رابطه فعالیت بدنی و افسردگی
Abstract
1- Introduction
2- Methods
3- Results
4- Discussion
5- Conclusion
Acknowledgements
References
Abstract
Background: The level of physical activity (PA) and the prevalence of depression both change across the lifespan. We examined whether the association between PA and depression is moderated by age. As sense of mastery and functional limitations have been previously associated with low PA and depression in older adults, we also examined whether these are determinants of the differential effect of age on PA and depression. Methods: 1079 patients with major depressive disorder (aged 18–88 years) were followed-up after twoyears; depression diagnosis and severity as well as PA were re-assessed. Linear and logistic regression analyses were used to test reciprocal prospective associations between PA and depression outcomes. In all models the interaction with age was tested. Results: PA at baseline predicted remission of depressive disorder at follow-up (OR = 1.43 [95% CI: 1.07– 1.93], p = .018). This effect was not moderated by age. PA predicted improvement of depression symptom severity in younger (B = 2.03; SE = .88; p = .022), but not in older adults (B = 2.24; SE = 1.48; p = .128) (p = .015 for the interaction PA by age in the whole sample). The level of PA was relatively stable over time. Depression, sense of mastery and functional limitation were for all ages not associated with PA at follow-up. Conclusions: Age did not moderate the impact of PA on depressive disorder remission. Only in younger adults, sufficient PA independently predicts improvement of depressive symptom severity after twoyear follow-up. Level of PA rarely changed over time, and none of the determinants tested predicted change in PA, independent of age.
Introduction
Physical activity (PA) is an important and potentially modifiable determinant of healthy ageing with positive effects on healthrelated quality of life [1]. It is often assumed that depression increases with age, but current epidemiological studies point to a lower prevalence of depressive disorder at higher age, compared to younger age patients [2]. Population-based studies have provided strong evidence that PA decreases the risk for depressive symptoms in younger [3] as well as in older adults [4]. As the majority of studies rely on (self-report) depressive symptom scales, it remains unknown whether these findings can be extrapolated to patients experiencing depressive disorder according to DSM-criteria [5,6]. To our knowledge, four longitudinal observational studies on the amount of PA in clinically depressed patients have been conducted in three different samples [7–10]. Low PA as well as less sports activity predict unfavorable outcome of depression in depressed adults over time [7,10], with a reduction in the effect of low PA on depression outcome with increasing age up to 60 years [7]. In younger depressed adults, increasing levels of PA three weeks after admission was associated with decreasing levels of depressive symptoms [9]. Another sample of depressed patients aged 60 years and over, showed a lower level of PA during a depressive episode compared to their non-depressed counterparts [11].