Bidirectional association between mental health and physical activity in older adults: Whitehall II prospective cohort study

ObjectiveTo investigate longitudinal and bidirectional associations between mental health and physical activity from midlife into old age.MethodsAnalysis was based on data from 6909 participants (aged 45 to 69 in 1997/99) from the Whitehall II cohort in the UK. Latent growth curve analysis examined possible bidirectional associations between the SF-36 Mental Component Summary and weekly physical activity measured at three time-points over ten years.ResultsMental health and physical activity were associated at baseline (β = 0.17, 95% CI 0.13, 0.21) and associations persisted into old age. In the latent growth curve model, both mental health and physical activity increased and their rates of change ‘moved together’ over time (β = 0.24, 95% CI 0.11, 0.37). Relatively high baseline levels of either variable were associated with slightly slower increases in the other outcome (β = − 0.02, 95% CI − 0.03, − 0.01; β = − 0.07, 95% CI − 0.11, − 0.13), which are thought to reflect regression to the mean. However, those who started high on either variable remained the most advantaged at end of follow-up.ConclusionsFrom midlife to old age, greater physical activity is associated with better mental health and vice versa. These findings suggest persistent longitudinal and bidirectional associations between physical activity and mental health.     

围生期抑郁和焦虑症状关联及方向的纵向研究

目的 利用重复测量资料探讨围生期抑郁和焦虑症状的纵向关联及方向。方法 2019年5—9月在马鞍山市妇幼保健院纳入孕早期妇女,分别在孕中、晚期及产后一年内对其进行抑郁、焦虑症状随访评估。对围生期抑郁、焦虑症状进行单因素分析后,在自回归交叉滞后模型中调整单因素分析有统计学意义的因素进行路径分析以阐明围生期抑郁和焦虑症状的关联及可能的预测方向。结果 1 094名妇女纳入分析,围生期抑郁、焦虑症状及其共患的检出率分别为27.3%、44.3%和23.5%。路径分析结果显示,同一时期的抑郁和焦虑症状均存在正相关（相关系数r分别为0.705、0.636、0.547、0.665,P＜0.001）;围生期抑郁、焦虑症状的自回归路径均有统计学意义（回归系数b抑郁分别为0.315、0.462、0.373,b焦虑分别为0.473、0.567、0.589,P＜0.001）;在整个围生期均观察到前一时期焦虑症状与后一时期抑郁症状的正向关联（b分别为0.155、0.234、0.271,P＜0.001）,而只在孕中期抑郁症状对孕晚期焦虑症状中观察到正向关联（b = 0.120,P＜0.05）。敏感性分析显示路径分析结果具有稳健性。结论 围生期抑郁和焦虑症状存在共患,且焦虑症状对随后的抑郁症状有稳定正向预测作用。     

Work, retirement and physical activity: cross-sectional analyses from the Whitehall II study

BACKGROUND: To explore the relationship between work, retirement and physical activity. METHODS: Cross-sectional analyses of data from self-completed questionnaires by 6224 civil servants aged 45-69 years participating in phase 5 of the Whitehall II longitudinal study. RESULTS: There appeared to be a dose-response relationship between hours worked and the prevalence of physical activity, with a lower prevalence of recommended physical activity amongst participants working full time (> or =30 h/week), higher prevalence rates amongst those working part time (<30 h/week), and the highest rates amongst participants who were not working at all. Physical activity rates did not increase greatly amongst study participants who had retired from the Civil Service but had gone on to do further full-time work, however, the higher physical activity rates of participants working part time, or not at all, were further enhanced amongst those who had also retired. CONCLUSIONS: These findings suggest that full-time work is associated with lower rates of recommended physical activity levels in this cohort of middle-aged white-collar office workers. Lower grade occupations are also less likely to meet the recommended physical activity levels. While retirement is associated with higher rates of recommended physical activity levels, this benefit is evident amongst those who work part time, or not at all, during their retirement, for whom the benefits of retirement and lower working hours on rates of physical activity appear additive. The frequency of different types of physical activity is associated with different occupational grades, with more sport and gardening being done by the higher occupational grades.     

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

PurposeLow 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.MethodsDepressive 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.ResultsWe 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.ConclusionsAn inverse bidirectional association between PA and general depressive symptoms was observed. This association was restricted to affective symptoms.     

