Independent relationships between different domains of physical activity and depressive symptoms among 60,202 Brazilian adults

Association between physical activity and depression in adult prescription opioid users: A cross-sectional analysis based on NHANES 2007-2018

OBJECTIVE

This study was designed to examine the association between physical activity (PA) and depression among adult prescription opioid users.

METHOD

Data of adults who recently took prescription opioids were collected from NHANES 2007-2018. Participants were divided into two groups according to whether PA in each domain was ≥600 MET-min/week. According to weekly activity frequency, recreational physical activity (RPA) was divided into inactivity, insufficient activity, weekend warrior (WW), and regular activity. PHQ-9 scores ≥10 were identified as depression.

RESULTS

RPA of ≥600 MET-min/week was associated with a 40% (OR: 0.60, 95%CI: 0.38-0.96, P = 0.032) reduction in the risk of depression. Restricted Cubic Spline plots found a nonlinear dose-response relationship between RPA and depression (P = 0.045), and the turning point of depression risk was around 600 MET-min/week. There was no significant difference in the risk of depression between the WW and inactivity groups (OR: 0.65, 95%CI: 0.25-1.72, P = 0.382). The regular activity group had an 45% (OR: 0.55, 95%CI: 0.31-0.99, P = 0.046)lower risk for depression than the inactivity group.

CONCLUSION

Only regular RPA is associated with a reduced risk of depression, and RPA showed a nonlinear dose-response relationship. The antidepressant effect of the WW is not significant.

Associations of occupational physical activity and active transport with depressive symptoms in a middle-income country

OBJECTIVE

This study investigated the associations of occupational physical activity and active transport with depressive symptoms, stratified by income range, among Brazilian working adults.

STUDY DESIGN

This cross-sectional study drew on data from the 2019 Brazilian National Health Survey.

METHODS

We used the Patient Health Questionnaire (PHQ-9) to assess depressive symptoms in working adults aged 18-65 years, with physical activities (occupational physical activity and active transport) self-reported through a specially developed questionnaire. Crude and adjusted logistic regression models were fitted.

RESULTS

Individuals at the highest level of occupational physical activity (odds ratio [OR] 1.35; 95% confidence interval [95% CI] 1.19-1.53) and at the moderate level of active transport to work (OR 1.66; 95% CI 1.24-2.22) returned increased odds of depressive symptoms as compared with those who were inactive in these domains. Stratified by income group, light active transport to work (OR 0.57; 95% CI 0.34-0.95) in the lower income group (Range 1) was associated with lower odds of depressive symptoms. On the other hand, individuals at the highest level of active transport to work returned higher odds of depressive symptoms in the low- and intermediate-income groups, Ranges 3 and 4 (OR 1.92; 95% CI 1.22-3.00 and OR 2.91; 95% CI 1.71-4.95, respectively).

CONCLUSION

Our results suggest that occupational physical activity and active transport may be a risk factor for depressive symptoms. They also point to differences in this relationship by income range. Further studies are needed to pursue the analysis of how specific domains of physical activity contribute to depressive symptoms.

Household physical activity and subjective well-being: An international comparison among East Asian older adult populations

PURPOSE

Engaging in lifelong physical activity has multiple health benefits for older populations. Household physical activity occupies older adults' awake time, and they can be an important energy expenditure during the day. The purpose of this study was to investigate the association between older adults' household physical activity and subjective well-being in four East Asian societies.

METHODS

The study design was a secondary data analysis. Data were retrieved from the module of Families 2016 in the database of the East Asian Social Survey. Participants were community-dwelling older adults with a mean age of 70.30±7.50 years and who lived in China, Japan, Korea, and Taiwan. Data were collected by interviews via structured questionnaires between 2016 and 2018. Descriptive analyses, independent t-tests, and an analysis of covariance were performed for the statistical analyses.

RESULTS

In total, there were 3,432 valid responses. Participants who lived in Taiwan had significantly lower levels of total household physical activity than those living in other societies. Older adults' household physical activity was found to significantly differ by age, educational degree, gender, religion, marital status, occupation, and whether living alone. Older adults with high levels of household physical activity had significantly higher self-rated health and marital satisfaction than those with low levels.

CONCLUSIONS

Household physical activity has potential benefits for subjective well-being across international older adult populations. Increasing household physical activity is recommended for older married couples to maintain marital satisfaction.

