Exercise and depression in midlife: a prospective study

The longitudinal relationship between leisure activities and depressive symptoms among older Chinese adults: an autoregressive cross-lagged analysis approach

BACKGROUND

Existing studies have shown a correlation between leisure activities and depressive symptoms in older adults, but the direction of the longitudinal relationship is inconsistent. This study used an autoregressive cross-lagged model to examine the longitudinal relationship between leisure activity participation and geriatric depression.

METHODS

A total of 7,138 participants aged 60 years or older from the 2nd to the 4th wave of the China Health and Retirement Longitudinal Study (CHARLS) were analysed.

RESULTS

First, present depressive symptoms were significantly associated with future depressive symptoms (β2013-2015 = .893, p < .001; β2015-2018 = .946, p < .001), and the same rule applied to leisure activities (β2013-2015 = .402, p < .001; β2015-2018 = .404, p < .001). Second, current depressive symptoms negatively predicted future leisure activities (β2013-2015 = -.071, p < .001; β2015-2018 = -.085, p < .001), but the inverse relationship was not statistically significant (β2013-2015 = -.003, p > .05; β2015-2018 = -.003, p > .05).

CONCLUSION

These findings underscore the importance of interventions targeting depressive symptoms to potentially enhance engagement in leisure activities among older adults. The results contribute to the understanding of the complex dynamics between mental health and lifestyle choices in older populations, highlighting the potential of proactive mental health interventions to improve overall well-being.

Physical activity, physical frailty and depressive symptoms among Chinese male and female older adults: do different indicators make a difference?

Objectives

Older adults become more inactive and frailer with aging. Physical status is closely linked to mental health, but it is unclear which physical indicator is more strongly associated with depressive symptoms in older adults. The present study aimed to compare relationships between self-reported physical activity, physical frailty (muscle mass, muscle strength, and gait ability) and depressive symptoms in community male and female older adults.

Methods

A total of 1,180 adults aged 60 years and older were recruited to participate in this study from a Chinese community receiving annual check-up service from September 2018 to May 2019. Physical activity was assessed by the International Physical Activity Questionnaire (IPAQ). The Bio-electrical Impedance Analyzer was used to determine the muscle mass. As the indicators of muscle function, grip strength and gait ability were assessed by the dynamometer and Timed Up and Go Test (TUGT), respectively. The 15-item version of Geriatric Depression Scale (GDS-15) was used to examine depressive symptoms. Demographic variables, health status and sleep quality were collected using questionnaire.

Results

11.8% men and 11.9% women reported depressive symptoms. Logistic regression showed that depressive symptoms was associated with low grip strength (OR = 2.42, 95% CI: 1.04-5.63), slow gait ability (OR = 3.60, 95% CI: 1.28-10.13) in older males, and associated with low level of self-reported physical activity (OR = 3.85, 95% CI: 2.00-7.42) in older females. No significant association was found between muscle mass and depressive symptoms.

Conclusion

There were gender differences in the relationship between physical activity, physical frailty, and depressive symptoms. Grip strength and gait ability may be a better indicator of frailty for predicting depressive symptoms in older men while physical activity may be useful in predicting depressive symptoms in older women.

The relationship between social participation and depressive symptoms among Chinese middle-aged and older adults: A cross-lagged panel analysis

Objectives

This study examined the mutual effects of social participation and depressive symptoms in middle-aged and older Chinese adults from offline and online perspectives. Reciprocal relationships between depressive symptoms and the four subtypes of offline participation were also examined.

Methods

Based on China Health and Retirement Longitudinal Study data (CHARLS), this study conducted ID matching for three waves of data from 2013, 2015, and 2018. One thousand nine hundred ninety-nine samples for individuals over 50 were obtained. A series of cross-lagged analyses were conducted to examine the mutual influence of social participation and depressive symptoms. Depressive symptoms were assessed using the short version of the Center for Epidemiologic Studies Depression Scale (CESD-10). The social participation questionnaire included nine items referring to offline participation (eight items) and online participation (one item). Several demographic variables were adjusted when conducting the cross-lagged analyses.

Results

Social and offline participation had significant two-way associations with depressive symptoms. Depressive symptoms had greater impacts on social and offline participation than in the opposite direction. Online participation has a significant one-way impact on depressive symptoms. The relationship between specific types of offline participation and depressive symptoms varied in existence and direction.

Discussion

Overall, there was significant bidirectional causality between social participation and depressive symptoms. Social participation, both offline and online, played a positive role in alleviating depressive symptoms. Depressive symptoms also affected the level of social participation to some extent among middle-aged and older Chinese adults over time.

Physical activity and the prevention of depression: A cohort study

OBJECTIVE

This study aims to identify the optimal amount and appropriate state of physical activity for reducing incident depressive symptoms.

METHOD

The data of 107,901 Korean adults who had undergone at least two annual health examinations from 2012 to 2015 were analyzed. At baseline, the amount of physical activity was measured using the International Physical Activity Questionnaire-Short Form and metabolic equivalents (METs)-min/wk., which is the amount of oxygen consumed while sitting at rest per week. In addition, one-year changes in physical activity were categorized into four groups: persistent sedentary, maintenance, relapse, and adoption groups. For the study's endpoint, new-onset depressive symptoms (score of ≥21) were considered, defined by the Center for Epidemiologic Studies Rating Scale for Depression. A Cox proportional hazards model was used to identify the optimal amount and appropriate state of physical activity for reducing incident depressive symptoms.

RESULTS

Compared with sedentary status (<600 METs-min/wk), achieving 1200-3000 METs-min/wk. was associated with a lower risk of incident depressive symptoms, illustrating a U-shaped relationship. The results show that the amount of physical activity for reducing the onset of depressive symptoms was higher for men (1800-3000 METs-min/wk.: HR, 0.84 [95% CI, 0.74-0.95]) than women (1200-1800 METs-min/wk.: HR, 0.84 [95% CI, 0.71-0.99]). In terms of one-year changes in physical activity, compared to the persistent sedentary group, the maintenance group was associated with a lower risk of the development of depressive symptoms in both sexes (men: HR, 0.81 [95% CI, 0.71-0.93]; women: HR, 0.84 [95% CI, 0.75-0.94]). Women in the adoption group showed a positive effect in terms of a decrease in incident depressive symptoms (HR, 0.87 [95% CI, 0.76-0.99]).

CONCLUSIONS

This study suggests an optimal amount of physical activity for reducing the onset of depressive symptoms. In addition, maintaining an appropriate level of physical activity for one year proved beneficial for decreasing incident depressive symptoms.

