used to examine the characteristics of daily walkers and associations between LTDW time with systolic BP (SBP) and diastolic BP (DBP). Older adults of younger age (ß = -0.02, p = 0.012) and higher education (ß = 0.52, p = 0.018) were more likely to engage in LTDW, whereas being married was associated with less LTDW (ß = -0.24, p = 0.025). In addition, 2 to 4 hours of LTDW time was associated with lower DBP (ß = -4.13, p = 0.002). For hypertensive older adults, 30 minutes to 2 hours of LTDW time was related to lower DBP (ß = -4.42, p = 0.024). LTDW may have varying benefits on BP. Clinical recommendations should be based on patient characteristics and chronic conditions. [Res Gerontol Nurs. 2019; 12(5): 248-258.].
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McDowell CP, Dishman RK, Hallgren M, MacDonncha C, Herring MP. Associations of physical activity and depression: Results from the Irish Longitudinal Study on Ageing. Exp Gerontol 2018; 112:68-75. [PMID: 30217663 DOI: 10.1016/j.exger.2018.09.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 08/13/2018] [Accepted: 09/10/2018] [Indexed: 12/28/2022]
Abstract
Physical activity (PA) can protect against depression, but few studies have assessed whether meeting PA guidelines is sufficient, or if benefits can be derived from greater volumes of PA. The present study examines cross-sectional and prospective associations between different volumes of moderate-to-vigorous PA (MVPA) and walking, and depressive symptoms and status. Participants (n = 4556; 56.7% female) aged ≥ 50 years completed the International PA Questionnaire (IPAQ) at baseline and the Center for Epidemiological Studies Depression Scale at baseline and two years later. Prevalence and incidence of depression were 9.0% (n = 410) and 5.0% (n = 207), respectively. After full adjustment, odds of prevalent depression were: 40% (OR = 0.60, 95%CI: 0.48-0.76) lower among those meeting PA guidelines; 23% (OR = 0.77, 0.49-1.21) and 43% (OR = 0.57, 0.45-0.73) lower among those in moderate and high categories, respectively; and, 22% (OR = 0.78, 0.61-1.01) and 44.0% (OR = 0.56, 0.42-0.74) lower among those in moderate and high walking tertiles, respectively. Odds of incident depression were: 23% (OR = 0.77, 0.58-1.04) lower among those meeting PA guidelines; 37% (OR = 0.63, 0.32-1.22) and 20.0% (OR = 0.80, 0.59-1.09) lower among those in moderate and high categories, respectively; and, 21% (OR = 0.79, 0.56-1.12) and 25% (OR = 0.75, 0.52-1.07) lower among those in moderate and high walking tertiles, respectively. Moderate and high volumes of MVPA were significantly associated with lower odds of concurrent depression, and significantly and non-significantly associated with reduced odds of incident depression, respectively. Meeting recommended levels of MVPA and walking were associated with significantly lower odds of concurrent depression, and non-significantly reduced odds of the development of depression over two years.
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Affiliation(s)
- C P McDowell
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland.
| | - R K Dishman
- Department of Kinesiology, The University of Georgia, Athens, GA, United States.
| | - M Hallgren
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
| | - C MacDonncha
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland; Health Research Institute, University of Limerick, Limerick, Ireland.
| | - M P Herring
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland; Health Research Institute, University of Limerick, Limerick, Ireland.
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DiFrancisco-Donoghue J, Jung MK, Stangle A, Werner WG, Zwibel H, Happel P, Balentine J. Utilizing wearable technology to increase physical activity in future physicians: A randomized trial. Prev Med Rep 2018; 12:122-127. [PMID: 30234000 PMCID: PMC6140803 DOI: 10.1016/j.pmedr.2018.09.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 09/05/2018] [Accepted: 09/08/2018] [Indexed: 11/02/2022] Open
Abstract
This study examined the use of activity trackers alone or combined with weekly communication through email to improve activity and body composition over one academic year in medical students. This randomized clinical trial conducted at the New York Institute of Technology from July 7, 2016 through June 4, 2017 enrolled 120 medical students. The first group (Fitbit-Plus) wore activity trackers and received weekly emails offering fitness challenges and lifestyle modification challenges. The second group (Fitbit-Only) received only activity trackers and did not receive weekly emails. The third group (Control) was asked not to purchase an activity tracker of any kind throughout the study. All groups had a body composition analysis prior to the start of the academic year and at the end of the first academic year. Outcome measures included step count and body composition (body fat percentage and lean body mass). The results showed the overall mean daily steps were greater in the Fitbit-Plus group than the Fitbit-Only group for the academic year (7429 ± 2833 vs. 6483 ± 2359) with only months April and May showing a significant difference between the groups (p = 0.011; p = 0.044). Body fat percentage decreased in the Fitbit-Plus overweight women (2.1 ± 1.6%) lean body mass increased in the Fitbit-Plus group in overweight men (2.4 ± 4.6 lbs.). A subsequent finding of this study showed improved body composition in a small sub-group of over-weight students. Weekly behavioral challenges combined with an activity tracker increased step count in medical students compared to an activity tracker alone. Clinicaltrials.gov Identifier: NCT02778009.