Developing a nomogram for predicting depression in diabetic patients after COVID-19 using machine learning

Objective

This study identified major risk factors for depression in community diabetic patients using machine learning techniques and developed predictive models for predicting the high-risk group for depression in diabetic patients based on multiple risk factors.

Methods

This study analyzed 26,829 adults living in the community who were diagnosed with diabetes by a doctor. The prevalence of a depressive disorder was the dependent variable in this study. This study developed a model for predicting diabetic depression using multiple logistic regression, which corrected all confounding factors in order to identify the relationship (influence) of predictive factors for diabetic depression by entering the top nine variables with high importance, which were identified in CatBoost.

Results

The prevalence of depression was 22.4% (n = 6,001). This study calculated the importance of factors related to depression in diabetic patients living in South Korean community using CatBoost to find that the top nine variables with high importance were gender, smoking status, changes in drinking before and after the COVID-19 pandemic, changes in smoking before and after the COVID-19 pandemic, subjective health, concern about economic loss due to the COVID-19 pandemic, changes in sleeping hours due to the COVID-19 pandemic, economic activity, and the number of people you can ask for help in a disaster situation such as COVID-19 infection.

Conclusion

It is necessary to identify the high-risk group for diabetes and depression at an early stage, while considering multiple risk factors, and to seek a personalized psychological support system at the primary medical level, which can improve their mental health.

Differential Factors Are Associated with Physical Activity in Older Adults in Brazil with and without Non-Communicable Chronic Diseases: A Cross-Sectional Analysis of the 2019 National Health Survey

This study analyzed whether sociodemographic factors, health perception, dietary habits, and screen time are related to physical activity (PA) in older people with and without non-communicable chronic diseases (NCDs). This cross-sectional study analyzed data from the 2019 Brazilian National Health Survey; the sample was older adults (≥60 years old; n = 22,726). The outcome of this study was being physically active or inactive during leisure time, and NCD was used as a moderating variable. The correlates investigated were sociodemographic and health-related variables. According to the logistic regression analysis, it was observed that being male had an association only in the group with NCDs (OR = 1.25 (1.05-1.48)), as well as residing in the northeastern region (OR = 1.26 (1.04-1.53)). On the other hand, high levels of education (OR = 4.09 (2.92-5.2); OR = 1.92 (1.48-2.49)) and income (OR = 1.64 (1.09-2.48); OR = 1.86 (1.33-2.60)) were associated with PA in both groups, as well as dietary habits (OR = 1.03 (1.01-1.05); (OR = 1.05 (1.04-1.07)). Advanced age (OR = 0.96 (0.94-0.97); OR = 0.97 (0.96-0.98)) and reporting a regular health perception (OR = 0.53 (0.43-0.66); OR = 0.61 (0.52-0.73)) were factors associated with physical inactivity in both groups. Gender, education, and income were unequally associated with an active lifestyle in both groups, and therefore, barriers to PA may arise.

Association between pregnancy termination history and metabolic syndrome in southwestern Chinese women: modification effect of physical activity

STUDY QUESTION

Is there a relationship between pregnancy termination history and metabolic syndrome (MetS), and if so, is the relationship moderated by physical activity (PA)?

SUMMARY ANSWER

Induced abortion, and both miscarriage and induced abortion, increased the risk of MetS, while leisure PA attenuated the effects of induced abortion, and both miscarriage and induced abortion, on the risk of MetS.

WHAT IS KNOWN ALREADY

Pregnancy termination history is a risk factor for cardiovascular disease, but studies on women's history of pregnancy termination and MetS are limited. PA is a preventive behavior for MetS, but its modification effect on any association between pregnancy termination history and MetS is unknown.

STUDY DESIGN, SIZE, DURATION

The cross-sectional study included 53 702 women (age range of 30-79 years old) from southwestern China who participated in the China Multi-Ethnic Cohort (CMEC) study from May 2018 to September 2019.

PARTICIPANTS/MATERIALS, SETTING, METHODS

Participants self-reported both the number and type of pregnancy termination. PA was assessed primarily by asking participants about the cumulative time they spent doing PA either as their occupation, transportation, housework, and leisure activity in the past year. MetS was defined according to the National Cholesterol Education Program Adult Treatment Panel III (ATP III) criteria.

