Psychosocial Mediation of Light-Moderate Physical Activity and Cognitive Performance among Adults Aged 60+ in China

Sequential link in depression, sleep and cognition: Longitudinal evidence from a serial multiple mediation analysis of older adults in China

BACKGROUND

A growing body of literature examines the link between depression, sleep and cognition, but little is known regarding the extent to which this relationship holds among older adults over time.

OBJECTIVE

This study examines how sleep duration mediates the relationship between depressive symptoms and cognitive performance, by utilizing partial least squares structural equation modelling (PLS-SEM) estimation.

METHODS

This study utilizes the 2013-18 China Health and Retirement Longitudinal Study (CHARLS) dataset, of which 3557 participants over the age of 50 satisfied inclusion criteria. Depressive symptoms and cognitive performance are measured by the Center for Epidemiological Studies Depression Scale (CESD) and the Mini-Mental State Examination (MMSE); sleep duration is assessed using the adapted Pittsburgh Sleep Quality Index (PSQI). A serial multiple mediation model was built to assess how depressive symptoms in 2013 and in 2018 are related, in addition to assessing their links with sleep duration and cognitive performance.

FINDINGS

Results indicate that early depression positively predicts depression progression (std.β = 0.564, 95 % Confidence Interval: 0.534, 0.594), but negatively predicts sleep duration (std.β = -0.081, 95 % CI: -0.128, -0.034) and cognitive performance (std.β = -0.118, 95 % CI: -0.165, -0.072). The sequential indirect effect of early depression operating via depression progression and sleep duration is evaluated to be -0.083 (95 % CI: -0.110, -0.056), representing as much as 41.29 % of the total effect.

CONCLUSIONS

Early depressive symptoms are directly associated with increased depressive symptoms and shortened sleep, which are identified as key channels through which early depression is linked with worsened cognition.

CLINICAL IMPLICATIONS

Many older adults may underestimate the adverse costs of early depression, since its net effects on cognition could be channeled indirectly and discretely via depression progression and sleep, which is worth highlighting in health guidelines and clinical recommendations.

Exploring Perceived Barriers to Physical Activity among Older Adults Living in Low-Population Density Regions: Gender Differences and Associations with Activity Dimensions

Older people in low-population density regions tend to have fewer resources to engage in regular physical activity (PA) compared to their counterparts in urban areas. Moreover, PA assumes different dimensions, and the amount of PA related to each dimension may differ between women and men, predisposing them to different PA practices. Therefore, this cross-sectional study aims to describe the prevalence of barriers to PA, gender differences, and their associations with different PA dimensions. A total of 259 older adults (153 women and 106 men; age, 75.17 ± 8.05 years old) living in the community in the region of Guarda (Portugal) were interviewed face to face to record their sociodemographic characteristics, general health status (comorbidity index and self-reported health), PA behaviour, and barriers to PA. Women were more likely to report "low" income and living alone (p ≤ 0.05), while men reported a higher negative health status than women (p < 0.05). Two intrinsic ("Fear of injury" (40.1%) and "Need for rest" (26.3%)) and two extrinsic barriers ("Lack of nearby facilities" (30.5%) and "I don't have transport" (25.6%)) were the most prevalent. For women, age, self-reported health, comorbidity index, and intrinsic and extrinsic barriers were similarly associated with the different PA dimensions. However, only self-reported health and extrinsic barriers were the variables associated with the different PA dimensions in men. Therefore, strategies to promote active ageing in low-population density regions should be focused on reducing intrinsic and extrinsic barriers based on gender and the PA dimension to be achieved.

The Impact of Physical Activity on Depressive Symptoms among Urban and Rural Older Adults: Empirical Study Based on the 2018 CHARLS Database

Using data from the China Health and Retirement Longitudinal Study 2018, we employed the propensity score matching method to examine the effect of physical activity on depressive symptoms among older adults across rural and urban areas. The study sample consisted of 5055 participants, with urban and rural populations representing 31.3% and 68.7%, respectively. This study found that rural older adult individuals exhibited a greater incidence of depressive symptoms and lower physical activity levels when compared to their urban counterparts. Engagement in high-intensity physical activity was identified as an effective method for mitigating depressive symptoms among older adults. However, the moderating effects of physical activity were only observed among urban older adult individuals. Our findings revealed a cross-sectional correlation between physical activity and depressive symptoms among older adult Chinese individuals, and this link differed between urban and rural areas. Although high-intensity physical activity has a positive effect on depressive symptoms among older adults, physical activity interventions should sufficiently consider the variations in older adults' living conditions and environments due to urban-rural differences so that interventions can be customized to improve the mental health of older adults.