Social inequalities in depressive symptoms and physical functioning in the Whitehall II study: exploring a common cause explanation

STUDY OBJECTIVE: This study investigated which risk factors might explain social inequalities in both depressive symptoms and physical functioning and whether a common set of risk factors might account for the association between depressive symptoms and physical functioning. DESIGN: A longitudinal prospective occupational cohort study of female and male civil servants relating risk factors at baseline (phase 1: 1985-8) to employment grade gradients in depressive symptoms and physical functioning at follow up (phase 5: 1997-9). Analyses include the 7270 men and women who participated at phase 5. SETTING: Whitehall II Study: 20 London based white collar civil service departments. PARTICIPANTS: Male and female civil servants, 35-55 years at baseline. MAIN RESULTS: Depressive symptoms were measured by a subscale of items from the 30 item General Health Questionnaire. Physical functioning was measured by a subscale of the SF-36. Employment grade was used as a measure of socioeconomic position as it reflects both income and status. The grade gradient in depressive symptoms was entirely explained by risk factors including work characteristics, material disadvantage, social supports, and health behaviours. These risk factors only partially explained the gradient in physical functioning. The correlation between depressive symptoms and physical functioning was reduced by adjustment for risk factors and baseline health status but not much of the association was explained by adjustment for risk factors. Among women, the association between depression and physical functioning was significantly stronger in the lower grades both before and after adjustment for risk factors and baseline health. For women, there was only a significant grade gradient in depressive symptoms among those reporting physical ill health. CONCLUSIONS: Some risk factors contribute jointly to the explanation of social inequalities in mental and physical health although their relative importance differs. Work is most important for inequalities in depressive symptoms in men, and work and material disadvantage are equally important in explaining inequalities in depressive symptoms in women while health behaviours are more important for explaining inequalities in physical functioning. These risk factors did not account for the association between mental health and physical health or the greater comorbidity seen in women of lower socioeconomic status. The risk of secondary psychological distress among those with physical ill health is greater in the low employment grades.     

Effect of intensity and type of physical activity on mortality: results from the Whitehall II cohort study

Objectives. We examined the association of intensity and type of physical activity with mortality.Methods. We assessed the duration of physical activity by intensity level and type in 7456 men and women from the Whitehall II Study by questionnaire in 1997–1999 (mean ±SD age = 55.9 ±6.0 years) and 5 years later. All-cause mortality was assessed until April 2009.Results. A total of 317 participants died during the mean follow-up of 9.6 years (SD = 2.7). Reporting at least 1 hour per week of moderate activity was associated with a 33% (95% confidence interval [CI] = 14%, 45%) lower risk of mortality compared with less than 1 hour. For all physical activity types examined, except housework, a duration of physical activity greater than 0 (≥ 3.5 hours for walking) was associated with lower mortality in age-adjusted analyses, but only the associations with sports (hazard ratio [HR] = 0.71; 95% CI = 0.56, 0.91) and do-it-yourself activity (HR = 0.68; 95% CI = 0.53, 0.98) remained in fully adjusted analyses.Conclusions. It is important to consider both intensity and type of physical activity when examining associations with mortality.The dose-response association between physical activity and all-cause mortality is well established,^1,2 but few studies have investigated whether the different types of leisure-time physical activity are equally beneficial.^3–5 There are a variety of ways to expend energy, such as sports, walking, and domestic physical activity, and different types of activities require different levels of energy expenditure.⁶ Sports activities have been clearly shown to be associated with a lower risk of mortality.^3,5,7,8 However, less is known about less intensive physical activities, particularly those that are a part of daily living and leisure. Two recent reports showed “global domestic activity” to protect against all-cause mortality,^3,5 and a previous article on Finnish data suggested that specific types of domestic physical activity may have a protective effect.⁴ Our objective in the present study was to examine the associations of mortality with intensity, in terms of mild, moderate, and vigorous activity, and type of physical activity, specifically, walking, sports, housework, gardening, and do-it-yourself activities.     

社区老年人身体活动、社会支持与抑郁症状的关系分析

目的 了解社区老年人身体活动、社会支持与抑郁症状的关系。方法 采用身体活动量表、简版老年人抑郁症状自评量表和社会支持评定量表对1 386名老年人进行问卷调查。结果 社区老年人身体活动得分为（18.9±9.1）,社会支持得分为（35.4±6.3）,抑郁症状得分为（5.8±1.6）,抑郁症状阳性检出率为21.0%（249/1 188）;身体活动与社会支持存在正相关（r=0.291,P<0.001）,身体活动与抑郁症状存在负相关（r=-0.210,P=0.012）,社会支持与抑郁症状存在负相关（r=-0.308,P<0.001）。身体活动对抑郁症状具有直接效应（β=-0.179,P<0.001）,社会支持在身体活动与抑郁症状间具有中介效应（β=-0.063,P<0.001）。结论 身体活动可以直接对抑郁症状产生负向作用,也可以通过社会支持产生间接负向作用。     

