Adherence to the 24-hour movement behavior guidelines and depression risk among older adults from the United States.

BACKGROUND

While recent studies, primarily among Asian cohorts, have linked adherence to 24-hour movement behavior (24-HMB) guidelines with improved mental health-some of which show sex differences-few studies have explored these relationships among older adults from the United States.

METHODS

National Health and Nutrition Examination Survey data from 2011-2018 were examined in 2,812 older adults (≥ 65years). Those considered adherent to 24-HMB guidelines had a sleep duration of 7-8 h./night, moderate-vigorous physical activity (MVPA) ≥ 150 min/wk., and sedentary behavior (SB) < 8 h./day. Sleep duration, SB, and MVPA were self-reported, with SB and MVPA obtained from the validated Global Physical Activity Questionnaire. Depression was measured using the Patient Health Questionnaire (PHQ-9), with a score of ≥ 10 indicating depression. Logistic regression was used to evaluate overall and sex-stratified associations between non-adherence to all three behaviors, combinations of two behaviors, or individual behavior guidelines, with odds of depression, adjusted for putative confounders.

RESULTS

Among the full sample, non-adherence to all three 24-HMB guidelines was associated with 1.7 [95% confidence interval (CI):1.1, 3.1; p = 0.02] higher odds of depression versus those that adhered to all three behaviors. After sex stratification, the association only persisted among males [OR = 2.5 (95% CI:1.1, 5.4); p = 0.02]. Within the overall sample, higher odds of depression were observed for those who did not adhere to the SB + sleep duration guidelines and the sleep duration + MVPA guidelines. Sex-stratified findings revealed that associations only remained significant in males. While in the overall sample of older adults, non-adherence to the sleep duration guideline was associated with 2.1 (95% CI:1.4, 3.3; p = 0.001) higher odds of depression compared to those that adhered to the guideline.

CONCLUSIONS

Results provide evidence of associations between non-adherence to 24-HMB and higher odds of depression, specifically in older males, suggesting a potential sex-specific effect that warrants further investigation. Future studies using longitudinal designs are needed to confirm these findings and explore the mechanisms underlying these associations.