The Impact of Regular Exercise on Life Satisfaction, Self-Esteem, and Self-Efficacy in Older Adults

This study employed the correlational survey model to examine how regular exercise influenced life satisfaction, self-esteem, and self-efficacy in men over 65. The study sample included a total of 215 participants, of whom 110 exercised regularly (for at least 45 min, three times a week), while 105 engaged in no physical exercise. Regular exercisers were found to score significantly higher on life satisfaction, self-esteem, and self-efficacy scales as compared to non-exercisers. These scores also increased significantly with age and prolonged exercise history. A moderate and positive correlation was detected between life satisfaction, self-esteem, and self-efficacy among regular exercisers, while non-exercisers showed low to moderate correlations. The findings suggest that regular exercise can enhance life satisfaction, self-esteem, and self-efficacy in the elderly male population. Such effects appear to be associated with greater age and lifetime exercise history, highlighting the value of regular physical exercise in improving the quality of life among older adults.

Effects of physical activity on regulatory emotional self-efficacy, resilience, and emotional intelligence of nurses during the COVID-19 pandemic

The normalization of epidemic prevention and control has exacerbated nurses' physical and mental stresses. The important role of physical activity in relieving nurses' physical and mental stresses has received extensive attention from researchers in recent years. The purpose of this study was to investigate the influence of physical activity on the regulatory emotional self-efficacy, resilience, and emotional intelligence of nurses and explain their interactions. The present study adopted the cluster sampling method. From April to May 2022, a total of 500 nurses in six municipal hospitals in Changsha City were selected. Finally, 402 valid data samples were obtained. Afterward, AMOS 23.0 (by maximum likelihood estimation) was used to process the collected data and analyze the proposed hypotheses by using 5,000 bootstrap samples to test the mediating effects of the structural equation model. The results demonstrated that there are positive correlations between physical activity and resilience (standardized coefficients = 0.232, p < 0.001), resilience and regulatory emotional self-efficacy (standardized coefficients = 0.449, p < 0.001), and emotional intelligence and regulatory emotional self-efficacy (standardized coefficients = 0.330, p < 0.001). The positive influence of physical activity on emotional regulation self-efficacy is completely mediated by emotional intelligence and resilience (standardized indirect effect = 0.237, p < 0.01), and this explanatory power is far higher than any previous study (R ² = 0.49). The positive emotions generated by an individual's physical activity have an important explanatory role for individuals who want to establish more emotional regulation self-efficacy, emotional intelligence, and psychological resilience.

Quantifying the parallel mediation influence of body mass index and depression on physical activity and cognitive function among 3,611 Chinese older adults

Background

Engagement in physically active lifestyles brings multidimensional health benefits including better cognitive function. While prior studies examined the link between physical activity and cognitive function, a remaining unanswered question is what modifiable factors channel such effects.

Objective

This study investigates the extent to which subject’s body mass index (BMI) and depression mediate the link between physical activity and cognitive function among older adults in China.

Methods

This study builds a parallel structural equation model utilizing the 2013–2018 China Health and Retirement Longitudinal Study (CHARLS) dataset. We screened a total of 14,724 subjects, among which 3,611 subjects met the inclusion criteria. Physical activity, depression, and cognitive function are measured using the International Physical Activity Questionnaire (IPAQ), Center for Epidemiological Research Depression Scale (CES-D), and Mini-Mental State Examination (MMSE) instruments.

Results

Parallel mediation analyses indicate that depression significantly mediates the link between physical activity and cognitive function (std. β = 0.023, p-value = 0.010), while no significant mediation was observed via BMI (std. β = 0.005, p-value = 0.155). Findings also show that physical activity is positively associated with cognitive function (std. β = 0.104, p-value = 0.004), whereas physical activity is inversely associated with BMI (std. β = –0.072, p-value = 0.045). Both BMI (std. β = –0.071, p-value = 0.042) and depression (std. β = –0.199, p-value = 0.001) are negatively associated with cognitive function.

Conclusion

This study quantifies the positive association between physical activity and cognitive function in older Chinese adults, and uncovers a significant mediation channel occurring through depression. From a clinical perspective, physical behavioral modifications can lead to linked improvements in both mental and cognitive wellbeing for older adults.