The association between physical activity and depressive symptoms in young women: A review

ObjectiveThis review synthesises results of studies examining the association between physical activity (PA) and depressive symptoms and the effects of PA intervention studies on depression among young women.MethodsA search of electronic databases and bibliographic searches of observational and intervention studies was conducted that included women between the ages of 18 and 35.ResultsA total of eight observational and five intervention studies were identified. Evidence from observational studies indicated that physical activity was inversely associated with depressive symptoms in young women. Even a small amount of physical activity was found to be associated with reduced depressive symptoms. No clear dose–response relationship was shown. Evidence from intervention studies indicated that physical activity reduced depressive symptoms. Direct study comparisons were difficult due to variations in study methods and measures. The studies provided little or no information on understanding dose–response effects or on the mechanisms involved.ConclusionThe limited number of studies examining physical activity and depressive symptoms in young women and the methodological problems identified in a number of these studies, make it difficult to draw firm conclusions. However, this review suggests that engaging in even low levels of physical activity may be protective against depressive symptoms in young women. There is a need for objective measures of physical activity in future studies, particularly with a focus on those with clinical depression in non-student populations.     

大学生体育活动与焦虑和抑郁评分变化轨迹之间的关联

目的分析不同运动量的体育活动持续状态与焦虑、抑郁评分变化轨迹之间的关联,为更好认识体育活动对大学生焦虑、抑郁发展情况的影响提供参考。方法采用分层整群抽样法,对山东省某综合性大学2017级1 265名学生进行5次随访,使用体育活动等级量表、焦虑自评量表、抑郁自评量表进行问卷调查,并通过潜在类线性混合模型识别焦虑、抑郁评分变化轨迹,采用无序多分类Logistic回归分析5次调查小运动量的体育活动持续状态与焦虑和抑郁评分变化轨迹之间的关联。结果每次均为小运动量者940名(74.3%),每次均为中等或大运动量者325名(25.7%)。焦虑评分变化轨迹被分为低水平组、高水平-下降组、高水平组,分别为686(54.2%)、144(11.4%)、435(34.4%)名;抑郁评分变化轨迹被分为低水平组、中水平-下降组、高水平组、中水平-上升组,分别为604(47.8%)、170(13.4%)、177(14.0%)、314(24.8%)名。以中等或大运动量学生作为参照,持续为小运动量状态会增加焦虑保持在高水平的风险(OR=1.78)、使抑郁评分在中等水平继续降低的可能性降低(OR=0.67)、增加抑郁评...     

Genetic covariation between neuroticism and the symptoms of anxiety and depression

A genetic analysis of the trait of neuroticism and symptoms of anxiety and depression in 3,810 pairs of adult MZ and DZ twins is reported. Differences between people in these measures can be explained simply by differences in their genes and in their individual environmental experiences. There is no evidence that environmental experiences that are shared by cotwins, such as common family environment or social influences, are important. There are differences between the sexes in gene action affecting neuroticism, and genetic effects become more pronounced with age in females. The lack of evidence for dominance variance affecting neuroticism contrasts well with the detection of considerable genetical nonadditivity for extraversion in the same sample and reinforces the view that these two traits are not only statistically, but also genetically, quite independent. An analysis of the causes of covariation between anxiety, depression, and neuroticism shows that additive gene effects are more important causes of covariation than environmental factors. Genetic variation in symptoms of anxiety and depression is largely dependent on the same factors as effect the neuroticism trait. However, there is also evidence for genetic variation specific to depression.     

Effects of physical activity on cognitive functioning in middle age: evidence from the Whitehall II prospective cohort study

OBJECTIVES: We examined the association between physical activity and cognitive functioning in middle age. METHODS: Data were derived from a prospective occupational cohort study of 10308 civil servants aged 35-55 years at baseline (phase 1; 1985-1988). Physical activity level, categorized as low, medium, or high, was assessed at phases 1, 3 (1991-1994), and 5 (1997-1999). Cognitive functioning was tested at phase 5, when respondents were 46-68 years old. RESULTS: In both prospective (odds ratio [OR] = 1.65; 95% confidence interval [CI]=1.30, 2.10) and cross-sectional (OR=1.79; 95% CI=1.38, 2.32) analyses, low levels of physical activity were a risk factor for poor performance on a measure of fluid intelligence. Analyses aimed at assessing cumulative effects (summary of physical activity levels at the 3 time points) showed a graded linear relationship with fluid intelligence, with persistently low levels of physical activity being particularly harmful (OR=2.21; 95% CI=1.37, 3.57). CONCLUSIONS: Low levels of physical activity are a risk factor for cognitive functioning in middle age, fluid intelligence in particular.     