MAIN RESULTS AND THE ROLE OF CHANCE

After adjusting for all confounders, the risk of MetS was significantly increased in women who experienced induced abortion alone, and both miscarriage and induced abortion, with odds ratios (ORs) of 1.08 (95% CI = 1.03-1.13) and 1.20 (95% CI = 1.08-1.33), respectively. A dose-response relationship was observed between the number of induced abortions and MetS, with the risk increasing by 3.0% for every additional induced abortion (OR = 1.03, 95% CI = 1.01-1.05). Leisure PA had a significant modification effect on the relationship between pregnancy termination history and MetS, as leisure PA attenuates the negative effects of induced abortion on MetS.

LIMITATIONS, REASONS FOR CAUTION

Causality cannot be established in this study. Information on pregnancy termination and PA was collected by self-report, which might be subject to recall bias.

WIDER IMPLICATIONS OF THE FINDINGS

A history of induced abortion was associated with an increased risk of MetS, and the risk increased with the number of induced abortions. Leisure PA attenuated the negative effect of induced abortion on MetS, whereas occupational and transportation PA amplified the negative effect of induced abortion on glucose.

STUDY FUNDING/COMPETING INTEREST(S)

This work was supported by the National Key R&D Program of China (grant no.: 2017YFC0907300) and the National Nature Science Foundation of China (grant no.: 82273745). The authors declare no conflicts of interest.

TRIAL REGISTRATION NUMBER

N/A.

Geriatric depression: prevalence and its associated factors in rural Odisha

The world's population is aging rapidly, and the epidemiological transition has led to increased mental disorders worldwide. Geriatric depression is masked by multiple comorbidities or the natural process of aging. Our study aims to estimate the prevalence of geriatric depression and find the risk factors associated with geriatric depression in rural Odisha. The study was a multistage cross-sectional study conducted in the Tangi block, district Khordha, Odisha, from August 2020 to September 2022, among 520 participants selected by probability proportional to size sampling. From the selected participants, eligible 479 older adults were interviewed using a semi-structured interview schedule, Hindi Mini Mental Scale, Geriatric Depression Scale-15, and Hamilton Depression Rating Scale. The step forward multivariable logistic regression was used to assess the associated factors of depression among older adults. Among our participants, 44.4% (213) of older adults were depressed. Substance abuse in family members [AOR: 16.7 (9.1-30.9)], history of elder abuse [AOR: 3.7 (2.1-6.7)], physical dependency [AOR: 2.2 (1.3-3.6)], and financial dependency [AOR: 2.2 (1.3-3.6)] are significant independent risk factors associated with geriatric depression. Living with children [AOR: 0.33 (0.18-0.59)] and recreational activity [AOR: 0.54 (0.34-0.85)] are significant protective factors of geriatric depression. Our study found that geriatric depression is highly prevalent in rural Odisha. Poor quality of family life and physical and financial dependency was found to be the most significant risk factor for geriatric depression.

The relationship between physical activity and depressive symptoms is domain-specific, age-dependent, and non-linear: An analysis of the Brazilian national health survey

Although there is consistent evidence of the beneficial effects of leisure physical activity (PA) on mental health, the role of PA in the domestic, transport, and occupational domains is inconclusive. This study aimed to analyze the relationship between domain-specific PA and depressive symptoms and examine whether the association is moderated by age in a representative sample of the Brazilian population. Cross-sectional data of 89,923 (52.4% female) individuals aged ≥15 years were analyzed. Depressive symptoms were assessed using the Patient Health Questionnaire-9. Physical activity (min/week) performed in different domains (domestic, transport, occupation, and leisure) was self-reported. Generalized additive models with penalized splines were used to explore associations. Lower leisure-time PA and higher levels of PA in the domestic, occupational, and transport domains at distinct PA thresholds were associated with higher depressive symptoms. Leisure PA, even at lower levels, was associated with lower depressive symptoms compared to no PA at all. The increase in depressive symptoms as a function of occupational PA was observed only at PA levels higher than 40 h/week. Although non-leisure PA levels were related to higher depressive symptoms among the total sample, higher domestic and transport PA levels were related to lower depressive symptoms among older adults. This study provides insights into the non-linearity and age-group dependence of the relationship between domain-specific PA and depressive symptoms in a middle-income country. The evidence suggests that care should be taken on recommending PA regardless of context or domain.