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Affiliation(s)
- Joanne DiFrancisco-Donoghue
- Department of Osteopathic Medicine, New York Institute of Technology College of Osteopathic Medicine (NYIT-COM) Old Westbury, NY, USA.,Center for Sports Medicine NYIT-COM, Old Westbury, NY, USA
| | | | | | | | - Hallie Zwibel
- Department of Family Medicine, NYIT-COM, Old Westbury, NY, USA.,Center for Sports Medicine NYIT-COM, Old Westbury, NY, USA
| | - Patricia Happel
- Department of Family Medicine, NYIT-COM, Old Westbury, NY, USA
| | - Jerry Balentine
- Office of the Vice President NYIT-COM, Old Westbury, NY, USA
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14
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Kelly P, Williamson C, Niven AG, Hunter R, Mutrie N, Richards J. Walking on sunshine: scoping review of the evidence for walking and mental health. Br J Sports Med 2018; 52:800-806. [PMID: 29858467 DOI: 10.1136/bjsports-2017-098827] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 03/11/2018] [Accepted: 03/13/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND/OBJECTIVES Walking has well-established positive relationships with, and effects on, physical health. In contrast, while poor mental health contributes substantially to global health burden, an overview of the benefits from walking has not previously been published. We aimed to scope the literature and present what is known, and highlight what is not known, about walking and mental health. METHODS Design: Scoping review. DATA SOURCES Ovid (Medline), ProQuest, Web of Science.Screening and reporting: 13 014 records were identified and screened by a team of researchers. Included full texts were analysed and reported according to mental health outcome. RESULTS For the 8 mental health outcomes (identified a priori), there were a total of 5 systematic reviews and 50 individual papers included. Depression had the most evidence and existing systematic reviews were reported. Evidence for anxiety, psychological stress, psychological well-being, subjective well-being and social isolation and loneliness varied in volume and effectiveness, but no harmful effects were identified. There were no studies for walking and resilience. The setting and context of walking seems to be important variables. CONCLUSION The evidence base that suggests walking benefits mental health is growing, but remains fragmented and incomplete for some important outcomes. Policy and national guidelines should promote the known mental health benefits of increased walking and future research should directly address the gaps we have identified.
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Affiliation(s)
- Paul Kelly
- Physical Activity for Health Research Centre, Institute for Sport, Physical Education and Health Sciences, University of Edinburgh, Edinburgh, UK
| | - Chloë Williamson
- Physical Activity for Health Research Centre, Institute for Sport, Physical Education and Health Sciences, University of Edinburgh, Edinburgh, UK
| | - Ailsa G Niven
- Physical Activity for Health Research Centre, Institute for Sport, Physical Education and Health Sciences, University of Edinburgh, Edinburgh, UK
| | | | - Nanette Mutrie
- Physical Activity for Health Research Centre, Institute for Sport, Physical Education and Health Sciences, University of Edinburgh, Edinburgh, UK
| | - Justin Richards
- Charles Perkins Centre & School of Public Health, University of Sydney, Sydney, New South Wales, Australia
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15
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Longitudinal Association Between Objectively Measured Walking and Depressive Symptoms Among Estonian Older Adults. J Aging Phys Act 2017; 25:639-645. [DOI: 10.1123/japa.2016-0303] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Although an inverse correlation between physical activity and depressive symptoms among older adults has been found in research, this relation has seldom been examined prospectively. Accordingly, the current study examined the reciprocal relations between physical activity and depressive symptoms in Estonian older adults over a 2-year period. A three-wave longitudinal model was tested using cross-lagged analysis for 195 individuals aged over 70 years (mean = 72.1, SD = 2.1; 145 females). Results indicated that a cross-lagged model in which depressive symptoms predicted walking at subsequent time points (higher depressive symptoms were related to fewer walking steps), and walking predicted depressive symptoms at subsequent time points (higher walking steps were related to lower depressive symptoms) was most parsimonious and provided acceptable model fit. These results suggest that reduced physical activity may be a long-term consequence of depressive symptoms in older adults.
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16
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Showa S, Kitazawa K, Takeuchi M, Mori M. Influence of volunteer-led net step exercise class on older people's self-rated health in a depopulated town: A longitudinal study. SSM Popul Health 2016; 2:136-140. [PMID: 29349134 PMCID: PMC5757802 DOI: 10.1016/j.ssmph.2016.01.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 12/25/2015] [Accepted: 01/06/2016] [Indexed: 11/24/2022] Open
Abstract
In a depopulated region where population aging is advancing, it is necessary to establish a method so local residents themselves can be actively involved in older people’s health promotion. Net Step Exercise, a novel dual-task walking program, introduced residents to opportunities for physical activities and social participation without any health specialist support. In one depopulated town (Ikeda, Nakagawa-gun, Hokkaido, Japan), volunteer residents have held Net Step Exercise classes throughout the town since 2007. We longitudinally examined the influence of volunteer-led Net Step Exercise class participation on subsequent self-rated health in all individuals aged 70–79 years living in Ikeda. A total of 662 people who completed a baseline mail-in questionnaire survey in 2012 were followed until 2014. Logistic regression analysis was performed to examine the association with self-rated health after two years of class participation once a month or more at baseline, after controlling for confounds such as age, sex, years of education, living alone, baseline self-rated health, regular exercise, and other physical activities. The odds ratio of poor self-rated health in older people who participated in classes was 0.53 (95% confidence interval [CI]: 0.34–0.85) compared to older people not participating in classes. Even after confounding factors were adjusted, the odds ratio of class participation was 0.50 (95% CI: 0.29–0.85). This study showed that participation in volunteer-led Net Step Exercise might prevent poor self-rated health. Such Net Step Exercise classes are a feasible method for older people’s health promotion in depopulated municipalities. Local residents’ active involvement in older people’s health promotion is vital. NSE provides physical exercise, cognitive activity, and social participation. Older people in NSE class had significantly lower risk of poor self-rated health. The association held despite covariates for monthly class attendance or more. Local residents’ volunteer leading of NSE classes promotes health in older people.