A Cross Sectional Examination of the Relation Between Depression and Frequency of Leisure Time Physical Exercise among the Elderly in Jinan, China

Depression has become a major global public health problem. Many studies have shown the positive effects of physical exercise on depression. However, few studies have examined the relationship between frequency of leisure time physical exercise and depression without considering the time and intensity of exercise among middle-aged and elderly people of urban communities in northern China. We conducted a cross-sectional survey that included 1604 participants among urban residents aged 50 years or older in China to evaluate how the frequency of physical exercise was related to depression. Our study showed that the prevalence of depression in the urban community of Jinan is 16.52%. For physical exercise, the odds ratios (ORs) and 95% confidence intervals (CIs) for 1~2 times per week, 3~4 times per week and ≥5 times per week were 1.137 (0.661, 1.953), 0.516 (0.304, 0.875) and 0.548 (0.392, 0.768) respectively, with adjustment for age, gender, marital status, BMI, hypertension, previously diagnosed type 2 diabetes, triglyceride, total cholesterol, soy food intake, milk food intake, vegetable and fruit intake and meat intake. We concluded that physically exercising three times a week is associated with a low prevalence of depression.

Leisure Time Physical Activity and Risk of Developing Depression among the Youth of Kangra District, Himachal Pradesh, India

BACKGROUND

Physical inactivity during adolescence and youth has been considered as potential risk factor for future mental health problems. The present study was conducted with the aim to examine whether an association exists between leisure-time physical activity (PA) and depression among the youth of Kangra district, studying in professional or degree colleges.

METHODOLOGY

A cross-sectional study was conducted among the students of Medical College (MC), Central University (CU) and Industrial Training Institute (ITI) of Kangra district. 370 adolescents and youth of age <25 years, who consented to participate, were recruited. The sample size was divided into three parts among all the three institutes. Only one question regarding leisure time PA (LTPA) was asked, as to how many hours spent in the last week; and Center for Epidemiologic Studies Depression Scale for Children (CES-DC) was used.

RESULTS

There were 124 participants from ITI, 126 from CU and 120 from MC. The mean score of CES-DC was highest among CU students 22.7 (±11.0) and lowest among MC students; 13.6 (±9.2). Low LTPA (<4 h) was significantly associated with higher depressive symptoms among all students (odds ratio [95% confidence interval]; 3.34 [1.41-7.92]).

CONCLUSION

LTPA was associated with lower rates of depression.

Children's Physical Activity and Depression: A Meta-analysis

CONTEXT

Research regarding the protective effects of early physical activity on depression has yielded conflicting results.

OBJECTIVE

Our objective was to synthesize observational studies examining the association of physical activity in childhood and adolescence with depression.

DATA SOURCES

Studies (from 2005 to 2015) were identified by using a comprehensive search strategy.

STUDY SELECTION

The included studies measured physical activity in childhood or adolescence and examined its association with depression.

DATA EXTRACTION

Data were extracted by 2 independent coders. Estimates were examined by using random-effects meta-analysis.

RESULTS

Fifty independent samples (89 894 participants) were included, and the mean effect size was significant (r = -0.14; 95% confidence interval [CI] = -0.19 to -0.10). Moderator analyses revealed stronger effect sizes in studies with cross-sectional versus longitudinal designs (k = 36, r = -0.17; 95% CI = -0.23 to -0.10 vs k = 14, r = -0.07; 95% CI = -0.10 to -0.04); using depression self-report versus interview (k = 46, r = -0.15; 95% CI = -0.20 to -0.10 vs k = 4, r = -0.05; 95% CI = -0.09 to -0.01); using validated versus nonvalidated physical activity measures (k = 29, r = -0.18; 95% CI = -0.26 to -0.09 vs k = 21, r = -0.08; 95% CI = -0.11 to -0.05); and using measures of frequency and intensity of physical activity versus intensity alone (k = 27, r = -0.17; 95% CI = -0.25 to -0.09 vs k = 7, r = -0.05; 95% CI = -0.09 to -0.01).

LIMITATIONS

Limitations included a lack of standardized measures of physical activity; use of self-report of depression in majority of studies; and a small number of longitudinal studies.

CONCLUSIONS

Physical activity is associated with decreased concurrent depressive symptoms; the association with future depressive symptoms is weak.

Physical Activity as a Nonpharmacological Treatment for Depression: A Review

Physical activity is increasingly being cited as an alternative to more traditional drug treatments for treating depression. Although an increasing amount of research has investigated this theory, much of the literature has been criticized from a methodological perspective. Given rising concern for the increasing costs of mental health care, it is timely and important to examine valid, reliable, and objective research findings on the potential role of physical activity as a low-cost non-pharmacological intervention for the treatment of depression. This article reviews cross-sectional, longitudinal, and randomized studies that investigated the role of physical activity in the prevention and alleviation of depression. The review found that although there is undoubtedly a need for more research with a greater emphasis on methodological strength, the scientific literature is generally supportive of the beneficial effects of aerobic and nonaerobic exercise on depression in clinically and nonclinically depressed adults. Implications for public health are discussed.

The Association Between Midlife Physical Activity and Depressive Symptoms in Late Life: Age Gene/Environment Susceptibility-Reykjavik Study

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.

Physical activity and the prevention of depression: a systematic review of prospective studies

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.

Daily Pedometer Steps among Older Men: Associations with Health-Related Quality of Life and Psychosocial Health

Purpose.

To determine the associations of daily pedometer steps with health-related quality of life (HRQoL) and psychosocial health.

Design.

Cross-sectional.

Setting.

Alberta, Canada.

Subjects.

Three hundred eighty-five older-aged men 55 years of age and older.

Measures.

Subjects completed a mailed survey that assessed HRQoL (RAND-12 Health Status Inventory [RAND-12]), depression, anxiety, and satisfaction with life. Steps/day were assessed with a pedometer via a 3-day step-monitoring period.

Analysis.

Average pedometer steps/d were categorized into quartiles (Qs). The primary model assessed the association between average pedometer steps/d as the independent variable of interest and our dependent variables of interest (physical, mental, and global health component scores of the RAND-12).

Results.

For HRQoL, all three adjusted models (i.e., physical, mental, and global health) indicated a significant linear trend between HRQoL indices across pedometer step Qs, with participants in Q3 and Q4 demonstrating higher physical, mental, and global health compared to participants in the lowest Q of pedometer steps (Q1) (all p < .05). For depression, significant differences were observed between Q1 and Q3 (Mdiff = 3.3, p = .006, η2 = .019) and Q1 and Q4 (Mdiff = 2.7, p = .025, η2 = .013).

Conclusion.

Higher average steps/d were significantly associated with HRQoL across all domains. Older men in the higher Qs of pedometer steps/d reported less depressive symptoms compared to those in the lowest Q of pedometer steps/d.

Decline in cardiorespiratory fitness and odds of incident depression

BACKGROUND

Studies of physical activity and incidence of physician-diagnosed depression have been limited to a single estimate of self-reported physical activity exposure, despite follow-up periods lasting many years.

PURPOSE

To examine longitudinal change in cardiorespiratory fitness, an objective marker of habitual physical activity, and incident depression complaints made to a physician.

