Liu Xing-Yue, Peng Shu-Zhi, Pei Meng-Yun, Zhang Peng
Graduate School, Shanghai University of Medicine & Health Sciences, Shanghai 201318, China; Graduate School, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
Graduate School, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
J Affect Disord. 2023 May 1;328:153-162. doi: 10.1016/j.jad.2023.02.061. Epub 2023 Feb 17.
Women are more likely to experience depressive symptoms and poor quality of life (QoL) during perimenopause. The effectiveness of physical activity (PA) in perimenopause on mental well-being and health outcomes has been frequently reported. This study aimed to investigate the mediating effect of PA on the relationship between depression and QoL in Chinese perimenopausal women.
A cross-sectional study was performed, and participants were recruited through a multistage, stratified, probability proportional to size sampling method. Depression, PA, and QoL were measured by Zung Self-rating Depression Scale, Physical Activity Rating Scale-3, and World Health Organization Quality of Life Questionnaire. The direct and indirect effects of PA on QoL were analyzed by PA in a mediation framework.
1100 perimenopausal women participated in the study. PA mainly plays partial mediating roles in the relationship between depression and physical (ab = -0.493, 95 % CI: -0.582 to -0.407; ab = -0.449, 95 % CI: -0.553 to -0.343) and psychological (ab = -0.710, 95 % CI: -0.849 to -0.578; ab = -0.721, 95 % CI: -0.853 to -0.589; ab = -0.670, 95 % CI: -0.821 to -0.508) domains of QoL. Additionally, intensity (ab = -0.496, 95 % CI: -0.602 to -0.396; ab = -0.355, 95 % CI: -0.498 to -0.212) and duration (ab = -0.201, 95 % CI: -0.298 to -0.119; ab = -0.134, 95 % CI: -0.237 to -0.047) intermediated the relationship between moderate-to-severe depression and physical domain; frequency (ab = -0.130, 95 % CI: -0.207 to -0.066) only had a mediation influence between moderate depression and physical domain; intensity (ab = -0.583, 95 % CI: -0.712 to -0.460; ab = -0.709, 95 % CI: -0.854 to -0.561; ab = -0.520, 95 % CI: -0.719 to -0.315), duration (ab = -0.433, 95 % CI: -0.559 to -0.311; ab = -0.389, 95 % CI: -0.547 to -0.228; ab = -0.258, 95 % CI: -0.461 to -0.085), and frequency (ab = -0.365, 95 % CI: -0.493 to -0.247; ab = -0.270, 95 % CI: -0.414 to -0.144) all interceded between the psychological domain and all levels of depression, except for the frequency between severe depression and psychological domain; in terms of social relationship and environment domains, intensity (ab = -0.458, 95 % CI: -0.593 to -0.338; ab = -0.582, 95 % CI: -0.724 to -0.445), duration (ab = -0.397, 95 % CI: -0.526 to -0.282; ab = -0.412, 95 % CI: -0.548 to -0.293), and frequency (ab = -0.231, 95 % CI: -0.353 to -0.123; ab = -0.398, 95 % CI: -0.533 to -0.279) were mediators only on mild depression.
The cross-sectional study and self-reported data are major limiting factors.
PA and its components partially mediated the association between depression and QoL. Suitable prevention methods and interventions for PA may improve the QoL for perimenopausal women.
女性在围绝经期更易出现抑郁症状和生活质量低下的情况。围绝经期体育活动对心理健康和健康结局的有效性已有诸多报道。本研究旨在探讨体育活动对中国围绝经期女性抑郁与生活质量关系的中介作用。
开展一项横断面研究，采用多阶段、分层、按规模大小概率抽样的方法招募参与者。通过zung自评抑郁量表、体育活动量表-3和世界卫生组织生活质量问卷来测量抑郁、体育活动和生活质量。在中介框架中分析体育活动对生活质量的直接和间接影响。
1100名围绝经期女性参与了本研究。体育活动在抑郁与生活质量的身体（ab = -0.493，95%CI：-0.582至-0.407；ab = -0.449，95%CI：-0.553至-0.343）和心理（ab = -0.710，95%CI：-0.849至-0.578；ab = -0.721，95%CI：-0.853至-0.589；ab = -0.670，95%CI：-0.821至-0.508）领域关系中主要起部分中介作用。此外，强度（ab = -0.496，95%CI：-0.602至-0.396；ab = -0.355，95%CI：-0.498至-0.212）和持续时间（ab = -0.201，95%CI：-0.298至-0.119；ab = -0.134，95%CI：-0.237至-0.047）在中重度抑郁与身体领域关系中起中介作用；频率（ab = -0.130，95%CI：-0.207至-0.066）仅在中度抑郁与身体领域关系中有中介影响；强度（ab = -0.583，95%CI：-0.712至-0.460；ab = -0.709，95%CI：-0.854至-0.561；ab = -0.520，95%CI：-0.719至-0.315）、持续时间（ab = -0.433，95%CI：-0.559至-0.311；ab = -0.389，95%CI：-0.547至-0.228；ab = -0.258，95%CI：-0.461至-0.085）和频率（ab = -0.365，95%CI：-0.493至-0.247；ab = -0.270，95%CI：-0.414至-0.144）在心理领域与各抑郁水平关系中均起中介作用，但重度抑郁与心理领域关系中的频率除外；在社会关系和环境领域，强度（ab = -0.458，95%CI：-0.593至-0.338；ab = -0.582，95%CI：-0.724至-0.445）、持续时间（ab = -0.397，95%CI：-0.526至-0.282；ab = -0.412，95%CI：-0.548至-0.293）和频率（ab = -0.231，95%CI：-0.353至-0.123；ab = -0.398，95%CI：-0.533至-0.279）仅在轻度抑郁中起中介作用。
横断面研究和自我报告数据是主要限制因素。
体育活动及其各组成部分部分介导了抑郁与生活质量之间的关联。针对体育活动采取合适的预防方法和干预措施可能会改善围绝经期女性的生活质量。