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Affiliation(s)
- Satoko Showa
- Department of Public Health, Sapporo Medical University School of Medicine, S1, W17, Chuo-ku, Sapporo, Hokkaido 060-8556, Japan
| | | | - Miki Takeuchi
- Department of Public Health, Sapporo Medical University School of Medicine, S1, W17, Chuo-ku, Sapporo, Hokkaido 060-8556, Japan
| | - Mitsuru Mori
- Department of Public Health, Sapporo Medical University School of Medicine, S1, W17, Chuo-ku, Sapporo, Hokkaido 060-8556, Japan
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17
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Chang M, Snaedal J, Einarsson B, Bjornsson S, Saczynski JS, Aspelund T, Garcia M, Gudnason V, Harris TB, Launer LJ, Jonsson PV. The Association Between Midlife Physical Activity and Depressive Symptoms in Late Life: Age Gene/Environment Susceptibility-Reykjavik Study. J Gerontol A Biol Sci Med Sci 2015; 71:502-7. [PMID: 26525090 DOI: 10.1093/gerona/glv196] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 10/07/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND There is little evidence on the long-term association between physical activity (PA) and depressive symptoms in old age. We examined the association of midlife PA and depressive symptoms in late life. METHODS A large community-based population residing in Reykjavik, Iceland, participated in a longitudinal study with an average of 25 years of follow up. Midlife PA was categorized as active and inactive groups (n = 4,140, Active = 1,292, Inactive = 2,848, mean age 52±7 years). The main outcome had six or higher depressive symptoms assessed by the 15-item Geriatric Depression scale. Participants who had a history of depression (n = 226), and were diagnosed with dementia (n = 393), and had incomplete cognitive data (n = 595) and incomplete analytical data (n = 422) were excluded. Level of weekly PA was ascertained by a questionnaire at midlife. Depressive symptoms were assessed on average 25 (±4) years later. RESULTS After controlling for demographic and health-related risk factors, those who were active at midlife were less likely to have high level of depressive symptomatology (6 or higher Geriatric Depression scale scores, odds ratio = 0.58, 95% confidence interval: 0.41-0.83, p < .005) compared with those who were inactive in midlife. After full adjustment of three domains of late-life cognitive function the results remained significant (odds ratio = 0.61, 95% confidence interval: 0.43-0.86, p = .005). CONCLUSION Our study shows that midlife PA is associated with lower depressive symptoms 25 years later. Participating in regular PA in midlife may improve mental health in late life.
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Affiliation(s)
- Milan Chang
- Icelandic Gerongological Research Center, National University Hospital of Iceland, Reykjavik. Department of Sport Science, School of Science and Engineering, Reykjavik University, Iceland.
