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身体活动与焦虑症状和状况的关联:来自爱尔兰老龄化纵向研究的结果。

Associations of physical activity with anxiety symptoms and status: results from The Irish longitudinal study on ageing.

机构信息

Department of Physical Education and Sport Sciences,University of Limerick,Limerick,Ireland.

出版信息

Epidemiol Psychiatr Sci. 2019 Aug;28(4):436-445. doi: 10.1017/S204579601800001X. Epub 2018 Jan 31.

Abstract

AIMS

Anxiety is debilitating and associated with numerous mental and physical comorbidities. There is a need to identify and investigate low-risk prevention and treatment strategies. Therefore, the purpose of this study was to investigate cross-sectional and longitudinal associations between different volumes of moderate-to-vigorous physical activity (PA) and anxiety symptoms and status among older adults in Ireland.

METHODS

Participants (n = 4175; 56.8% female) aged ⩾50 years completed the International PA Questionnaire (IPAQ) at baseline, and the anxiety subscale of the Hospital Anxiety and Depression Scale at baseline and follow-up (2009-2013). Participants were classified according to meeting World Health Organisation PA guidelines, and divided into IPAQ categories. Respondents without anxiety at baseline (n = 3165) were included in prospective analyses. Data were analysed in 2017.

RESULTS

Anxiety symptoms were significantly higher among females than males (p < 0.001). Models were adjusted for age, sex, waist circumference, social class, smoking status and pain. In cross-sectional analyses, meeting PA guidelines was associated with 9.3% (OR = 0.91, 95% confidence interval 0.78-1.06) lower odds of anxiety. Compared with the inactive group, the minimally- and very-active groups were associated with 8.4% (OR = 0.92, 0.76-1.10) and 18.8% (OR = 0.81, 0.67-0.98) lower odds of anxiety, respectively. In prospective analyses, meeting guidelines was associated with 6.3% (OR = 0.94, 0.63-1.40) reduced odds of anxiety. Compared with the inactive group, the minimally and very-active groups were associated with 43.5% (OR = 1.44, 0.89-2.32) increased, and 4.3% (OR = 0.96, 0.56-1.63) reduced odds of anxiety. The presence of pain, included in models as a covariate, was associated with a 108.7% (OR = 2.09, 1.80-2.42) increase in odds of prevalent anxiety, and a 109.7% (OR = 2.10, 1.41-3.11) increase in odds of incident anxiety.

CONCLUSION

High volumes of PA are cross-sectionally associated with lower anxiety symptoms and status, with a potential dose-response apparent. However, significant associations were not observed in prospective analyses. The low absolute number of incident anxiety cases (n = 109) potentially influenced these findings. Further, as older adults may tend to experience and/or report more somatic anxiety symptoms, and the HADS focuses primarily on cognitive symptoms, it is plausible that the HADS was not an optimal measure of anxiety symptoms in the current population.

摘要

目的

焦虑会使人虚弱,并与许多精神和身体的合并症相关。因此,有必要确定和研究低风险的预防和治疗策略。因此,本研究的目的是调查爱尔兰老年人中不同数量的中等至剧烈体力活动(PA)与焦虑症状和状况之间的横断面和纵向关联。

方法

年龄 ⩾50 岁的参与者(n=4175;56.8%为女性)在基线时完成了国际 PA 问卷(IPAQ),并在基线和随访(2009-2013 年)时完成了医院焦虑和抑郁量表的焦虑子量表。根据世界卫生组织 PA 指南,参与者被分为符合标准和不符合标准两组,并分为 IPAQ 类别。基线时无焦虑的受访者(n=3165)被纳入前瞻性分析。数据于 2017 年进行分析。

结果

女性的焦虑症状明显高于男性(p<0.001)。模型调整了年龄、性别、腰围、社会阶层、吸烟状况和疼痛。在横断面分析中,符合 PA 指南与焦虑的可能性降低 9.3%(OR=0.91,95%置信区间 0.78-1.06)相关。与不活动组相比,轻度活动组和非常活跃组的焦虑可能性分别降低 8.4%(OR=0.92,0.76-1.10)和 18.8%(OR=0.81,0.67-0.98)。在前瞻性分析中,符合指南与焦虑可能性降低 6.3%(OR=0.94,0.63-1.40)相关。与不活动组相比,轻度活动组和非常活跃组的焦虑可能性分别增加 43.5%(OR=1.44,0.89-2.32)和 4.3%(OR=0.96,0.56-1.63)。疼痛被纳入模型作为协变量,与现患焦虑的可能性增加 108.7%(OR=2.09,1.80-2.42)和新发焦虑的可能性增加 109.7%(OR=2.10,1.41-3.11)相关。

结论

高水平的 PA 与焦虑症状和状况呈横断面相关,且可能存在剂量反应。然而,前瞻性分析中并未观察到显著的相关性。新出现的焦虑病例数量较少(n=109)可能影响了这些发现。此外,由于老年人可能更容易经历和/或报告更多的躯体焦虑症状,而 HADS 主要关注认知症状,因此在当前人群中,HADS 可能不是评估焦虑症状的最佳方法。

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