METHODS

Cardiorespiratory fitness assessed at four clinic visits between 1971 and 2006, each separated by an average of 2-3 years, was used to objectively measure cumulative physical activity exposure in cohorts of 7936 men and 1261 women, aged 20-85 years, from the Aerobics Center Longitudinal Study who did not complain of depression at their first clinic visit in 1971-2003. Data were analyzed in August 2010.

RESULTS

Across subsequent visits, there were 446 incident cases in men and 153 cases in women. After adjustment for age, time between visits, BMI at each visit, and fitness at Visit 1, each 1-minute decline in treadmill endurance (i.e., a decline in cardiorespiratory fitness of approximately 1 half-MET) between ages 51 and 55 years in men and ages 53 and 56 years in women, increased the odds of incident depression complaints by approximately 2% and 9.5%, respectively. The increased odds remained significant but were attenuated to 1.3% and 5.4% after further adjustment at each visit for smoking, alcohol use, chronic medical conditions, anxiety, and sleep problems.

CONCLUSIONS

Maintenance of cardiorespiratory fitness during late middle age, when decline in fitness typically accelerates, helps protect against the onset of depression complaints made to a physician.

Bidirectional association between physical activity and symptoms of anxiety and depression: the Whitehall II study

Although it has been hypothesized that the association of physical activity with depressive and anxiety symptoms is bidirectional, few studies have examined this issue in a prospective setting. We studied this bidirectional association using data on physical activity and symptoms of anxiety and depression at three points in time over 8 years. A total of 9,309 participants of the British Whitehall II prospective cohort study provided data on physical activity, anxiety and depression symptoms and 10 covariates at baseline in 1985. We analysed the associations of physical activity with anxiety and/or depression symptoms using multinomial logistic regression (with anxiety and depression symptoms as dependent variables) and binary logistic regression (with physical activity as the dependent variable). There was a cross-sectional inverse association between physical activity and anxiety and/or depressive symptoms at baseline (ORs between 0.63 and 0.72). In cumulative analyses, regular physical activity across all three data waves, but not irregular physical activity, was associated with reduced likelihood of depressive symptoms at follow-up (OR = 0.71, 95 % CI 0.54, 0.99). In a converse analysis, participants with anxiety and depression symptoms at baseline had higher odds of not meeting the recommended levels of physical activity at follow-up (OR = 1.79, 95 % CI 1.17, 2.74). This was also the case in individuals with anxiety and/or depression symptoms at both baseline and follow-up (OR = 1.70, 95 % CI 1.10, 2.63). The association between physical activity and symptoms of anxiety and/or depression appears to be bidirectional.

Bidirectional prospective associations between physical activity and depressive symptoms. The TRAILS Study

PURPOSE

Low levels of physical activity (PA) have been shown to be associated with depression in adults. The few studies that focused on adolescents yielded mixed and inconsistent results. Efforts to examine the direction of this relationship have been inconclusive up to now. The aims of this study were therefore to investigate (1) the direction of the inverse association between PA and depressive symptoms over time, and (2) whether these associations are specific to particular clusters of depressive symptoms in adolescents.

METHODS

Depressive symptoms and PA were assessed in a population sample of adolescents (N = 2,230) who were measured at three waves between age 10 and age 17. Depressive symptoms were measured by the Affective Problems scale of the Youth Self-Report and Child Behavior Checklist, whereas PA was operationalized as the amount of time spent on physical exercise. Structural equation modeling was used to examine bidirectional effects of PA and depressive symptoms over time.

RESULTS

We found significant cross-lagged paths from prior PA to later depression as well as from prior depression to later PA (beta values = -.039 to -.047). After subdividing depression into affective and somatic symptoms, the affective symptoms were reciprocally related to PA, whereas the paths between somatic symptoms and PA did not reach statistical significance.

CONCLUSIONS

An inverse bidirectional association between PA and general depressive symptoms was observed. This association was restricted to affective symptoms.

Physical activity after myocardial infarction: is it related to mental health?

BACKGROUND

Physical inactivity and poor mental wellbeing are associated with poorer prognoses in patients with cardiovascular disease. We aimed to analyse the cross-sectional and prospective associations between physical activity and mental wellbeing in patients with a history of myocardial infarction.

DESIGN

Longitudinal, observational study.

METHODS

We investigated 600 older subjects with a history of myocardial infarction (age range 60-80 years) who participated in the Alpha Omega Trial (AOT). They were tested twice at baseline and at 40 months follow-up for physical activity - with the Physical Activity Scale for the Elderly (PASE); depressive symptoms - with the Geriatric Depression Scale (GDS-15); and dispositional optimism - with the Life Orientation Test (LOT-R). Linear (multilevel) and logistic regression analyses were used to examine cross-sectional and longitudinal associations.

RESULTS

Physical activity was cross-sectionally associated with depressive symptoms (adjusted beta = -0.143; p = 0.001), but not with dispositional optimism (adjusted beta = 0.074; p = 0.07). We found a synchrony of change between physical activity and depressive symptoms (adjusted beta = -0.155; p < 0.001), but not with dispositional optimism (adjusted beta = 0.049; p = 0.24). Baseline physical activity did not predict depressive symptoms at 40 months follow-up.

CONCLUSIONS

Concordant inverse associations were observed for (changes) in physical activity and depressive symptoms. Physical activity did not predict depressive symptoms or low optimism.

Physical activity, stress reduction, and mood: insight into immunological mechanisms

Psychosocial factors, such as chronic mental stress and mood, are recognized as an important predictor of longevity and wellbeing. In particular, depression is independently associated with cardiovascular disease and all-cause mortality, and is often comorbid with chronic diseases that can worsen their associated health outcomes. Regular exercise is thought to be associated with stress reduction and better mood, which may partly mediate associations between depression, stress, and health outcomes. The underlying mechanisms for the positive effects of exercise on wellbeing remain poorly understood. In this overview we examine epidemiological evidence for an association between physical activity and mental health. We then describe the exercise withdrawal paradigm as an experimental protocol to study mechanisms linking exercise, mood, and stress. In particular we will discuss the potential role of the inflammatory response as a central mechanism.

Physical exercise in adults and mental health status findings from the Netherlands mental health survey and incidence study (NEMESIS)

OBJECTIVE

To establish associations between physical exercise during leisure time and prevalence, incidence and course of mental disorders.

METHOD

Data were derived from the Netherlands Mental Health Survey and Incidence Study, a 3-wave cohort study in a representative sample (N=7,076) of Dutch adults. Mental disorders were assessed with the Composite International Diagnostic Interview. Physical activity was established by the number of hours per week people spent on taking physical exercise.

RESULTS

Physical exercise was negatively associated with presence and first-onset of mood and anxiety disorders after adjustment for confounders. Evidence for a dose-response relationship between exercise levels and mental health was not found. Among those with mental disorder at baseline, exercise participants were more likely to recover from their illness (OR=1.47) compared to their counterparts who did not take exercise.