| | - Jon Snaedal
- Icelandic Gerongological Research Center, National University Hospital of Iceland, Reykjavik. Faculty of Medicine, University of Iceland, Reykjavik
| | - Bjorn Einarsson
- Icelandic Gerongological Research Center, National University Hospital of Iceland, Reykjavik
| | - Sigurbjorn Bjornsson
- Icelandic Gerongological Research Center, National University Hospital of Iceland, Reykjavik
| | - Jane S Saczynski
- Division of Geriatric Medicine and Meyers Primary Care Institute, University of Massachusetts Medical School, Worcester
| | - Thor Aspelund
- Icelandic Heart Association, Kopavogur. Faculty of Science, University of Iceland, Reykjavik
| | - Melissa Garcia
- Laboratory of Epidemiology and Population Science, National Institute on Aging, Bethesda, Maryland
| | - Vilmundur Gudnason
- Faculty of Medicine, University of Iceland, Reykjavik. Icelandic Heart Association, Kopavogur
| | - Tamara B Harris
- Laboratory of Epidemiology and Population Science, National Institute on Aging, Bethesda, Maryland
| | - Lenore J Launer
- Laboratory of Epidemiology and Population Science, National Institute on Aging, Bethesda, Maryland
| | - Palmi V Jonsson
- Icelandic Gerongological Research Center, National University Hospital of Iceland, Reykjavik. Faculty of Medicine, University of Iceland, Reykjavik
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18
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Yoshida Y, Iwasa H, Kumagai S, Suzuki T, Awata S, Yoshida H. Longitudinal association between habitual physical activity and depressive symptoms in older people. Psychiatry Clin Neurosci 2015; 69:686-92. [PMID: 26037604 DOI: 10.1111/pcn.12324] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Revised: 03/11/2015] [Accepted: 05/29/2015] [Indexed: 11/29/2022]
Abstract
AIMS Prevention of depressive symptoms is an essential issue with regard to the promotion of healthy lifestyles in older people. To date, few studies have examined the relation between fluctuations in physical activity and depression among older individuals. We thus conducted a longitudinal survey of older adults to examine the effect of long-term fluctuating physical activity on the incidence of depressive symptoms. METHODS A 3-year prospective cohort study was performed in a community-based environment. A total of 680 individuals (291 men and 389 women) aged 65 years and over at the baseline assessment participated. The 15-item Geriatric Depression Scale was used to assess depressive symptoms, with scores of ≥6 indicative of depression. Participants were categorized into the following four groups based on change in physical activity status between 2002 and 2003: sedentary, cessation, initiation, and maintenance. RESULTS The incidence of depressive symptoms was 16.9% (16.8% in men and 17.0% in women) at the 3-year follow up (in 2006). Multiple logistic regression analyses showed that physical activity maintenance (odds ratio, 0.50; 95% confidence interval, 0.30-0.83) only reduced the incidence of depressive symptoms at the 3-year follow up after adjusting for confounding variables. CONCLUSIONS Continuous physical activity may be a valuable and simple way to prevent depressive symptoms in community-dwelling older people. Therefore, it is necessary to implement interventions that teach older adults how to integrate physical activity into their daily lives.
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Affiliation(s)
- Yuko Yoshida
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Hajime Iwasa
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.,Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Shu Kumagai
- University of Human Arts and Sciences, Saitama, Japan
| | - Takao Suzuki
- National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Shuichi Awata
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Hideyo Yoshida
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
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Park JE, Lee JY, Kim BS, Kim KW, Chae SH, Cho MJ. Above-moderate physical activity reduces both incident and persistent late-life depression in rural Koreans. Int J Geriatr Psychiatry 2015; 30:766-75. [PMID: 25503946 DOI: 10.1002/gps.4244] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 11/05/2014] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To investigate the natural course of depressive symptoms among community-dwelling elderly over 5 years. Rates and correlates of the incidence and the persistence of late-life depression were examined. METHODS A total of 701 elderly people 65 years of age or older without dementia at baseline were included in this study. The association between categorically defined late-life depression (score of ≥ 8 on the Korean version of the Geriatric Depression Scale-Short Form) and possible lifestyle and clinical risk factors, including physical activity assessed with a modified Korean version of the International Physical Activity Questionnaire (IPAQ) and transformed into weekly Metabolic Equivalent Task (MET) values, was longitudinally investigated using multiple logistic regression analyses. Adjustment was done with sociodemographic variables, chronic medical illnesses, and cognitive dysfunction. RESULTS During the 5-year follow-up, 74 (26.5%) of the non-depressed elderly developed depression, whereas 30 (49.2%) of the depressed elderly experienced persistent depression. Above-moderate baseline physical activity was independently associated with decreased incidence and persistence rates of late-life depression (adjusted odds ratio (AOR) = 0.44, 95% confidence interval (CI) = 0.22-0.85; AOR = 0.17, 95% CI = 0.03-0.92, respectively), whereas mild physical activity was not. Conversely, poorer executive function also predicted 5-year incident depression (AOR = 0.93, 95% CI = 0.89-0.98) but not persistent depression. CONCLUSION This study suggests that a minimum of moderate physical activity is related to both emergent and persistent depression in elderly individuals. Research with an extended follow-up period and a shorter inter-assessment interval is needed to confirm this result.
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Affiliation(s)
- Jee Eun Park
- Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, South Korea.,Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
| | - Jun-Young Lee
- Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, South Korea.,Department of Neuropsychiatry, Seoul Metropolitan Boramae Medical Center, Seoul, South Korea
| | - Byung-Soo Kim
- Department of Psychiatry, Kyungpook National University Medical Center, Kyungpook National University School of Medicine, Daegu, South Korea
| | - Ki Woong Kim
- Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, South Korea.,Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea.,Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, South Korea
| | - Song Hwa Chae
- Department of Psychology, Sungshin Women's University, Seoul, South Korea
| | - Maeng Je Cho
- Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, South Korea.,Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
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20
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Shahabi L, Naliboff BD, Shapiro D. Self-regulation evaluation of therapeutic yoga and walking for patients with irritable bowel syndrome: a pilot study. PSYCHOL HEALTH MED 2015; 21:176-88. [PMID: 26086986 DOI: 10.1080/13548506.2015.1051557] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
With limited efficacy of medications for symptom relief, non-medication treatments may play an important role in the treatment of irritable bowel syndrome (IBS), the most common functional gastrointestinal (GI) disorder. This study aimed to evaluate the efficacy of two self-regulation strategies for symptom relief and mood management in IBS patients. Thirty-five adult participants meeting ROME III criteria for IBS were enrolled, 27 of the 35 participants (77%) completed treatment and pre- and post-treatment visits (89% women, 11% men; M (SD) age = 36 (13)), and 20 of the 27 (74%) completed a 6-month follow-up. Participants were randomly assigned to 16 biweekly group sessions of Iyengar yoga or a walking program. Results indicated a significant group by time interaction on negative affect with the walking treatment showing improvement from pre- to post-treatment when compared to yoga (p < .05). There was no significant group by time effect on IBS severity. Exploratory analyses of secondary outcomes examined change separately for each treatment condition. From pre- to post-treatment, yoga showed significant decreases in IBS severity measures (p < .05), visceral sensitivity (p < .05), and severity of somatic symptoms (p < .05). Walking showed significant decreases in overall GI symptoms (p < .05), negative affect (p < .05), and state anxiety (p < .05). At 6-month follow-up, overall GI symptoms for walking continued to significantly decline, while for yoga, GI symptoms rebounded toward baseline levels (p < .05). When asked about self-regulated home practice at 6 months, significantly more participants in walking than in yoga practiced at least weekly (p < .05). In sum, results suggest that yoga and walking as movement-based self-regulatory behavioral treatments have some differential effects but are both beneficial for IBS patients, though maintenance of a self-regulated walking program may be more feasible and therefore more effective long term.
