久坐行为与抑郁的关系：在中低收入国家 42469 人中跨越生命周期的影响因素的中介分析。

Relationship between sedentary behavior and depression: A mediation analysis of influential factors across the lifespan among 42,469 people in low- and middle-income countries.

机构信息

Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London Box SE5 8AF, United Kingdom; Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, United Kingdom.

KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven, University Psychiatric Center KU Leuven, Leuven-Kortenberg, Belgium.

出版信息

J Affect Disord. 2018 Mar 15;229:231-238. doi: 10.1016/j.jad.2017.12.104. Epub 2018 Jan 3.

DOI:10.1016/j.jad.2017.12.104

PMID:29329054

Abstract

BACKGROUND

Sedentary behavior (SB) is associated with diabetes, cardiovascular disease and low mood. There is a paucity of multi-national research investigating SB and depression, particularly among low- and middle-income countries. This study investigated the association between SB and depression, and factors which influence this.

METHODS

Cross-sectional data were analyzed from the World Health Organization's Study on Global Ageing and Adult Health. Depression was based on the Composite International Diagnostic Interview. The association between depression and SB (self-report) was estimated by multivariable linear and logistic regression analyses. Mediation analysis was used to identify influential factors.

RESULTS

A total of 42,469 individuals (50.1% female, mean 43.8 years) were included. People with depression spent 25.6 (95%CI8.5-42.7) more daily minutes in SB than non-depressed participants. This discrepancy was most notable in adults aged ≥ 65y (35.6min more in those with depression). Overall, adjusting for socio-demographics and country, depression was associated with a 1.94 (95%CI1.31-2.85) times higher odds for high SB (i.e., ≥ 8h/day). The largest proportion of the SB-depression relationship was explained by mobility limitations (49.9%), followed by impairments in sleep/energy (43.4%), pain/discomfort (31.1%), anxiety (30.0%), disability (25.6%), cognition (16.1%), and problems with vision (11.0%). Other health behaviors (physical activity, alcohol consumption, smoking), body mass index, and social cohesion did not influence the SB-depression relationship.

CONCLUSION

People with depression are at increased risk of engaging in high levels of SB. This first multi-national study offers potentially valuable insight for a number of hypotheses which may influence this relationship, although testing with longitudinal studies is needed.

摘要

背景

久坐行为（SB）与糖尿病、心血管疾病和情绪低落有关。目前，很少有针对 SB 和抑郁的多国家研究，特别是在中低收入国家。本研究调查了 SB 与抑郁之间的关联，以及影响这种关联的因素。

方法

横断面数据来自世界卫生组织的全球老龄化和成人健康研究。抑郁基于综合国际诊断访谈。使用多变量线性和逻辑回归分析估计抑郁与 SB（自我报告）之间的关联。中介分析用于确定影响因素。

结果

共纳入 42469 人（50.1%为女性，平均年龄 43.8 岁）。抑郁患者每天比非抑郁患者多花 25.6（95%CI8.5-42.7）分钟进行 SB。在≥65 岁的成年人中，这种差异最为明显（抑郁患者多 35.6 分钟）。总体而言，调整社会人口统计学和国家因素后，抑郁与高 SB（即≥8 小时/天）的几率增加 1.94 倍（95%CI1.31-2.85）有关。SB-抑郁关系中最大比例可由行动能力受限（49.9%）解释，其次是睡眠/能量受损（43.4%）、疼痛/不适（31.1%）、焦虑（30.0%）、残疾（25.6%）、认知功能障碍（16.1%）和视力问题（11.0%）。其他健康行为（体力活动、饮酒、吸烟）、体质指数和社会凝聚力并不影响 SB-抑郁关系。