CONCLUSION

Physical exercise is beneficial to mental health, but it remains uncertain whether this association truly reflects a causal effect of exercise.

Relation between clinical depression risk and physical activity and time spent watching television in older women: a 10-year prospective follow-up study

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.

Associations of objectively-assessed physical activity and sedentary time with depression: NHANES (2005-2006)

BACKGROUND

Studies provide conflicting evidence for the protective effects of moderate-to-vigorous-intensity physical activity on depression. Recent evidence suggests that sedentary behaviors may also be associated with depression.

PURPOSE

To examine the associations of accelerometer-derived moderate-to-vigorous-intensity physical activity and sedentary time with depression among a population-based sample.

METHODS

Cross-sectional study using 2,862 adults from the 2005-2006 US National Health and Nutrition Examination Survey. ActiGraph accelerometers were used to derive both moderate-to-vigorous-intensity physical activity and sedentary time.

RESULTS

Depression occurred in 6.8% of the sample. For moderate-to-vigorous-intensity physical activity, compared with those in quartile 1 (least active), significantly lower odds of depression were observed for those participants in quartiles 2 (OR=0.55, 95% CI, 0.34 to 0.89), 3 (OR=0.49, 95% CI, 0.26 to 0.93), and 4 (most active) (OR=0.37, 95% CI, 0.20 to 0.70) (p for trend p<0.01). In overweight/obese participants only, those in quartile 4 (most sedentary) had significantly higher odds for depression than those in quartile 1 (least sedentary) [quartile 3 vs 1 (OR=1.94, 95% CI, 1.01 to 3.68) and 4 vs 1 (OR=3.09, 95% CI, 1.25 to 7.68)].

CONCLUSION

The current study identified lower odds of depression were associated with increasing moderate-to-vigorous-intensity physical activity and decreasing sedentary time, at least within overweight/obese adults.

Physical activity and depressive symptoms in community-dwelling elders from southern Brazil

OBJECTIVE: To determine the existence of a relationship between physical activity and depressive symptoms in community-dwelling elders. METHOD: This is a cross-sectional, population-based study, which included 379 community-dwelling elders from Novo Hamburgo, state of RS, Brazil. The level of physical activity was estimated using the International Physical Activity Questionnaire and depressive symptoms were diagnosed according to the Yesavage Geriatric Depression Scale. The association between the level of physical activity and depressive symptoms was analyzed by logistic regression. RESULTS: A tendency towards a lower prevalence of depressive symptoms was observed in individuals with higher levels of physical activity, both in the sample as a whole as well as among men, but not among women (p for linear trend 0.04, 0.03 and 0.36, respectively). The odds ratio of the presence of depressive symptoms in the very active group, as compared against that of the insufficiently active group was 0.32 (95% CI: 0.12-0.86) for men and 0.76 (95% CI: 0.39-1.46) for women. CONCLUSION: In this population of aged individuals, more intense physical activity is related to a lower prevalence of depressive symptoms. As shown by gender stratification, physical activity is inversely related to depressive symptoms in men, albeit not in women.

Habitual physical activity and the risk for depressive and anxiety disorders among older men and women

BACKGROUND

Regular physical activity is generally associated with psychological well-being, although there are relatively few prospective studies in older adults. We investigated habitual physical activity as a risk factor for de novo depressive and anxiety disorders in older men and women from the general population.

METHODS

In this nested case-control study, subjects aged 60 years or more were identified from randomly selected cohorts being followed prospectively in the Geelong Osteoporosis Study. Cases were individuals with incident depressive or anxiety disorders, diagnosed using the Structured Clinical Interview for DSM-IV-TR (SCID-I/NP); controls had no history of these disorders. Habitual physical activity, measured using a validated questionnaire, and other exposures were documented at baseline, approximately four years prior to psychiatric interviews. Those with depressive or anxiety disorders that pre-dated baseline were excluded.

RESULTS

Of 547 eligible subjects, 14 developed de novo depressive or anxiety disorders and were classified as cases; 533 controls remained free of disease. Physical activity was protective against the likelihood of depressive and anxiety disorders; OR = 0.55 (95% CI 0.32-0.94), p = 0.03; each standard deviation increase in the transformed physical activity score was associated with an approximate halving in the likelihood of developing depressive or anxiety disorders. Leisure-time physical activity contributed substantially to the overall physical activity score. Age, gender, smoking, alcohol consumption, weight and socioeconomic status did not substantially confound the association.

CONCLUSION

This study provides evidence consistent with the notion that higher levels of habitual physical activity are protective against the subsequent risk of development of de novo depressive and anxiety disorders.

Sedentary lifestyle and emergence of hopelessness in middle-aged men

BACKGROUND

A sedentary lifestyle and psychosocial factors such as hopelessness and depression increase cardiovascular risk. Cross-sectional evidence suggests positive effects of physical exercise on psychological well being, but the time order of the relationship between physical activity and hopelessness has not been addressed.

DESIGN

Population-based prospective cohort study with 630 middle-aged men participating in the 4-year follow-up and 509 men in the 11-year follow-up.

METHODS

We investigated the association of leisure-time physical activity (LTPA) with the development of hopelessness during the follow-up. LTPA and hopelessness were quantified with questionnaires.

RESULTS

In cross-sectional analyses, LTPA was inversely associated with hopelessness, independently of depression. Among men who did not have feelings of hopelessness at baseline, those who reported engaging in at least 2.5 h/week of moderate-to-vigorous physical activity had a lower risk (odds ratio 0.65, 95% confidence interval: 0.39-1.09, P for the trend=0.047) to feel hopeless than sedentary men 4 years later after adjustment for age, smoking, alcohol consumption, cardiovascular disease and socioeconomic status. Furthermore, this relationship was not explained by body mass index or maximal oxygen uptake. Adjustment for depressive symptoms slightly weakened the association (odds ratio 0.66, 95% confidence interval: 0.39-1.11, P for the trend=0.060). After 11 years, men who reported being physically active at baseline were still less likely to feel hopeless, after adjusting for age. However, after further adjustment for other confounding factors the association was no longer significant.

CONCLUSION

Moderate-to-vigorous physical activity seems to prevent development of hopelessness in middle-aged men. This protective effect may diminish over time.