A Matter of Health? A 24-Week Daily and Weekly Diary Study on Workplace Bullying Perpetrators' Psychological and Physical Health

Workplace bullying (WB) studies focusing on perpetrators are increasing. Many processes, events, circumstances and individual states are being studied to understand and inhibit what causes some employees to become perpetrators. Using a 24-week diary design and drawing on the Conservation of Resources Theory, we investigated how sleep, physical activity (PA), and being bullied predicted perpetration on a within-level. On a between-level, we controlled for a supervisory position, psychological distress and mental illnesses over 38 employees from Spain and Turkey. Their average age was 38.84 years (SD = 11.75). They were from diverse sectors (15.8% in manufacturing, 15.8% in education, 13.2% in wholesale and retail trade, 13.2% in information and communication, 7.9% in health, 7.9% in other services and 26.3% from other sectors) with diverse professions such as finance manager, psychologist, graphic designer, academic, human resources professional, forensic doctor, IT and Administration head, municipality admin executive, waiter, and sales executives. Data collection was conducted over 24 consecutive work weeks, where only 31 participants were involved in perpetration (final observations = 720). We analyzed the data using multilevel structural equation modeling decomposed into within-and-between-person variance parts. The results indicated that on a within-level, PA as steps taken during the work week and being bullied positively predicted perpetration the same week, while sleep quality did not. By connecting sleep, physical exercise and WB literature, we draw attention to the health condition of perpetrators. Organizations should actively inhibit workplace bullying and be mindful of employees' physical activities at work or commuting to work. Managers should also be attentive to physical fatigue that employees may feel due to their responsibilities in their private lives and allow employees to rest and recuperate to inhibit negative behaviors at work.

Association of domain-specific physical activity with depressive symptoms: A population-based study

BACKGROUND

It remains unclear whether all physical activity (PA) domains (e.g., occupation-related PA [OPA], transportation-related PA [TPA], and leisure-time PA [LTPA]) have equivalent beneficial relationships. We aimed to investigate the associations of OPA, TPA, and LTPA with depressive symptoms in adults.

METHODS

We included and analyzed 31,221 participants (aged ≥18 years) from the cross-sectional 2007-2018 U.S. National Health and Nutrition Examination Survey (NHANES). The PA domains were assessed by a self-report questionnaire and categorized based on the PA guidelines. Depressive symptoms were measured by the nine-item Patient Health Questionnaire.

RESULTS

Participants achieving PA guidelines (≥150 min/week) were 26% (odds ratio [OR] 0.74, 95% confidence interval [CI] 0.68-0.80) and 43% (OR 0.57, 95% CI 0.51-0.62) less likely to have depressive symptoms depending on total PA and LTPA, respectively, while OPA or TPA did not demonstrate lower risks of depressive symptoms. LTPA at levels of 1-149, 150-299, and ≥300 min/week was associated with 31% (OR 0.69, 95% CI 0.60-0.78), 43% (OR 0.57, 95% CI 0.49-0.67), and 51% (OR 0.49, 95% CI 0.43-0.55) lower odds of depressive symptoms, respectively.

CONCLUSION

LTPA, but not OPA or TPA, was associated with a lower risk of depressive symptoms at any amount, suggesting that significant mental health would benefit from increased PA, even at levels below the recommendation.

The moderating effect of physical activity on the association between screen-based behaviors and chronic diseases

We analyzed the associations of screen-based behaviors with obesity, hypertension, and diabetes, and the moderation of different physical activity (PA) domains in these associations. We used data from the 2019 Brazilian National Health Survey, including data from 80,940 adults (mean age of 32.6 years). TV viewing, other screens (PC, tablet, and cell phone), PA domains (leisure-time, occupational, and transport) were collected via interview. Logistic regression models were used. There was a dose–response association of higher TV viewing with diabetes. Within the groups with medium and higher time spent on other screens, those with < 150 min/week in leisure-time PA increased the odds for obesity [1–2.9 h/day: OR = 1.18 (1.01, 1.39)] and hypertension [1–2.9 h/day: OR = 1.29 (1.08, 1.53); ≥ 6 h/day: OR = 1.47 (1.03, 2.09)]. Likewise, among the participants who spent ≥ 6 h/day of TV viewing, those with < 150 min/week of occupational PA presented higher odds for hypertension [OR = 1.61 (1.03, 2.53)]. In the group with higher use of other screens, < 150 min per week of occupational PA was associated with lower odds for obesity [1–2.9 h/day: OR = 0.81 (0.68, 0.97)] and hypertension [≥ 6 h/day: OR = 0.65 (0.44, 0.98)]. In conclusion, the associations of other screens with obesity and hypertension were strongest among those without leisure-time PA, while the moderator role of occupational PA was not clear.

