Shi Yan, Guo Huaqing, Tian Ruonan, Zhang Nan, Wang Chen, Liu Weiliang, Duan Zhiguang
School of Humanities and Social Sciences, Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China.
School of Public Health, Changzhi Medical College, Changzhi, Shanxi, People's Republic of China.
J Multidiscip Healthc. 2025 Jul 25;18:4185-4196. doi: 10.2147/JMDH.S521285. eCollection 2025.
The trajectories of the associations of physical activity (PA) with depressive symptoms in postmenopausal women are still unclear. This study aimed to identify the joint trajectories of PA and depressive symptoms over a 5-year period among Chinese postmenopausal women and to comprehensively examine their associations and predictors.
The study included 1303 postmenopausal women who participated in the China Health and Retirement Longitudinal Survey (CHARLS) between 2015, 2018 and 2020. Depressive symptoms were measured by CESD-10. PA was assessed by the IPAQ-SF. Group-based dual trajectory modeling (GBDTM) was applied to examine the joint trajectories of PA and depressive symptoms in postmenopausal women. Quantile regression assessed their associations within trajectory groups, and a multinomial logistic model identified group predictors.
Three distinct dual trajectories of PA and depressive symptoms were identified in postmenopausal women: moderate stable-low increase (32.0%), high curve-moderate increase (46.1%), and low stable-high increase (21.9%), all showing a worsening trend in depressive symptoms. Consistent moderate PA was accompanied by low slightly increased depressive symptoms. Low PA was positively associated with high depressive symptoms in the 10th and 30th quantiles. High PA initially suppressed depressive symptoms, but its inhibitory effect diminished as symptoms worsened. Predictors of latent trajectory groups included rural residence, uneducated, insufficient sleep, and comorbidities.
Screening for depressive symptoms in postmenopausal women is necessary, especially in those with long-term low PA. PA interventions should be tailored according to the severity and trajectory of depressive symptoms.
绝经后女性身体活动（PA）与抑郁症状之间关联的轨迹仍不明确。本研究旨在确定中国绝经后女性在5年期间PA和抑郁症状的联合轨迹，并全面检查它们之间的关联及预测因素。
该研究纳入了2015年、2018年和2020年间参加中国健康与养老追踪调查（CHARLS）的1303名绝经后女性。抑郁症状通过CESD-10量表进行测量。PA通过IPAQ-SF量表进行评估。采用基于组的双轨迹模型（GBDTM）来检查绝经后女性PA和抑郁症状的联合轨迹。分位数回归评估轨迹组内它们之间的关联，多项逻辑模型确定组预测因素。
在绝经后女性中确定了三种不同的PA和抑郁症状双轨迹：中度稳定-轻度增加（32.0%）、高曲线-中度增加（46.1%）和低稳定-高度增加（21.9%），所有轨迹的抑郁症状均呈恶化趋势。持续的中度PA伴随着轻度增加的抑郁症状。在第10和30分位数中，低PA与高抑郁症状呈正相关。高PA最初抑制抑郁症状，但随着症状恶化其抑制作用减弱。潜在轨迹组的预测因素包括农村居住、未受过教育、睡眠不足和合并症。
对绝经后女性进行抑郁症状筛查是必要的，尤其是对长期PA较低的女性。PA干预应根据抑郁症状的严重程度和轨迹进行调整。