Does the association between depressive symptomatology and physical activity depend on body image perception? A survey of students from seven universities in the UK

This cross-sectional study assessed the association between depression and PA in university students of both genders and the role of body image perception as a potential effect modifier. Undergraduate students (N = 3706) from seven universities in the UK completed a self-administered questionnaire that assessed sociodemographic information; a range of health, health behaviour and health awareness related factors; the modified version of Beck’s Depression Inventory (M-BDI); educational achievement, and different levels of physical activity (PA), such as moderate PA (at least 5 days per week moderate exercise of at least 30 minutes), and vigorous PA (at least 3 days per week vigorous exercise of at least 20 minutes). Only 12.4% of the sample achieved the international recommended level for moderate PA, and 33.1% achieved the recommendations for vigorous PA. Both moderate and vigorous PA were inversely related to the M-BDI score. Physically active students, regardless of the type of PA, were significantly more likely to perceive their health as good, to have higher health awareness, to perform strengthening exercises, and to be males. The stratified analyses indicated that the association between depression and PA differed by body image. In students perceiving their body image as ‘just right’, moderate (>4th percentile) and high (>5th percentile) M-BDI scores were inversely related to vigorous PA. However, in students who perceived their body image as ‘overweight’, the inverse association was only significant in those with high M-BDI scores. We conclude that the positive effect of PA on depression could be down modulated by the negative impact of a ‘distorted’ body image on depression. The practical implications of these findings are that PA programmes targeting persons with depressive symptoms should include effective components to enhance body image perception.

A cohort study of leisure time physical activity and depression

OBJECTIVE

The objective of the study was to examine the role of leisure time physical activity on the risk of developing depression in a large longitudinal setting.

METHODS

A prospective cohort study was used, comprising three updated measures of leisure time physical activity and covariates and 26 years of follow-up data on 18,146 individuals from the Copenhagen City Heart Study, Denmark. The study population was linked to two Danish hospital registers for information on depression. Data were collected in three rounds, namely, 1976-1978, 1981-1983, and 1991-1994, and analyses were conducted in 2010.

RESULTS

Compared to women with a high physical activity level, women with a moderate level had a hazard ratio of 1.07 (95% confidence interval: 0.80-1.44) for developing depression while women with a low level had a hazard ratio of 1.80 (95% confidence interval: 1.29-2.51). Compared to men with a high physical activity level, men with a moderate level had a hazard ratio of 1.11 (95% confidence interval: 0.73-1.68) for developing depression, while men with a low level had a hazard ratio of 1.39 (95% confidence interval: 0.83-2.34).

CONCLUSION

Among women, a low level of physical activity was significantly associated with a greater risk of depression.

The relationship between depressive symptoms and walking among Hispanic older adults: a longitudinal, cross-lagged panel analysis

OBJECTIVES

This study examines the relationship between depressive symptoms and walking behavior across 30 months in a prospective study of 217 community-dwelling, Hispanic older adults in Miami, Florida (ages 70-100 years).

METHOD

Analyses examine the direction of the relationship between depressive symptoms and physical activity (i.e., walking) over time, as well as test for a potential bi-directional or reciprocal relationship between these two variables.

RESULTS

Structural equation modeling (SEM) with a cross-lagged panel design revealed that walking was unrelated to subsequent depressive symptoms. However, depressive symptoms were related to subsequent walking behavior at every time-point, such that higher levels of depressive symptoms were predictive of less walking in the future. Older adults who had clinically-relevant depressive symptoms at the initial assessment had 1.34 times the risk of not walking 30 months later, compared to older adults without clinically-relevant depressive symptoms.

CONCLUSION

Results support the need for primary care providers to evaluate and address depressive symptoms among older adults, as a means of reducing sedentary behavior and potentially improving health. Further research on the prevention and management of depressive symptoms and sedentary behavior is needed, given the morbidity related to both of these health risks, particularly for minority and low-socio-economic status (SES) older adults.

Neighborhood characteristics, adherence to walking, and depressive symptoms in midlife African American women

BACKGROUND

African American women have more symptoms of depressed mood than white women. Adverse neighborhood conditions may contribute to these symptoms. Although reductions in depressive symptoms with physical activity have been demonstrated in white adults, little research has examined the mental health benefits of physical activity in African American women. Further, it is unknown whether physical activity can offset the effects of living in disadvantaged neighborhoods on depressive symptoms. The purpose of this study was to examine the relationships among neighborhood characteristics, adherence to a physical activity intervention, and change over time in depressive symptoms in midlife African American women.

METHODS

Two hundred seventy-eight women participated in a home-based, 24-week moderate-intensity walking intervention. Either a minimal treatment (MT) or enhanced treatment (ET) version of the intervention was randomly assigned to one of the two community health centers. Walking adherence was measured as the percentage of prescribed walks completed. Objective and perceived measures of neighborhood deterioration and crime were included.

RESULTS

Adjusting for demographics, body mass index (BMI), and depressive symptoms at baseline, walking adherence and objective neighborhood deterioration were associated with significantly lower depressive symptoms, whereas perceived neighborhood deterioration was associated with significantly higher depressive symptoms at 24 weeks.

CONCLUSIONS

Adherence to walking as well as aspects of the environment may influence depressive symptoms in African American women. In addition to supporting active lifestyles, improving neighborhood conditions may also promote mental health among African American women.

Prospective study of cardiorespiratory fitness and depressive symptoms in women and men

Most studies of the relationship between cardiorespiratory fitness (CRF) and depression have been limited to cross-sectional designs. The objective of this study was to follow individuals over time to examine whether those with higher levels of CRF have lower risk of developing depressive symptoms. Participants were 11,258 men and 3085 women enrolled in the Aerobics Center Longitudinal Study in Dallas, TX. All participants completed a maximal treadmill exercise test at baseline (1970-1995) and a follow-up health survey in 1990 and/or 1995. Individuals with a history of a mental disorder, cardiovascular disease, or cancer were excluded. CRF was quantified by exercise test duration, and categorized into age and sex-stratified groups as low (lowest 20%), moderate (middle 40%), or high (upper 40%). Depressive symptoms were assessed using the 20-item Center for Epidemiologic Studies Depression Scale (CES-D). Those who scored 16 or more on the CES-D were considered to have depressive symptoms. After an average of 12 years of follow-up, 282 women and 740 men reported depressive symptoms. After adjusting for age, baseline examination year, and survey response year, the odds of reporting depressive symptoms were 31% lower for men with moderate CRF (odds ratio, OR 0.69; 95% confidence interval, CI 0.56-0.85) and 51% lower for men with high CRF (OR 0.49, CI 0.39-0.60), compared to men with low CRF. Corresponding ORs for women were 0.56 (CI 0.40-0.80) and 0.46 (CI 0.32-0.65). Higher CRF is associated with lower risk of incident depressive symptoms independent of other clinical risk predictors.

A prospective study of overweight, physical activity, and depressive symptoms in young women

This study examined the prospective associations of BMI, physical activity (PA), changes in BMI, and changes in PA, with depressive symptoms. Self-reported data on height, weight, PA, selected sociodemographic and health variables and depressive symptoms (CESD-10) were provided in 2000 and 2003 by 6,677 young adult women (22-27 years in 2000) participating in the Australian Longitudinal Study on Women's Health (ALSWH). Results of logistic regression analyses showed that the odds of developing depressive symptoms at follow-up (2003) were higher in women who were overweight or obese in 2000 than in healthy weight women, and lower in women who were active in 2000 than in sedentary women. Changes in BMI were significantly associated with increased odds of depressive symptoms at follow-up. Sedentary women who increased their activity had lower odds of depressive symptoms at follow-up than those who remained sedentary. Increases in activity among initially sedentary young women were protective against depressive symptoms even after adjusting for BMI changes. These findings indicate that overweight and obese young women are at risk of developing depressive symptoms. PA appears to be protective against the development of depressive symptoms, but does not attenuate the depressive symptoms associated with weight gain. However, among initially sedentary young women, even small increases in PA over time may reduce the odds of depressive symptoms, regardless of weight status.