Associations Between Consumption of Different Vegetable Types and Depressive Symptoms in Japanese Workers: A Cross-Sectional Study

Purpose

Vegetable intake is an important part of our everyday diet and is associated with many positive health outcomes. Although previous studies have investigated the association between vegetable consumption and depressive symptoms among various populations, no study has examined this association in the adult working population. The present study investigated whether the frequency of consumption of a specific type of vegetable is associated with the prevalence of depressive symptoms in Japanese adult workers.

Participants and Methods

The final participants consisted of 1724 Japanese adults, and a cross-sectional study was conducted to analyze the results. The frequency of vegetable consumption and depressive symptoms was evaluated using a brief-type self-administered diet history questionnaire and the Zung Self-Rating Depression Scale (SDS), respectively. The association between the variables was examined using Poisson regression analysis. Age-stratified analysis was performed, and SDS cut-off values of 45 and 50 were used to perform a sensitivity analysis.

Results

After adjustment for covariates, including age, body mass index, sociodemographic and lifestyle-related variables, health condition, C-reactive protein, and other dietary variables, an inverse association was found between tomato product consumption and the prevalence of depressive symptoms among men (P for trend <0.01); however, no significant association was found for other vegetable types. For women, there was no association between the frequency of consumption of any of the vegetable types and the prevalence of depressive symptoms. The results were confirmed by the age-stratified analysis for both genders.

Conclusion

Consumption of tomato products may help alleviate depressive symptoms, regardless of differences in dietary culture among men.

Does stressful workplace characteristics moderate or confound the association between occupational physical activity and elevated depressive symptoms? A large study including 36,442 adults

BACKGROUND

We tested whether stressful workplace characteristics confound or moderate the association between occupational physical activity and depressive symptoms.

METHOD

We used data of 36,442 employed adults (16,992 women), with a mean age of 39.3 ± 12.6y, from the 2013 Brazilian National Health Survey. Depressive symptoms were assessed through the Patient Health Questionnaire-9 (cut-point: ≥10). Occupational physical activity was self-reported and classified using the cut-point of 150 min/week and the highest quintile. Ten stressful workplace characteristics (e.g. exposure to stress, noise, violence) were also self-reported dichotomously. Logistic regression models were used considering the adjustment for potential confounders.

RESULTS

Most of the stressful workplace characteristics were associated with elevated depressive symptoms (8/10 characteristics) and higher occupational physical activity (9/10 characteristics). Although there were no interactions in combined associations, we found that the association between occupational physical activity and depressive symptoms consistently reduced after adjusting for the cluster of positive screening for at least two stressful workplace characteristics in men [highest quintile: OR_unadjusted: 1.63 (95%CI 1.22-2.17) vs OR_adjusted: 1.36 (1.08-1.91); ≥150 min/week: OR_unadjusted: 1.43 (1.09-1.88) vs OR_adjusted: 1.25 (0.95-1.64)], and women [highest quintile: OR_unadjusted: 2.15 1.73-2.66) vs OR_adjusted: 1.83 (1.47-2.29); ≥150 min/week: OR_unadjusted: 2.11 (1.68-2.65) vs OR_adjusted: 1.80 (1.42-2.27)].

LIMITATIONS

The cross-sectional design limits the causal inference.

CONCLUSIONS

Stressful workplace characteristics did not moderate, but acted as confounders in the association between occupational physical activity and elevated depressive symptoms and should be considered in future studies.

Developing a Predictive Model for Depressive Disorders Using Stacking Ensemble and Naive Bayesian Nomogram: Using Samples Representing South Korea

This study provided baseline data for preventing depression in female older adults living alone by understanding the degree of their depressive disorders and factors affecting these depressive disorders by analyzing epidemiological survey data representing South Koreans. To achieve the study objective, this study explored the main risk factors of depressive disorders using the stacking ensemble machine technique. Moreover, this study developed a nomogram that could help primary physicians easily interpret high-risk groups of depressive disorders in primary care settings based on the major predictors derived from machine learning. This study analyzed 582 female older adults (≥60 years old) living alone. The depressive disorder, a target variable, was measured using the Korean version of Patient Health Questionnaire-9. This study developed five single predictive models (GBM, Random Forest, Adaboost, SVM, XGBoost) and six stacking ensemble models (GBM + Bayesian regression, RandomForest + Bayesian regression, Adaboost + Bayesian regression, SVM + Bayesian regression, XGBoost + Bayesian regression, GBM + RandomForest + Adaboost + SVM + XGBoost + Bayesian regression) to predict depressive disorders. The naive Bayesian nomogram confirmed that stress perception, subjective health, n-6 fatty acid, n-3 fatty acid, mean hours of sitting per day, and mean daily sleep hours were six major variables related to the depressive disorders of female older adults living alone. Based on the results of this study, it is required to evaluate the multiple risk factors for depression including various measurable factors such as social support.