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Affiliation(s)
- Leila Shahabi
- a Department of Medicine , University of California , Los Angeles , CA , USA
| | - Bruce D Naliboff
- a Department of Medicine , University of California , Los Angeles , CA , USA
| | - David Shapiro
- b Department of Psychiatry and Biobehavioral Sciences , University of California , Los Angeles , CA , USA
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Julien D, Gauvin L, Richard L, Kestens Y, Payette H. Longitudinal associations between walking frequency and depressive symptoms in older adults: results from the VoisiNuAge study. J Am Geriatr Soc 2013; 61:2072-2078. [PMID: 24279599 DOI: 10.1111/jgs.12546] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Cross-sectional studies show that walking is associated with depression among older adults, but longitudinal associations have rarely been examined. The aim of this study was to investigate longitudinal associations between walking frequency and depressive symptoms in older adults to determine which variable is the stronger prospective predictor of the other. DESIGN Longitudinal; four repeated measures over 5 years. SETTING Population-based sample of urban-dwelling older adults living in the Montreal metropolitan area. PARTICIPANTS Participants from the VoisiNuAge study aged 68 to 84 (N=498). MEASUREMENTS MAIN EXPOSURES depressive symptoms (Geriatric Depression Scale) and number of walking days in previous week (Physical Activity Scale for the Elderly). Covariates: age, education, and number of chronic illnesses. Cross-lagged panel analyses were performed in the entire sample and in sex-stratified subsamples. RESULTS Depressive symptoms predicted walking frequency at subsequent time points (and more precisely, higher depressive symptoms were related to fewer walking days), but walking frequency did not predict depressive symptoms at subsequent time points. Stratified analyses revealed that prospective associations were statistically significant in women but not men. CONCLUSION The longitudinal association between walking frequency and depressive symptoms is one in which depressive symptoms predict reduced walking frequency later. Higher depressive symptoms are more likely a cause of reduced walking because of time precedence than vice versa. Future research on longitudinal relationships between meeting physical activity recommendations and depression are warranted.
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Affiliation(s)
- Dominic Julien
- Institut de Recherche en Santé Publique de l'Université de Montréal, Université de Montréal, Montréal, Québec, Canada
| | - Lise Gauvin
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Université de Montréal, Montréal, Québec, Canada.,Département de Médecine Sociale et Préventive, Université de Montréal, Montréal, Québec, Canada.,Centre de Recherche Léa-Roback sur les Inégalités Sociales de Santé de Montréal, Université de Montréal, Montréal, Québec, Canada
| | - Lucie Richard
- Institut de Recherche en Santé Publique de l'Université de Montréal, Université de Montréal, Montréal, Québec, Canada.,Centre de Recherche Léa-Roback sur les Inégalités Sociales de Santé de Montréal, Université de Montréal, Montréal, Québec, Canada.,Faculté des Sciences Infirmières, Université de Montréal, Montréal, Québec, Canada.,Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Université de Montréal, Montréal, Québec, Canada
| | - Yan Kestens
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Université de Montréal, Montréal, Québec, Canada.,Département de Médecine Sociale et Préventive, Université de Montréal, Montréal, Québec, Canada.,Centre de Recherche Léa-Roback sur les Inégalités Sociales de Santé de Montréal, Université de Montréal, Montréal, Québec, Canada
| | - Hélène Payette
- Centre de Recherche sur le Vieillissement, Centre de Santé et des Services Sociaux, Institut Universitaire de Gériatrie de Sherbrooke, Sherbrooke, Québec, Canada.,Département des Sciences de la Santé Communautaire, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, Québec, Canada
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22
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Mammen G, Faulkner G. Physical activity and the prevention of depression: a systematic review of prospective studies. Am J Prev Med 2013; 45:649-57. [PMID: 24139780 DOI: 10.1016/j.amepre.2013.08.001] [Citation(s) in RCA: 616] [Impact Index Per Article: 56.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Revised: 04/26/2013] [Accepted: 08/07/2013] [Indexed: 10/26/2022]
Abstract
CONTEXT Given its high prevalence and impact on quality of life, more research is needed in identifying factors that may prevent depression. This review examined whether physical activity (PA) is protective against the onset of depression. EVIDENCE ACQUISITION A comprehensive search was conducted up until December 2012 in the following databases: MEDLINE, Embase, PubMed, PsycINFO, SPORTDiscus, and Cochrane Database of Systematic Reviews. Data were analyzed between July 2012 and February 2013. Articles were chosen for the review if the study used a prospective-based, longitudinal design and examined relationships between PA and depression over at least two time intervals. A formal quality assessment for each study also was conducted independently by the two reviewers. EVIDENCE SYNTHESIS The initial search yielded a total of 6363 citations. After a thorough selection process, 30 studies were included for analyses. Among these, 25 studies demonstrated that baseline PA was negatively associated with a risk of subsequent depression. The majority of these studies were of high methodologic quality, providing consistent evidence that PA may prevent future depression. There is promising evidence that any level of PA, including low levels (e.g., walking <150 minutes/weeks), can prevent future depression. CONCLUSIONS From a population health perspective, promoting PA may serve as a valuable mental health promotion strategy in reducing the risk of developing depression.