Physical activity and likelihood of depression in adults: a review

OBJECTIVE

This review examines original research which has investigated associations between physical activity (PA) dose (i.e. frequency, intensity and duration) and domain and depression or symptoms of depression in adults.

METHODS

A search of electronic databases and authors' own bibliographic libraries was performed between 2006 and 2007 for original research articles investigating associations between PA and depression in adults. A total of 27 observational and 40 intervention studies were included.

RESULTS

Of the studies that focused on the association between duration of PA and likelihood of depression, all five observational studies, and five of the seven intervention studies found both shorter and longer durations of PA were associated with reduced likelihood of depression. Of the studies that focused on the association between intensity of PA and likelihood of depression, four of the six observational studies found that vigorous-intensity PA was more strongly associated with decreased likelihood of depression than lower intensities. Most intervention studies showed that both intensities were effective in reducing the likelihood of depression. Two observational studies found a stronger inverse relationship of leisure-time PA with depression than PA in other domains. There is insufficient evidence regarding the importance of the PA setting on depression.

CONCLUSION

Although the dose and domain of physical activity varied across studies reviewed, evidence suggests that even low doses of PA may be protective against depression. Further studies examining the optimal domain of PA for reducing the likelihood of depression are needed.

The association between weekly hours of physical activity and mental health: a three-year follow-up study of 15-16-year-old students in the city of Oslo, Norway

BACKGROUND

Mental health problems are a worldwide public health burden. The literature concerning the mental health benefits from physical activity among adults has grown. Adolescents are less studied, and especially longitudinal studies are lacking. This paper investigates the associations between weekly hours of physical activity at age 15-16 and mental health three years later.

METHODS

Longitudinal self-reported health survey. The baseline study consisted of participants from the youth section of the Oslo Health Study, carried out in schools in 2000-2001 (n = 3811). The follow-up in 2003-2004 was conducted partly at school and partly through mail. A total of 2489 (1112 boys and 1377 girls) participated in the follow-up. Mental health was measured by the Strengths and Difficulties Questionnaire with an impact supplement. Physical activity was measured by a question on weekly hours of physical activity outside of school, defined as exertion 'to an extent that made you sweat and/or out of breath'. Adjustments were made for well-documented confounders and mental health at baseline.

RESULTS

In boys, the number of hours spent on physical activity per week at age 15-16 was negatively associated with emotional symptoms [B (95%CI) = -0.09 (-0.15, -0.03)] and peer problems [B (95%CI) = -0.08 (-0.14, -0.03)] at age 18-19 after adjustments. In girls, there were no significant differences in SDQ subscales at age 18-19 according to weekly hours of physical activity at age 15-16 after adjustments. Boys and girls with five to seven hours of physical activity per week at age 15-16 had the lowest mean scores for total difficulties and the lowest percentage with high impact score at age 18-19, but the differences were not statistically significant after adjustments.

CONCLUSION

Weekly hours of physical activity at age 15-16 years was weakly associated with mental health at three-year follow-up in boys. Results encourage a search for further knowledge about physical activity as a possible protective factor in relation to mental health problems in adolescence.

Leisure time physical activity in relation to depressive symptoms in the Black Women's Health Study

BACKGROUND

A growing body of evidence suggests that physical activity might reduce the risk of depressive symptoms, but there are limited data on Black women.

PURPOSE

The objective was to evaluate the association between leisure time physical activity and depressive symptoms in U.S. Black women.

METHODS

Participants included 35,224 women ages 21 to 69 from the Black Women's Health Study, a follow-up study of African American women in which data are collected biennially by mail questionnaire. Women answered questions on past and current exercise levels at baseline (1995) and follow-up (1997). The Center for Epidemiologic Studies Depression Scale (CES-D) was used to measure depressive symptoms in 1999. Women who reported a diagnosis of depression before 1999 were excluded. We used multivariate logistic regression models to compute odds ratios (ORs) and 95% confidence intervals (CIs) for physical activity in relation to depressive symptoms (CES-D score > or = 16) with control for potential confounders.

RESULTS

Adult vigorous physical activity was inversely associated with depressive symptoms. Women who reported vigorous exercise both in high school (> or = 5 hr per week) and adulthood (> or = 2 hr per week) had the lowest odds of depressive symptoms (OR = 0.76, 95% CI = 0.71-0.82) relative to never active women; the OR was 0.90 for women who were active in high school but not adulthood (95% CI = 0.85-0.96) and 0.83 for women who were inactive in high school but became active in adulthood (95% CI = 0.77-0.91). Although walking for exercise was not associated with risk of depressive symptoms overall, there was evidence of a weak inverse relation among obese women (Body Mass Index > or = 30).

CONCLUSIONS

Leisure time vigorous physical activity was associated with a reduced odds of depressive symptoms in U.S. Black women.

Physical activity, exercise coping, and depression in a 10-year cohort study of depressed patients

BACKGROUND

Epidemiological research examining the relationship between physical activity and depression has been conducted almost exclusively with community samples. We examined associations between physical activity, exercise coping, and depression in a sample of initially depressed patients, using four waves of data spanning 10 years.

METHODS

A cohort (n=424) of depressed adults completed measures of physical activity, exercise coping, depression, and other demographic and psychosocial constructs at baseline, 1-year, 4-years, and 10-years, with a 90% wave-to-wave retention rate. Multilevel modeling was used to analyze individual depression trajectories.

RESULTS

More physical activity was associated with less concurrent depression, even after controlling for gender, age, medical problems, and negative life events. Physical activity counteracted the effects of medical conditions and negative life events on depression. However, physical activity was not associated with subsequent depression. The findings for exercise coping were comparable.

LIMITATIONS

Measures of physical activity and exercise coping encompassed a limited set of activities and did not include information about duration or intensity.

CONCLUSION

Our results suggest that more physical activity is associated with reduced concurrent depression. In addition, it appears that physical activity may be especially helpful in the context of medical problems and major life stressors. Clinically, encouraging depressed patients to engage in physical activity is likely to have potential benefits with few obvious risks.