The association between past and current physical activity and depressive symptoms in young adults: a 10-year prospective study

PurposeThe objectives of this study were to assess (1) the longitudinal associations of past moderate-to-vigorous physical activity (MVPA) and involvement in team sports during secondary school with depressive symptoms in early adulthood, and (2) the cross-sectional associations of current MVPA and involvement in team sports with depressive symptoms during young adulthood.MethodsData were drawn from the Nicotine Dependence in Teens study, which is an ongoing prospective cohort study of 1293 adolescents aged 12–13 years at baseline (52% female). Data analyses involved latent growth curve modeling and multiple hierarchical linear regression models.ResultsCurrent MVPA (β = ?0.12), but not past MVPA, participation was significantly negatively related to depressive symptoms during young adulthood (P < .05). Both current and past involvement in team sports were significantly negatively related to depressive symptoms (β ≥ ?0.09; P < .05); however, these associations were no longer significant (P = .08) when covariates were controlled for.ConclusionsFindings provide insight about the unique associations between the timing and type of physical activity and depressive symptoms, suggesting that physical activity within team sport contexts should be encouraged so that young adults may experience less depressive symptoms.     

Volume and social context of physical activity in association with mental health,anxiety and depression among youth

There is growing interest in physical activity (PA) to prevent mental disorders in youth. However, few studies examine the association between PA and mental health. Further, how PA volume and context relate to mental health and mental disorders remains unclear, especially among youth in transition to adulthood. This study examined the cross-sectional associations among PA volume and context, mental health, and symptoms of anxiety and depression in post-secondary students. A total of 1527 post-secondary students (97.4% were age 16–24 years) recruited in a CEGEP in Quebec, Canada completed a self-report questionnaire during class-time in October 2013. Multivariate linear regression was used to model the associations between PA volume and context and mental health, anxiety and depression controlling for sex, age and perceived socioeconomic status. Volume of moderate-to-vigorous leisure time PA (MVPA) was positively associated with mental health (β (95% CI) = 0.072 (0.045, 0.099)) and inversely associated with symptoms of anxiety (− 0.011 (− 0.020, − 0.001)) and depression (− 0.010 (− 0.017, − 0.003)). Volume including all PA intensities was associated with mental health (0.052 (0.028, 0.076)). After controlling for PA volume, active youth involved in team sports had better mental health than those who engaged in PA individually. PA volume and the social context of PA are independently associated with mental health among youth. MVPA is inversely associated with anxiety and depressive symptoms.     

But that's who I Am: The inability to enact physical activity identity is associated with depression and anxiety symptoms

There is strong evidence to suggest that physical activity reduces depression and anxiety symptoms, and recently there have been calls to consider the role of psychological determinants of physical activity behaviour as part of this effect. We investigated whether a person's physical activity identity moderated the impact of physical activity on depression and anxiety symptoms. Participants aged 19–33 years (N = 97; M = 21.8; 50.5% female, 44.3% Caucasian) self-reported their physical activity identity then wore activity monitors for six days. On the seventh day, participants self-reported their depression symptoms and anxiety symptoms. Multiple linear regression models were conducted to determine whether physical activity identity moderated the link of physical activity with prospective depression and anxiety symptoms. For people who had physical activity identity scores greater than 1.51 SD more than M, physical activity and depression symptoms were negatively associated. For people with a physical activity identity score greater than 0.52 SD more than M, physical activity and anxiety symptoms were negatively associated. For those with a strong physical activity identity, not being physically active was associated with more prospective depressive and anxiety symptoms although the effect sizes were small. It may be that there are negative mental health impacts of not being physical active for those with strong physical activity identities. Physical activity interventions targeting mental health outcomes may need to be tailored for a person's identity and provide support when people do not engage with the physical activity behaviour that they value as part of their identity standards.     