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Affiliation(s)
- George Mammen
- Faculty of Kinesiology and Physical Education, Toronto, Ontario, Canada.
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Lee H, Lee JA, Brar JS, Rush EB, Jolley CJ. Physical activity and depressive symptoms in older adults. Geriatr Nurs 2013; 35:37-41. [PMID: 24144579 DOI: 10.1016/j.gerinurse.2013.09.005] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Revised: 09/09/2013] [Accepted: 09/10/2013] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Depressive symptoms are prevalent in older adults, and physical activity (PA) may have beneficial effects on depression. The purpose of this study was to explore the association between physical activity and depressive symptoms, taking into account demographic factors, and the associations between selected demographic factors and physical activity levels in community-dwelling older adults (age ≥ 60 years). METHODS Data were drawn from the National Health and Nutrition Examination Survey 2005-2006. Descriptive statistics and logistic models were used in data analysis. RESULTS Four percent of participants reported moderate depressive symptoms, and 24% of subjects exhibited sedentary PA. Factors associated with increased risk of moderate depression included age, sedentary PA, and chronic medical conditions (ps < 0.05). Sedentary PA was significantly associated with age, race, education, BMI, smoking status, alcohol use, and taking psychotropics (ps < 0.05). DISCUSSION PA is a protective factor for depression in older adults, and clinical implications to encourage PA are discussed.
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Affiliation(s)
- Heeyoung Lee
- University of Pittsburgh, School of Nursing, Pittsburgh, PA, USA
| | - Jung-Ah Lee
- University of California, Irvine, Program in Nursing Science, Irvine, CA, USA.
| | - Jaspreet S Brar
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA, USA; The Western Psychiatric Institute and Clinic is the official name of the clinic within the University of Pittsburgh Medical Center
| | - Elizabeth B Rush
- University of California, Irvine, Department of Psychology and Social behavior, Irvine, CA, USA
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Scholz B, Crabb S, Wittert G. Development of Men's Depressive Symptoms: A Systematic Review of Prospective Cohort Studies. JOURNAL OF MENS HEALTH 2013. [DOI: 10.1089/jomh.2012.00066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Borges LJ, Benedetti TRB, Xavier AJ, d'Orsi E. Fatores associados aos sintomas depressivos em idosos: estudo EpiFloripa. Rev Saude Publica 2013; 47:701-10. [DOI: 10.1590/s0034-8910.2013047003844] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2011] [Accepted: 03/04/2013] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO Analisar a prevalência e fatores associados a sintomas depressivos em idosos. MÉTODOS Estudo epidemiológico transversal e de base domiciliar (inquérito EpiFloripa Idoso) com 1.656 idosos, realizado por conglomerados em dois estágios, setores censitários e domicílios, em Florianópolis, SC. A prevalência de sintomas depressivos (desfecho) foi obtida por meio da Geriatric Depression Scale (GDS-15), e testadas associações segundo variáveis sociodemográficas, de saúde, comportamentais e sociais. Foram calculadas razões de prevalências brutas e ajustadas com intervalo de 95% de confiança por regressão de Poisson. RESULTADOS A prevalência de sintomas depressivos foi de 23,9% (IC95% 21,84;26,01). Os fatores de risco associados no modelo final foram: escolaridade de cinco a oito anos (RP = 1,50; IC95% 1,08; 2,08), um a quatro anos (RP = 1,62; IC95% 1,18; 2,23) e nenhum ano de estudo (RP = 2,11; IC95% 1,46;3,05); situação econômica pior quando comparada com a que tinha aos 50 anos (RP = 1,33; IC95% 1,02;1,74); déficit cognitivo (RP = 1,45; IC95% 1,21;1,75); percepção de saúde regular (RP = 1,95; IC95% 1,47;2,60) e ruim (RP = 2,64; IC95% 1,82;3,83); dependência funcional (RP = 1,83; IC95% 1,43; 2,33); e dor crônica (RP = 1,35; IC95% 1,10;1,67). Grupo etário de 70 a 79 anos (RP = 0,77; IC95% 0,64;0,93); atividade física de lazer (RP = 0,75; IC95% 0,59;0,94); participação em grupos de convivência ou religiosos (RP = 0,80; IC95% 0,64;0,99); e ter relação sexual (RP = 0,70; IC95% 0,53;0,94) mostraram-se fatores protetores ao aparecimento dos sintomas depressivos. CONCLUSÕES Situação clínica adversa, desvantagem socioeconômica e pouca atividade social e sexual mostraram-se associadas aos sintomas depressivos em idosos.
