Dugan Sheila A, Bromberger Joyce T, Segawa Eisuke, Avery Elizabeth, Sternfeld Barbara
1Department of Preventive Medicine, Rush University Medical Center, Chicago, IL; 2Department of Physical Medicine and Rehabilitation, Rush University Medical Center, Chicago, IL; 3Departments of Epidemiology and Psychiatry, University of Pittsburgh, Pittsburgh, PA; and 4Department of Research Science, Kaiser Permanente, Oakland, CA.
Med Sci Sports Exerc. 2015 Feb;47(2):335-42. doi: 10.1249/MSS.0000000000000407.
The relation of physical activity (PA) and positive mood has been the focus of considerable research, which were primarily cross-sectional. This study was done to evaluate the relation between PA and high depressive symptoms across time and to examine whether being physically active attenuates the risk of depressive symptoms in midlife women.
The present study is a longitudinal observational study on the menopausal transition in a multiethnic population. Ten years of data on 2891 women were analyzed. The participants were women from seven geographic areas nationwide, age 42-52 yr at baseline, still menstruating, and not using exogenous reproductive hormones. PA was measured with the Kaiser Permanente Physical Activity Scale. The main outcome measure, depressive symptoms, was assessed with the Center for Epidemiological Studies Depression Scale (CES-D), with primary outcome of CES-D score of 16 or higher.
In mixed effect logistic regression models adjusted for covariates, compared with inactivity, PA meeting PA guidelines (approximating public health guidelines) and PA below PA guidelines were each associated with lower risk of high depressive symptoms (CES-D score of 16 or higher) (odds ratio, 0.52; 95% confidence interval, 0.40-0.70; and odds ratio, 0.81; 95% confidence interval, 0.67-0.98, respectively] across 10 yr. Being married, Japanese and Hispanic ethnicity, current smoking, reporting very upsetting life events, using antidepressive medications, having hot flashes, and high body mass index were all positively associated with high depressive symptoms, whereas high social support was negatively associated.
Higher PA was associated with lower levels of depressive symptoms persistently over 10 yr, independent of potential confounders. Our findings suggest that reaching moderate-intensity PA levels during midlife may be protective against depressive symptoms.
身体活动（PA）与积极情绪之间的关系一直是大量研究的焦点，这些研究主要是横断面研究。本研究旨在评估不同时间点PA与高抑郁症状之间的关系，并探讨进行身体活动是否能降低中年女性出现抑郁症状的风险。
本研究是一项针对多民族人群绝经过渡的纵向观察性研究。分析了2891名女性的十年数据。参与者是来自全国七个地理区域的女性，基线年龄为42 - 52岁，仍在月经，且未使用外源性生殖激素。PA通过凯撒医疗集团身体活动量表进行测量。主要结局指标抑郁症状采用流行病学研究中心抑郁量表（CES - D）进行评估，主要结局为CES - D得分16分及以上。
在调整协变量的混合效应逻辑回归模型中，与不活动相比，符合PA指南（接近公共卫生指南）的PA和低于PA指南的PA在10年期间均与高抑郁症状（CES - D得分16分及以上）的较低风险相关（比值比分别为0.52；95%置信区间为0.40 - 0.70；以及比值比为0.81；95%置信区间为0.67 - 0.98）。已婚、日本和西班牙裔种族、当前吸烟、报告有非常令人苦恼的生活事件、使用抗抑郁药物、有潮热症状以及高体重指数均与高抑郁症状呈正相关，而高社会支持与之呈负相关。
较高的PA与10年期间持续较低水平的抑郁症状相关，独立于潜在混杂因素。我们的研究结果表明，中年时期达到中等强度的PA水平可能对抑郁症状具有预防作用。
