美国老年人中久坐行为和体力活动与抑郁症状的等时替代建模：2007-2016 年全国健康和营养调查。
Isotemporal substitution modeling on sedentary behaviors and physical activity with depressive symptoms among older adults in the U.S.: The national health and nutrition examination survey, 2007-2016.
机构信息
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 123 West Franklin Street, Suite 42, Chapel Hill, NC 27516, USA.
Department of Health Services Administration, School of Public Health, University of Maryland, College Park, MD, USA.
出版信息
J Affect Disord. 2019 Oct 1;257:257-262. doi: 10.1016/j.jad.2019.07.036. Epub 2019 Jul 5.
BACKGROUND
Late-life depression is a great burden of public health. Previous studies reported that physical activity is associated with reduced depressive symptoms among older adults, while the competing nature of physical activity and sedentary behaviors has been largely neglected in studies. We aimed to examine the associations of replacing sedentary behaviors with walking/bicycling or moderate-to-vigorous physical activity (MVPA) with depressive symptoms in older adults.
METHODS
A cross-sectional analysis was conducted among 8374 older adults (60 years or older) included in the National Health and Nutrition Examination Survey (NHANES), 2007-2016. The Global Physical Activity Questionnaire was used to measure self-reported time for sedentary behaviors, walking/bicycling, and MVPA. The 9-item Patient Health Questionnaire was used to measure depressive symptoms (including overall, somatic, and cognitive). Z-scores were created for depressive symptoms. Isotemporal substitution models using multivariable linear regression were applied to examine the associations of sedentary behaviors, walking/bicycling, and MVPA with z-scores of depressive symptoms.
RESULTS
Replacing 30 min/day sedentary behaviors with 30 min/day of MVPA (beta (β) = -0.10, 95% confidence interval (CI): -0.14, -0.06) or 30 min/day of walking/bicycling (β = -0.04, 95% CI: -0.06, -0.02) was associated with lower z-score for depressive symptoms. Replacing 30 min/day of walking/bicycling for 30 min/day of MVPA was associated with lower z-score for depressive symptoms (β = -0.06, 95% CI: -0.10, -0.02).
LIMITATIONS
A cross-sectional study design precludes causal inferences.
CONCLUSION
Replacing sedentary behaviors with walking/bicycling or MVPA is associated with lower depressive symptoms among older adults. Future research is expected to investigate the effectiveness of physical activity on prevention and treatment of late-life depression.
背景
晚年抑郁症是公共卫生的一大负担。先前的研究报告称，身体活动与老年人抑郁症状的减轻有关，而身体活动与久坐行为之间的竞争性质在研究中被大大忽视。我们旨在研究用步行/骑自行车或中等到剧烈的身体活动（MVPA）替代久坐行为与老年人抑郁症状之间的关系。
方法
对纳入国家健康和营养检查调查（NHANES）2007-2016 年的 8374 名老年人（60 岁或以上）进行了横断面分析。使用全球体力活动问卷来测量自我报告的久坐行为、步行/骑自行车和 MVPA 的时间。使用 9 项患者健康问卷来测量抑郁症状（包括总体、躯体和认知）。抑郁症状的 Z 分数是创建的。使用多变量线性回归的等时替代模型来检查久坐行为、步行/骑自行车和 MVPA 与抑郁症状 Z 分数之间的关系。
结果
用 30 分钟/天的 MVPA（β（β）= -0.10，95%置信区间（CI）：-0.14，-0.06）或 30 分钟/天的步行/骑自行车（β= -0.04，95%CI：-0.06，-0.02）替代 30 分钟/天的久坐行为与抑郁症状的 Z 分数较低有关。用 30 分钟/天的步行/骑自行车替代 30 分钟/天的 MVPA 与抑郁症状的 Z 分数较低有关（β= -0.06，95%CI：-0.10，-0.02）。
局限性
横断面研究设计排除了因果推论。
结论
用步行/骑自行车或 MVPA 替代久坐行为与老年人的抑郁症状较低有关。未来的研究预计将调查身体活动对预防和治疗晚年抑郁症的效果。
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