Adherence to 24-hour movement guidelines among rural middle-aged and older adults in South Africa: prevalence, antecedents, and consequences on mental health outcomes

Abstract

ABSTRACT Objective The purpose of this study was to look into the prevalence, correlates, and mental health effects of middle-aged and older adults in South Africa meeting the 24-hour movement guidelines (HMG). Methods We analyzed data (N = 5059, aged 40 years and older) from A Longitudinal Study of an INDEPTH Community in South Africa, Health and Ageing in Africa (HAALSI, conducted in 2014/2015). Measures included demographics, activity limitations, depressive symptoms, posttraumatic stress disorder (PTSD), loneliness, happiness, and self-reported 24-HMG defined as follows: 150 minutes or more of physical activity per week; 480 minutes or less of sedentary time; 180 minutes or less of screen time; 7-9 hours of sleep for those aged 40–64; and 7-8 hours of sleep for those aged 65 and over. The relationship between self-rated mental health (e.g. measured using the CES-D 8-item version) and meeting the 24-HMG number was investigated using logistic regression models. Results The percentages of participants who adhered to none, one, and two movement guidelines were 10.9%, 29.7%, and 37.9%, respectively, whereas only 21.5% of participants met all three 24-HMG. Participants who were older, were South African, and had functional disabilities were less likely to meet all three 24-HMG. In adjusted analysis, compared with meeting all 3 24-HMG, all participants and male participants who met fewer 24-HMG were more likely to report depressive symptoms, PTSD and less likely to report happiness, and all participants, male and female participants who met fewer 24-HMG were more likely to report loneliness. Conclusions This is the first study to look at the prevalence, correlates, and relationships between 24-HMG adherence and mental health outcomes among older adults in Africa. The results highlight how critical it is to encourage senior citizens in South Africa to engage in healthy movement behaviors. Future mental health interventions for older adults should focus on improving their overall movement behaviors while taking demographic differences into account.