Prospective COVID-19 related changes in physical activity and sedentary time and associations with symptoms of depression and anxiety

ProblemThe COVID-19 pandemic is associated with psychological distress. Decreased moderate-vigorous physical activity (MVPA) and increased sedentary time may be exacerbating pandemic-related symptoms of anxiety and depression, but existing studies exploring these associations are almost entirely cross-sectional.MethodsReported data from 2018 and Summer 2020 were used to create change categories based on compliance with MVPA guidelines and relative sedentary time. Participants completed the Patient Health Questionnaire-4 (PHQ-4) in Summer 2020. Associations among changes in MVPA and sedentary time (separately and jointly) with psychological distress (total PHQ-4 score) were examined with ordinal logistic regression and associations with depressive or anxiety symptoms were examined with logistic regression.ResultsAmong 2,240 participants (65% women, mean age 57.5 years), 67% increased sedentary time and 21% became inactive between the two time points. After multivariate adjustment, participants who became (OR = 1.71, 95% CI: 1.05–2.78) or remained inactive (OR = 2.07, 1.34–3.22) were more likely to experience depressive symptoms compared to those who remained active. Participants who increased sedentary time were also more likely to experience depressive symptoms compared to those who maintained sedentary time (OR = 1.78, 1.13–2.81). Jointly, those who increased sedentary time while remaining (OR = 3.67, 1.83–7.38) or becoming inactive (OR = 3.02, 1.44–6.34) were much more likely to have depressive symptoms compared to the joint referent (remained active/maintained sedentary time). Associations with anxiety symptoms were not statistically significant.ConclusionsThese findings support the value of promoting MVPA and limiting sedentary time during stressful events associated with psychological distress, like the COVID-19 pandemic.     

不同职业紧张因子与抑郁症状的关联分析

目的评估上海不同职业人群中抑郁症状现患状况,探讨不同职业紧张因子与抑郁症状间的关联。方法采用方便整群抽样,选择教师、生产性外企员工、行政管理与研究人员、服务性外企员工、交通警察、社区卫生服务员工与物业管理人员共7种不同职业人群,运用简明职业紧张问卷和流行病学研究用抑郁量表进行调查,由调查对象自主完成问卷。运用Logistic回归与层次多元回归分析职业紧张与抑郁症状的关联。结果共回收有效问卷1301份,抑郁得分均分为16.83±8.63,抑郁症状阳性率为46.2%。不同年龄组、不同受教育程度、不同职业间抑郁得分与抑郁症状阳性率间比较,差异均有统计学意义。拥有个人业余爱好可有助于缓解抑郁症状(OR=0.63,95%CI=0.48～0.82)。高社会支持是抑郁症状的保护因子OR=0.38(95%CI=0.25～0.55);高内在投入和高付出回报失衡是抑郁症状的危险因子,OR分别为2.72(95%CI=1.76～4.21)和2.77(95%CI=1.09～7.05)。付出-回报失衡模式比工作要求-自主模式在预报抑郁症状具有更大的效能。结论付出回报失衡、高内在投入是抑郁症状的危险因素,而高社会支持与拥有业余爱好是保护因素。     

Agreement in symptoms of anxiety and depression between patients and GPs: the influence of ethnicity

BACKGROUND: Few studies have focused specifically on the role of ethnicity in the identification and treatment of anxiety and depressive symptoms among patients consulting GPs. METHODS: A survey was conducted of 4753 patients aged 18-90 years attending general practices in Sydney, Australia. Three methods of case detection were used: a GHQ-12 score (> or = 3), self-report symptoms (using a checklist) and GP detection of symptoms. Four regional groupings based on country of birth [other English speaking countries (ESB), European, Asian (predominantly south east Asian) and other non-English speaking (other NESB)] were compared with Australian (AB) patients. RESULTS: Compared with AB patients, Asian patients had a lower mean GHQ-12 score (2.04 versus 2.54) and a lower rate of GP detection (10.4% versus 20.5%) but they recorded a similar rate of self-report symptoms (16.7% versus 20.1%). For Asian patients, 24.6% of all cases identified by self-report or by GP detection were identified by both methods, compared with 44% for AB patients. Similar patterns of treatment and referral were observed for detected cases. Compared with AB patients, Asian and other NESB patients were more likely to desire more time to discuss their problems with their GP (18.5% versus 42.0%, 37.3%) and receive an explanation of medications prescribed (18.9% versus 46%, 40.0%). CONCLUSION: These results suggest that there are substantial variations in the rates of detection of anxiety and depressive symptoms in GP patients depending on the screening methods used and the broad ethnic background of patients. Such symptoms may be under-diagnosed in Asian patients in particular.