Is all activity equal? Associations between different domains of physical activity and depressive symptom severity among 261,121 European adults

BACKGROUND

Physical activity is often associated with better mental health. However, there is evidence that the domain of physical activity influences the strength and direction of this association. Therefore, this study aimed to examine the associations between different domains of physical activity and depression among a large sample of adults living in the European Union.

METHODS

Cross-sectional analyses were conducted on 261,121 adults, recruited in the European Health Interview Survey (wave 2). Validated items were used to assess physical activity domains (i.e., work-related, transport-related, leisure-time aerobic, and muscle-strengthening) and depression symptom severity (8-item personal health questionnaire). Generalized linear models with Poisson regressions provided adjusted prevalence ratios (APR) of depressive symptom severity categories across the physical activity domains.

RESULTS

Compared to doing no physical activity, any physical effort at work (APR: 0.82-0.86), moderate, high, and very high levels of transport-related (APR: 0.69-0.83) and aerobic leisure-time activity (APR: 0.78-0.87), and 3 days/week of muscle-strengthening (APR: 0.93) were associated with a lower prevalence of mild depressive symptom severity. Moreover, doing any level of physical activity in any domain was mostly associated with a lower prevalence of moderate (APR: 0.43-0.80), moderate-severe (APR: 0.34-0.82), and severe (APR: 0.26-0.56) depressive symptoms.

CONCLUSION

Favorable associations were seen between any domain (leisure-time, transport- and work-related) of physical activity and depressive symptom severity. The more severe the symptoms, the stronger the associations. Both modalities of leisure-time physical activity (aerobic and muscle-strengthening) demonstrated beneficial associations with depression, but slightly more so for aerobic physical activity.

Cross-sectional associations of leisure and transport related physical activity with depression and anxiety

BACKGROUND

Previous evidence supports the notion that the physical activity (PA) domain (leisure-time or transport), and the amount of time spent in PA, influence the association of PA with depressive and anxiety symptoms. However, no study evaluated the associations of different volumes of leisure-time PA (LTPA) and transport PA (TPA) with prevalent depression, anxiety, and co-occurring depression and anxiety (D&A) disorders.

AIM

To investigate the associations between different volumes of LTPA and TPA with prevalent depression, anxiety, and D&A.

METHODS

Cross-sectional study using baseline data of the ELSA-Brasil cohort. The International Physical Activity Questionnaire (IPAQ) long-form was used to assess PA levels in each domain. The Clinical Interview Scheduled Revised (CIS-R) was used to diagnose prevalent depressive, anxiety, and D&A disorders. Logistic regressions, adjusting for confounding factors, were employed. Results are expressed as adjusted odds ratios (aOR) and 95% confidence intervals (CI).

RESULTS

A total of 14,381 adults (54.5% female, 67.5% aged 45-64 years) were assessed. T^{ime spent in LTPA was associated with a lower prevalence of depression in low, and high volumes (}60-89min/week^{aOR = 0.47, 95%CI = 0.29-0.76, p = 0.002,} >300min/week^{aOR = 0.43, 95%CI = 0.31-0.59,} p < 0.001). High volumes of LTPA were associated with a lower prevalence ^{D&A (}270-299min/week^{aOR = 0.55, 95%CI 0.38-0.79, p = 0.001}; >300 minutes^{aOR = 0.63, 95%CI 0.54-0.74, p < 0.001). Low (}60-89min/week^{aOR = 0.56,95%CI = 0.40-0.79, p = 0.001)} volumes of TPA were associated with lower prevalence of depression.

LIMITATIONS

Cross-sectional design and self-reported PA. Lack of assessment of sedentary behaviour or occupational PA.

CONCLUSIONS

The present study highlights the importance of contextual factors in the association between PA and mental health, particularly at higher levels.

Prospective associations of different contexts of physical activity with psychological distress and well-being among middle-aged adults: An analysis of the 1970 British Cohort Study

BACKGROUND

Our aim was to investigate whether different types and social contexts of physical activity (PA) participation are prospectively associated with psychological distress and well-being among middle-aged adults.