Physical activity and depressive symptoms in cardiac rehabilitation: Long-term effects of a self-management intervention

Long-term effects of a self-management intervention on physical activity and depressive symptoms were studied in 198 men and women after cardiac rehabilitation in Germany. Participants were randomly assigned to either an intervention group or a standard-care control group. The intervention group received brief self-regulatory skills training that focused on exercise planning strategies. Four and 12 months later, physical exercise levels were half a standard deviation higher in the intervention group. Depressive symptoms 12 months after discharge were almost half a standard deviation lower in the intervention group than in the control group. Mediation analyses were performed to study the potential mechanism that accounted for the reduction in depression. Perceived attainment of exercise goals, but not physical exercise itself, emerged as a mediator between the intervention and the reduction of depressive symptoms. As such attainment of personal goals appears to be of particular importance for lowering depressive symptoms during health-behavior change. Thus, self-management strategies to help patients attain their goals should be part of rehabilitation programs.

Regular exercise, anxiety, depression and personality: a population-based study

OBJECTIVES

To examine whether regular exercise is associated with anxiety, depression and personality in a large population-based sample as a function of gender and age.

METHODS

The sample consisted of adolescent and adult twins and their families (N=19,288) who participated in the study on lifestyle and health from The Netherlands Twin Registry (1991-2002). Exercise participation, anxiety, depression and personality were assessed with self-report questionnaires.

RESULTS

The overall prevalence of exercise participation (with a minimum of 60 min weekly at 4 METs (Metabolic Energy Expenditure Index)) in our sample was 51.4%. Exercise participation strongly declined with age from about 70% in young adolescents to 30% in older adults. Among adolescents, males exercised more, whereas, among older adults, females exercised more. Exercisers were on average less anxious (-0.18 SD), depressed (-0.29 SD) and neurotic (-0.14 SD), more extraverted (+0.32 SD) and were higher in dimensions of sensation seeking (from+0.25 SD to+0.47 SD) than non-exercisers. These differences were modest in size, but very consistent across gender and age.

CONCLUSIONS

This study corroborates and extends previous findings: regular exercise is cross-sectionally associated with lower neuroticism, anxiety and depression and higher extraversion and sensation seeking in the population.

Can strenuous leisure time physical activity prevent psychological complaints in a working population?

AIMS

To investigate the longitudinal relation between strenuous leisure time physical activity and psychological complaints (depression and emotional exhaustion) in a Dutch working population in order to find evidence for the preventive role of physical activity in the development of psychological complaints.

METHODS

All data came from the Study on Musculoskeletal disorders, Absenteeism, Stress, and Health (SMASH), a three year follow up study that started between 1994 and 1995. The study population consisted of 1747 workers from 34 companies. Generalised estimating equation (GEE) analyses were performed to investigate the longitudinal relation between strenuous leisure time physical activity and psychological complaints using models with and without a time lag. Logistic regression analyses were performed to study the relation between physical activity and sickness absence due to psychological complaints during the three year follow up study.

RESULTS

Only in workers with a sedentary job was strenuous leisure time physical activity (1-2 times per week) significantly associated with a reduced risk of future depression and emotional exhaustion. This was not the case for physical activity at higher frequencies (> or =3 times per week). There was a dose-response relation between strenuous leisure time physical activity and poor general health which was strongest in workers with a sedentary job. Strenuous leisure time physical activity (1-2 times per week) was associated with a lower risk of long term absenteeism (>21 days), whereas physical activity at a higher frequency was not.

CONCLUSIONS

Results suggest that strenuous leisure time physical activity might play a role in the prevention of future psychological complaints, poor general health, and long term absenteeism in a working population. Workers with a sedentary job seem to benefit more from strenuous leisure time physical activity than workers without a sedentary job.

Exploring Racial Disparity in Posttraumatic Stress Disorder Diagnosis: Implications for Care of African American Women

OBJECTIVE

To explore factors contributing to disparities in posttraumatic stress disorder (PTSD) diagnosis between African Americans and White Americans, while controlling for gender and class by using a data set limited to poor women.

DESIGN

A cross-sectional epidemiological secondary analysis.

SETTING

Michigan Medicaid fee-for-service claims data from 1994 through 1997.

SAMPLE

A total of 20,298 African American and White American adolescents and adult women, including 2,996 with PTSD diagnosis.

MAIN OUTCOME MEASURES

Victimization, PTSD diagnosis, psychiatric and somatic comorbidities, and PTSD treatment.

RESULTS

African American women were under-represented in the group diagnosed with PTSD (12% versus 31% in the comparison group), despite having equal rates of hospitalization for rape and battering. They were less likely to be diagnosed with comorbidities associated with complex PTSD, such as dissociative disorder (OR = 0.259, p < .001) or borderline personality disorder (OR = 0.178, p < .001), but were equally likely to be diagnosed with conduct disorder, schizophrenia, or substance abuse. African American women were 40% less likely to have continuous insurance coverage.

CONCLUSIONS

Patient, provider, and system factors appear to interact to create disparities in PTSD diagnosis and treatment. Attention to case finding and provider or system bias may help reduce disparities.

Epidemiology of leisure-time physical activity in socio-demographic, lifestyle and psychological characteristics of men and women in Greece: the ATTICA Study

Background

We aimed to evaluate the prevalence, frequency and type of leisure-time physical activity (LTPA) among adults in Greece, as well as its relationship with socio-demographic, lifestyle and clinical characteristics of these people.

Methods

From May 2001 to December 2002 we randomly enrolled 1514 men and 1528 women, without any evidence of cardiovascular or any other chronic disease. The sampling was stratified by the age – gender distribution of (census 2001) of the greater area of Athens. Weekly energy expenditure assessed by considering frequency, duration (in minutes) and intensity of sports related physical activity during a usual week.

Results

53% of men and 48% of women were classified as physically active. Men were more likely to be active as compared to women (p < 0.05), while the lowest activity rates were observed in 40 to 49 years old participants (p < 0.01). Physically active people had higher occupation skills, were more likely to live in rural areas, to be unmarried, non smokers and they were devoted to a healthier dietary pattern, as compared to sedentary, irrespective of age and sex (all p < 0.05). In addition, the cumulative risk factors score of obesity, hypertension, hypercholesterolemia and diabetes, was inversely associated with activity status (p < 0.001). Finally, physically active men and women were less likely to report depressive symptoms (p < 0.01), after various adjustments were made.

Conclusion

Half of the studied population reported physically inactive, indicating that sedentary lifestyle becomes a serious epidemic in Greece. High occupation skills, non-smoking, devotion to a healthier dietary pattern and a better cardiovascular risk factors profile were some of the determinants of physically active people.

The association between physical exercises and health-related quality of life in subjects with mental disorders: results from a cross-sectional survey

OBJECTIVES

The present study examines the relationship between health-related quality of life and physical activity among adults with affective, anxiety, and substance dependence disorders.

METHODS

Analyses were conducted among participants in the German National Health Interview and Examination Survey (GHS), a nationally representative multistage probability survey, conducted from 1997 to 1999. Multiple linear regression analyses were used to determine the relationship between health-related quality of life and physical activity among subjects with mental disorders.