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Mekary RA, Lucas M, Pan A, Okereke OI, Willett WC, Hu FB, Ding EL. Isotemporal substitution analysis for physical activity, television watching, and risk of depression. Am J Epidemiol 2013; 178:474-83. [PMID: 23785112 DOI: 10.1093/aje/kws590] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The isotemporal substitution model (ISM) was previously developed as a methodology to study the time-substitution effects of 1 type of activity for another in a data setting with continuous outcomes. To demonstrate the application of ISM with a dichotomous outcome, we prospectively examined the associations of different activities with various activity displacements with depression risk among 32,900 US women from the Nurses' Health Study who were free from depressive symptoms at baseline (in 1996). During a 10-year follow-up, 5,730 incident depression cases were documented. Results from the ISMs indicated that for each physical activity, differences in magnitude of effects of each activity type were observed, dependent on the activity being displaced/substituted. Notably, an isotemporal substitution gradient was found for television watching, in which its association with depression risk varied by its substitution for slow-, average-, or brisk-paced walking in a gradient toward high depression risk when television watching replaced a faster walking pace (relative risk = 1.18, 95% confidence interval: 1.05, 1.31). Conversely, no association with depression was found for replacement of television watching with 60 minutes/day of slow walking, whereas a lower depression risk (relative risk = 0.85, 95% confidence interval: 0.76, 0.95) was found when 60 minutes/day of brisk walking replaced 60 minutes/day of television watching. Thus, the ISM could offer a more meaningful alternative to the standard nonsubstitution models to support public health recommendations.
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Affiliation(s)
- Rania A Mekary
- Harvard School of Public Health, Building 2, 665 Huntington Avenue, Boston, MA 02115, USA.
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The role of social participation and walking in depression among older adults: results from the VoisiNuAge study. Can J Aging 2013; 32:1-12. [PMID: 23472603 DOI: 10.1017/s071498081300007x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Lower social participation and less frequent walking represent two factors that may contribute to depression among older adults, but previous research on the subject is inconclusive. The aim of this cross-sectional study was to quantify associations between depression and the combined effects from social participation and walking in a sample of older adults living in Canada (n = 549). Linear and logistic regression analyses were conducted, in which we entered social participation and walking as predictors of depression while controlling for individual characteristics. Results of the final models show that individuals who do not walk outside their home report more depressive symptoms or a greater likelihood of possible clinical depression (the association in our study between social participation and depression was attenuated to non-significance). The current study highlights the central role played by life habits, such as walking, in older adults' mental health status.
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Abstract
OBJECTIVE Assess the association between depressive symptoms (not meeting the criteria for major depression) and gait dysfunction in older adults. DESIGN Cross-sectional study. SETTING Einstein Aging Study, a community-based longitudinal aging study. PARTICIPANTS Six hundred ten nondemented and nondepressed community-residing adults age 70 and older. MEASUREMENTS Depressive symptoms measured using the 15-item Geriatric Depression Scale. To obtain a comprehensive assessment of gait, eight individual quantitative gait parameters were assessed: velocity (cm/s), stride length (cm), cadence (steps/min), swing phase (seconds), stance phase (seconds), double support phase (seconds), stride length variability (SD of stride length), and swing time variability (SD of swing time). Multiple linear regression analysis was applied to study the association of depressive symptoms with gait, adjusting for potential confounders including demographic variables, medical illnesses, and clinical gait abnormalities. RESULTS Increased level of depressive symptoms was associated with worse velocity, stride, and swing time variability. The relationship of the remaining five gait variables with depressive symptoms was not significant in the fully adjusted models. CONCLUSIONS Higher levels of depressive symptoms are associated with worse performance in specific quantitative gait variables in community-residing older adults.