METHODS

Data from the 1970 British Cohort Study was used (N = 5144-2733 women). At age 42y, participants reported their type of leisure-time PA, which was classified as individual PA or group PA (exposure). At age 46y, participants reported co-primary outcomes: psychological distress (Malaise Inventory) and well-being (Warwick-Edinburgh scale). Highest academic achievement, employment status, country of interview, baseline values of psychological distress and well-being, smoking, alcohol use, TV-viewing and total physical activity at 42y were used as covariates. Main analyses included linear regression stratifying by sex.

RESULTS

Jogging, cross-country, road-running (both sexes) as well as team sports (men) were associated with higher well-being. Health, fitness, gym or conditioning activities and jogging, cross-country (women), road-running (women) and team sports (men) were associated with lower psychological distress. Participation in both individual and group PA were associated with lower psychological distress and higher well-being for both sexes in crude models. However, adjusted models revealed that only group PA was associated with lower psychological distress (B: -0.106; 95%CI: -0.188 to -0.025) and higher well-being (0.835; 0.050 to 1.619) among men but not women. In the sensitivity analysis, group PA was associated with higher well-being (0.855; 0.094 to 1.616) when compared with individual PA among men. Group PA was not associated with psychological distress among both sexes and well-being among women when compared with individual PA.

CONCLUSION

Group PA was prospectively associated with lower psychological distress and higher well-being among men but not females. Future PA interventions could focus on group activities for males. Further research to understand the relationship between individual/group PA and mental health is required in females.

Development of a Nomogram for Predicting Depression in the Elderly Using Patient Health Questionnaire-9 among a Nationwide Sample of Korean Elderly

This cross-sectional study developed a nomogram that could allow medical professionals in the primary care setting to easily and visually confirm high-risk groups of depression. This study analyzed 4011 elderly people (≥60 years old) who completed a health survey, blood pressure, physical measurement, blood test, and a standardized depression screening test. A major depressive disorder was measured using the Korean version of the Patient Health Questionnaire (PHQ-9). This study built a model for predicting major depressive disorders using logistic regression analysis to understand the relationship of each variable with major depressive disorders. In the result, the prevalence of depression measured by PHQ-9 was 6.8%. The results of multiple logistic regression analysis revealed that the major depressive disorder of the elderly living alone was significantly (p < 0.05) related to monthly mean household income, the mean frequency of having breakfast per week for the past year, moderate-intensity physical activity, subjective level of stress awareness, and subjective health status. The results of this study implied that it would be necessary to continuously monitor these complex risk factors such as household income, skipping breakfast, moderate-intensity physical activity, subjective stress, and subjective health status to prevent depression among older adults living in the community.

Physical Exercise Behaviors and Depressive Symptoms Among Elderly Chinese Women: Focus on Exercise Components

Purpose

Several studies have investigated the association between physical exercise and depressive symptoms in the elderly population. However, the relationship between components of physical exercise such as frequency, intensity, duration, and depressive symptoms remains unclear. This study was conducted on elderly Chinese women to investigate the association between each component of physical exercise and depressive symptoms and to examine the association between physical exercise patterns and depressive symptoms.

Patients and Methods

A total of 1429 Chinese women aged ≥60 years were enrolled in this cross-sectional study and provided information on their exercise behaviors through a self-reported questionnaire. Depressive symptoms were assessed using the Zung Self-Rating Depression Scale. Multiple logistic regression analysis was used to estimate adjusted odds ratios (ORs) to measure the association between exercise behaviors and depression.

Results

High frequency, moderate intensity, long duration, and exercise habits were significantly associated with lower levels of depressive symptoms. Furthermore, participants with more than one optimal exercise behavior were more likely to have a lower risk of depressive symptoms. These associations were not changed after adjustment for confounding factors.

Conclusion

This study shows that exercise behaviors were significantly associated with the risk of developing depression. This finding suggests that keeping an optimal exercise behavior may be associated with a lower risk of depressive symptoms in elderly Chinese women.