RESULTS

Affective, anxiety, and substance dependence disorders were associated with substantial impairment in health-related quality of life. Higher levels of physical activity were associated with higher health-related quality of life among persons with mental disorders. Even after controlling for sociodemographic characteristics, physically inactive subjects reported poorer quality of life.

CONCLUSIONS

Physical activity can be considered as beneficial for people suffering from mental disorders. The promotion of a physically active lifestyle is an important public health objective.

Long-term impact of preventive proactivity on quality of life of the old-old

OBJECTIVE

This research explored the long-term benefits of engaging in proactive health promotion efforts among old-old residents of Sunbelt retirement communities to empirically test components of the Preventive and Corrective Proactivity (PCP) Model of Successful Aging. Specifically, we examined the contributions of exercise, tobacco use, moderate alcohol use, and annual medical checkups to multidimensional quality of life indicators of physical health, psychological well-being, and mortality.

METHOD

Data were obtained from a longitudinal study of adaptation to aging. Annual in-home interviews were conducted with 1000 older adults over a 9-year period. Whether health promotion behaviors at baseline predicted quality of life outcomes 8 years later was examined, controlling for the baseline outcome, sociodemographic variables, and, as an additional test, baseline health conditions.

RESULTS

Exercise was predictive of fewer IADL limitations and greater longevity, positive affect, and meaning in life 8 years later. Avoiding tobacco was predictive of longevity. Before controlling for health conditions, exercise predicted decreased risk of basic activities of daily living limitations and having more goals; moderate alcohol use predicted longevity; annual health checkup predicted more IADL limitations; and having once smoked predicted having more IADL limitations and negative affect.

CONCLUSIONS

Among the old-old, exercise had long-term and multifaceted benefits over an 8-year period. Tobacco avoidance also contributed to long-term positive outcomes. These results lend support to the long-term preventive value of health-promoting proactivity spontaneously engaged in by old-old persons proposed in the framework of the PCP model.

Demographic and psychosocial correlates of physical activity in late life

INTRODUCTION

According to the Centers for Disease Control and Prevention and the World Health Organization, increasing physical activity may help prolong health and preserve the quality of life in late adulthood. Physical activity has taken center stage as the behavior most likely to alter health. However, there is little recent population-wide information about the demographic and psychosocial correlates of physical activity in the elderly population. The purpose of the study was to identify the factors associated with older adults' frequency of physical activity. The study may have implications for preventive interventions.

METHODS

Data for 12,611 community-dwelling people aged > or = 65 from the 1996-1997 Canadian National Population Health Survey were examined. Predictors of frequent versus infrequent self-reported physical activity lasting > 15 minutes were examined using logistic regression analyses. The predictor variables included geographic location, psychological distress (Generalized Distress Scale), demographic factors (age, gender, educational level, and marital status), perceived social support, chronic medical conditions, physical limitations due to injury, functional limitations, smoking behavior, and body mass index (BMI).

RESULTS

Gender (male); younger age; higher levels of education; being unmarried; absence of chronic conditions, injuries, and functional limitations; lower BMI; social support (females); nonsmoking; region; and lower levels of psychological distress were associated with frequent physical activity in late life. Older adults in western Canadian provinces were more active than those in eastern provinces.

CONCLUSIONS

The results will be useful for the design of interventions aimed at improving older adults' health behavior and other health and functional outcomes, especially for subgroups in particular need. Recommendations for further longitudinal research are presented.

Physical activity dose-response effects on outcomes of depression and anxiety

PURPOSE

The purpose of this study was to examine the scientific evidence for a dose-response relation of physical activity with depressive and anxiety disorders.

METHODS

Computer database searches of MEDLINE, PsychLit, and Internet and personal retrieval systems to locate population studies, randomized controlled trials (RCTs), observational studies, and consensus panel judgments were conducted.

RESULTS

Observational studies demonstrate that greater amounts of occupational and leisure time physical activity are generally associated with reduced symptoms of depression. Quasi-experimental studies show that light-, moderate-, and vigorous-intensity exercise can reduce symptoms of depression. However, no RCTs have varied frequency or duration of exercise and controlled for total energy expenditure in studies of depression or anxiety. Quasi-experimental and RCTs demonstrate that both resistance training and aerobic exercise can reduce symptoms of depression. Finally, the relation of exercise dose to changes in cardiorespiratory fitness is equivocal with some studies showing that fitness is associated with reduction of symptoms and others that have demonstrated reduction in symptoms without increases in fitness.

CONCLUSION

All evidence for dose-response effects of physical activity and exercise come from B and C levels of evidence. There is little evidence for dose-response effects, though this is largely because of a lack of studies rather than a lack of evidence. A dose-response relation does, however, remain plausible.

Women's college physical activity and self-reports of physician-diagnosed depression and of current symptoms of psychiatric distress

It is believed that physical activity is protective against depression. This paper investigates the association between women's athletic activity in the college and precollege years and physician-diagnosed depression in postcollege years. College alumnae (n = 3940), former college athletes and nonathletes, completed a detailed self-administered questionnaire that sought information on health histories up to the present time, including questions on history of physician-diagnosed depression and current symptoms of psychiatric distress. A negative association between college athletic activity and self-reported physician-diagnosed depression in the last 10 years was observed (adjusted odds ratio [OR] = 0.664, with 95% confidence limits [CL] 0.545, 0.808, p < 0.0001). Other factors significantly associated with depression are living with a spouse, at time of reporting-protective; self-rated current health good to poor compared with very good or excellent; alcoholism; and having a doctoral degree-risk factors. Current state variables based on the Rand Mental Health Inventory-5 (RMHI-5) were also more favorable among athletes. This is the first study to report a long-term beneficial association between women's college athletic activity and self-reported physician-diagnosed depression in the postcollege years and current symptoms of psychiatric distress. The findings support the Surgeon General's promotion of the health benefits of physical activity.

Effects of physical exercise on anxiety, depression, and sensitivity to stress: a unifying theory

Until recently, claims for the psychological benefits of physical exercise have tended to precede supportive evidence. Acutely, emotional effects of exercise remain confusing, both positive and negative effects being reported. Results of cross-sectional and longitudinal studies are more consistent in indicating that aerobic exercise training has antidepressant and anxiolytic effects and protects against harmful consequences of stress. Details of each of these effects remain unclear. Antidepressant and anxiolytic effects have been demonstrated most clearly in subclinical disorder, and clinical applications remain to be exploited. Cross-sectional studies link exercise habits to protection from harmful effects of stress on physical and mental health, but causality is not clear. Nevertheless, the pattern of evidence suggests the theory that exercise training recruits a process which confers enduring resilience to stress. This view allows the effects of exercise to be understood in terms of existing psychobiological knowledge, and it can thereby provide the theoretical base that is needed to guide future research in this area. Clinically, exercise training continues to offer clinical psychologists a vehicle for nonspecific therapeutic social and psychological processes. It also offers a specific psychological treatment that may be particularly effective for patients for whom more conventional psychological interventions are less acceptable.