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Physical activity and depressive symptoms in older adults: 11-year follow-up. Am J Prev Med 2012; 42:355-62. [PMID: 22424248 DOI: 10.1016/j.amepre.2011.11.010] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2011] [Revised: 10/26/2011] [Accepted: 11/30/2011] [Indexed: 10/28/2022]
Abstract
BACKGROUND Few studies have explored the reciprocal relationships between naturally occurring changes in physical activity and depressive symptoms in later life. PURPOSE This study examined the reciprocal associations between changes in physical activity and depressive symptoms in a population-based sample of Taiwanese older adults over an 11-year period. METHODS Analyses were based on nationally representative data from the Taiwan's Health and Living Status of the Elderly Survey collected in 1996, 1999, 2003, and 2007. Data from the fixed cohort of 1160 participants aged ≥67 years in 1996 with 11 years of follow-up were studied. Depressive symptoms were assessed using the ten-item Chinese version of the Center for Epidemiologic Studies-Depression Scale. Physical activity was self-reported as the number of sessions per week. Latent growth modeling was used to examine the bidirectional associations between changes in physical activity and depressive symptoms when controlling for sociodemographic variables, lifestyle behaviors, and health status. Data analyses were completed in 2011. RESULTS With multivariate adjustment, initial levels of physical activity were negatively associated with changes in depressive symptoms (β=-0.34, p<0.05). In contrast, early depressive symptoms were not related to change in physical activity (β=-0.17, p>0.05). CONCLUSIONS Physical activity engagement in later life is associated with a lower risk of subsequent depressive symptoms, but the reverse association is not supported. The finding has underlying implications for future physical activity and mental health promotion in aged populations.
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Chen LJ, Stevinson C, Ku PW, Chang YK, Chu DC. Relationships of leisure-time and non-leisure-time physical activity with depressive symptoms: a population-based study of Taiwanese older adults. Int J Behav Nutr Phys Act 2012; 9:28. [PMID: 22413813 PMCID: PMC3353843 DOI: 10.1186/1479-5868-9-28] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2011] [Accepted: 03/14/2012] [Indexed: 11/12/2022] Open
Abstract
Background Limited research has explored the relationship between non-leisure-time physical activity (NLTPA), including domestic and work-related physical activities, with depressive symptoms. This study was designed to elucidate independent associations between leisure-time physical activity (LTPA), NLTPA, and specific parameters of physical activity (frequency, duration and intensity) with depressive symptoms in older adults. Methods A total of 2,727 persons aged ≥ 65 years participating in the 2005 Taiwan National Health Interview Survey were studied. Depressive symptoms were measured by the Center for Epidemiological Studies Depression Scale. Information regarding energy parameters for each type of LTPA and NLTPA during the past 2-week period was analyzed. After adjusting for socio-demographic variables, lifestyle behaviors and health status, multivariate logistic regression models were used to compute adjusted odds ratios (AOR) for LTPA and NLTPA for predicting depressive symptoms. Results LTPA but not NLTPA was significantly associated with depressive symptoms. Compared with participants expending 2000+ kcal/week through LTPA, the risk of experiencing depressive symptoms was significantly higher for those expending 1-999 kcal/week (AOR = 2.06, 95% CI: 1.25-3.39), and those who expending 0 kcal/week (AOR = 3.72, 95%CI: 2.28-6.06). Among the three parameters of LTPA (intensity, duration and frequency) examined, only intensity was independently associated with depressive symptoms. Conclusions These findings imply that exercise recommendations for older adults should emphasize the importance of higher intensity activity, rather than frequency or duration, for improved mental well-being. However, well-designed prospective cohort studies or intervention trials are needed to confirm these findings.
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Affiliation(s)
- Li-Jung Chen
- Department of Exercise Health Science, National Taiwan University of Physical Education and Sport, No, 16, Section 1, Shuang-Shih Rd, Taichung 404, Taiwan.
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Lucas M, Mekary R, Pan A, Mirzaei F, O'Reilly EJ, Willett WC, Koenen K, Okereke OI, Ascherio A. Relation between clinical depression risk and physical activity and time spent watching television in older women: a 10-year prospective follow-up study. Am J Epidemiol 2011; 174:1017-27. [PMID: 21984659 DOI: 10.1093/aje/kwr218] [Citation(s) in RCA: 131] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Although physical activity (PA) has been inversely associated with depressive symptoms, it is not clear whether regular PA and television watching are associated with clinical depression risk. The authors conducted a prospective analysis involving 49,821 US women from the Nurses' Health Study who were free from depressive symptoms at baseline (1996). Information on PA was obtained from validated questionnaires completed in 1992, 1994, 1996, 1998, and 2000; analyses were conducted using the cumulative average of PA (minutes/day) with a 2-year latency period applied. Participants were asked about television-watching habits in 1992. Cox proportional hazards regression models adjusted for multiple risk factors were used to estimate relative risks of clinical depression (self-reported physician-diagnosed depression or use of antidepressants). During 10 years of follow-up (1996-2006), 6,505 incident cases of depression were documented. Higher levels of PA were associated with lower depression risk. The multivariate relative risk comparing the highest level of PA (≥ 90 minutes/day) with the lowest (<10 minutes/day) was 0.80 (95% confidence interval: 0.70, 0.92; P(trend) < 0.001). In contrast, the risk of depression increased with increasing television-watching time. The multivariate relative risk comparing women who spent 21 hours/week or more watching television with those who spent 0-1 hour/week was 1.13 (95% confidence interval: 1.00, 1.27; P(trend) = 0.01). Analyses simultaneously considering PA and television watching suggested that both contributed independently to depression risk.
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Affiliation(s)
- Michel Lucas
- Department of Nutrition, Harvard School of Public Health, 655 Huntington Avenue, Boston, MA 02115, USA.
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