Associations of Sociodemographic Factors and Health Behaviors with the Emotional Well-Being of Adolescents during the COVID-19 Pandemic in Brazil

This cross-sectional study utilizes data from a nationwide web-based survey aimed to identify the factors affecting the emotional well-being of Brazilian adolescents aged 12–17 during the period of school closures and confinement. Data collection took place from 27 June to 17 September 2020. We used the “virtual snowball” sampling method, and students from private and public schools were included. A total of 9470 adolescents were analyzed. A hierarchical logistic regression model was used to find the factors associated with reporting at least two of three self-reported problems—sadness, irritability, and sleep problems. The main proximal factor was loneliness (AdjOR = 8.12 p < 0.001). Problems related to school closures also played an important role. Regular intake of fruits and vegetables, as well as physical activity, demonstrated a positive influence on emotional well-being, while excessive screen time (AdjOR = 2.05, p < 0.001) and alcohol consumption negatively affected outcomes (AdjOR = 1.73, p < 0.001). As for distal variables, less affluent adolescents were the most affected, and males reported fewer emotional problems than females. Uncertainty regarding the disease in a context of socioeconomic vulnerability, together with rises in unhealthy behaviors and isolation from their immediate social circles, have negatively affected adolescents’ emotional status throughout the COVID-19 pandemic.

Factors affecting Brazilians' self-rated health during the COVID-19 pandemic

This is a cross-sectional study investigating the factors affecting brazilians' self-rated health during the COVID-19 pandemic, based on data from the web-based behavior survey. Carried out from April 24 to May 24, 2020, the survey recruited participants by a chain sampling procedure. Its outcome was the worsening of self-rated health during the pandemic. Statistical analysis was based on a hierarchical model of determination. Logistic regression models were used to test the associations between sociodemographic characteristics, pre-existing health conditions, lifestyle indicators and intensity of social restraint measures, and biological and psychological issues during the pandemic. From the total sample of 45,161 participants, 29.4% reported worsening of health state during this period. After adjusting for hierarchical distal factors, the health problems mostly associated with worsening health state were: bad self-rated health (adjusted OR = 4.35, p < 0.001), health care seeking for mental health problem (adjusted OR = 3.95, p < 0.001), and for COVID-19 (adjusted OR = 3.60, p < 0.001). People who experienced sleep problems, worsening of back pain, depression and at least one flu symptom during the pandemic were twice as likely to report worsening of health status. Sedentary and eating behaviors and adherence to social distancing measures showed significant correlation with the outcome. There exists a relation between social, biological, and psychological factors, mediated by lifestyles and variables pertaining to confinement. Altogether, these factors have negatively affected self-rated health during the COVID-19 pandemic in Brazil.

Leisure-time exercise is associated with lower depressive symptoms in community dwelling adults

Physical activity has been associated with enhanced mental health among adults. However, it is not clear in the literature which domains (occupational, transport and leisure-time exercise) and intensities (moderate, vigorous and moderate-to-vigorous) of activity provide the greatest benefits. The aim of the present study was to describe the association of different domains and intensities of physical activity with depressive symptoms in adults. This was a cross-sectional observational study conducted among 209 adults (≥18 years) in Brazil. Depressive symptoms were assessed using the HADS questionnaire (Hospital Anxiety and Depression Scale). Physical activity intensities (moderate, vigorous and moderate-to-vigorous) were device-measured by accelerometry. Physical activity in different domains (occupational, transport, and leisure-time exercise) was self-reported using a questionnaire. Chronological age, ethnicity, body mass index, highest academic achievement, employment status, alcohol consumption, tobacco smoking, chronic morbidity and soft-drink ingestion were adopted as adjustment confounding factors. Linear regression analysis revealed that total self-reported physical activity [β = -0.100 (95%CI: -0.180 to -0.019)] and leisure-time exercise [β = -0.311 (95%CI: -0.468 to -0.155)] were negatively associated with depressive symptoms, but only leisure-time exercise remained significant after adjustment for confounding factors [β = -0.243 (95%CI: -0.409 to -0.076)]. Thus, leisure-time exercise was cross-sectionally associated with lower depressive symptoms in community-dwelling adults.Highlights Leisure-time physical activity was the only physical activity domain associated with lower depressive symptoms.This association appears to be independent of potential confounders.Potential interventions should focus on leisure-time domain.

Association between different contexts of physical activity and anxiety-induced sleep disturbance among 100,648 Brazilian adolescents: Brazilian school-based health survey

Physical activity (PA) practice can be a protective factor for anxiety-induced sleep disturbance (AISD), however the association between different contexts of PA and anxiety-induced sleep disturbance is not clear. We aimed to analyze the association between different contexts of PA and AISD. Data from the Brazilian School-based Health Survey [n=100,648; age: 14.3y (range:11-18 years)], conducted in 2015, were used. Higher PA during transport was associated with higher AISD. PA during physical education classes presented lower odds for AISD. PA practiced outside school was associated with reduced AISD among boys. The association between PA and AISD seems to be context-dependent.