Associations of Depressive Symptoms With Diabetes, Chronic Kidney Disease, and Physical Activity in Later Life.

An insider's view on physical activity in later life

The mean dietary protein intake at different stages of chronic kidney disease is higher than current guidelines

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Smoking negatively impacts lung function and cardiovascular capacity, making physical activity (PA) more challenging and contributing to mental health issues. This study investigates the role of PA in mitigating the links between smoking, sleep disorders, and depressive symptoms in adults in the United States. Data from the 2017 to 2020 National Health and Nutrition Examination Survey (NHANES) were examined. Participants were categorized by PA adherence (≥ 900 metabolic equivalent tasks [METs]/week or not) and smoking status based on serum cotinine levels (< 0.05 for non-smokers, 0.05–15 for secondhand smokers, and > 15 ng/mL for active smokers). Relationships between sleep disorders, depressive symptoms, and PA/smoking were evaluated using survey logistic regression, with non-smokers meeting PA guidelines as the reference group. Stratified analyses were conducted by age group (21 - 39, 40 - 59, 60+ years). Active smokers not meeting PA guidelines had a significantly higher likelihood of moderate to severe depressive symptoms (odds ratio [OR] 2.21, 95% confidence interval [CI] = [1.34, 3.65]). Young active smokers meeting PA guidelines had greater odds of sleep disorders (OR = 2.86, 95% CI = [1.38, 5.93]). Among middle-aged adults, those not meeting PA guidelines exhibited elevated odds of sleep disorders (OR = 2.18, 95% CI = [1.33, 3.59]) and severe depressive symptoms (OR = 3.01, 95% CI = [1.11, 8.18]). For older adults, increased odds of depressive symptoms were observed (OR = 3.37, 95% CI = [1.22, 9.29]). These findings underscore the potential of PA to mitigate mental health risks among individuals exposed to smoking. Longitudinal research is required to confirm these associations and inform targeted interventions.

Purpose: Physical activity (PA) plays a crucial role in preventing diabetes, but few studies have examined whether sociodemographic factors were associated to PA, and PA and sociodemographic factors were related to diabetes. We aimed to 1) examine associations between sociodemographic factors and PA, and 2) investigate whether PA and sociodemographic are related to the prevalence of diabetes. Methods: Data came from the 2007-2020 National Health and Nutrition Examination Survey (NHANES), a series of cross-sectional cohort studies (total sample=30,788, Female: 49.1%, mean age =49.6). Two binary outcomes included: 1) Meeting PA guidelines (≥500 MET minutes/week) and 2) diabetes (yes/no). Sociodemographic variables included age group (20-44 [referent], 45-64, 65-79), sex, race/ethnicity (White [referent], Black, Hispanic, and other adults), and poverty income ratio (low, middle, high-income [referent]). PA guideline was also considered as exposure for diabetes analysis. By accounting for the complex survey design, two weighted generalized Poisson models were used to conduct the analyses, adjusting for covariates. Results: Model 1 showed that participants aged 45-64 and 65-79 had 14% and 16% lower likelihood of meeting PA guidelines than those aged 20-44. Females had an 18 % lower likelihood of meeting PA guidelines than males. Furthermore, Black, Hispanic, and other racial/ethnic adults were 7%, 8%, and 12% less likely to meet the PA guidelines than White adults. Adults with low- and middle-income had 13% and 8% lower likelihood of meeting PA guidelines than those with high income. Model 2 showed that participants from 2017-2020 were 22% more likely to have diabetes (AOR = 1.22) than those from 2007-2008. Adults aged 45-64 and 65-79 years had a 4.35- and 7.36-times higher likelihood of having diabetes than those aged 20-44. Females had a 25% lower likelihood of having diabetes than males. Black, Hispanic, and other groups were 49%, 35%, and 73% more likely to have diabetes than White adults, respectively. Adults with low- and middle-income had a 52% and 32% higher likelihood of having diabetes than those with high income. Adults meeting PA guidelines had a 28% lower likelihood of having diabetes than those not meeting the PA guidelines. Conclusion: The study highlights persistent disparities in PA levels and diabetes across different sociodemographic groups within the U.S. population. Future interventions targeting diabetes should prioritize addressing these disparities among vulnerable populations who do not meet PA guidelines. Emphasis should be placed on promoting PA as an integral component of diabetes prevention.

ABSTRACTObjective: Limited research has evaluated the individual and combined associations of physical activity (PA), cardiorespiratory fitness (CRF) and muscle strengthening activities (MSA) on generalized anxiety, panic and depressive symptoms. We evaluated this topic in a representative sample of young (20–39 years) adults, with considerations by sex.Methods: Data from the 1999–2004 National Health and Nutrition Examination Survey (N = 2088) were used. Generalized anxiety, panic and depressive symptoms were assessed via self-report as well as using the Generalized Anxiety Disorder, Panic Disorder, and Depressive Disorders modules of the automated version of the World Health Organization Composite International Diagnostic Interview (CIDI-Auto 2.1). PA and MSA were assessed via validated self-report questionnaires and CRF was determined via a submaximal treadmill-based test. An index variable was created summing the number (range = 0–3) of these parameters for each participant. For example, those meeting PA guidelines, MSA guidelines and having moderate-to-high CRF were classified as having an index score of 3.Results: MSA was not independently associated with generalized anxiety, panic and depressive symptoms, but those with higher levels of PA and CRF had a reduced odds of these symptoms (ranging from 40 to 46% reduced odds). Compared to those with an index score of 0, those with an index score of 1, 2, and 3, respectively, had a 39%, 54% and 71% reduced odds of having generalized anxiety, panic and depressive symptoms. Results were consistent across both sexes.Conclusion: PA and CRF, but not MSA, were independently associated with generalized anxiety, panic and depressive symptoms. There was evidence of an additive association between PA, CRF, and MSA on these symptoms.

Maintaining physical activity in later life is important for maintaining health and function. Activity outdoors, such as walking, jogging and cycling, may provide an accessible, sociable and practical solution, but maintaining outdoor mobility may be a challenge in later life. Providing green environments which are supportive of physical activity may facilitate this, yet research into how greenspace could be best used is inconclusive. This study evaluates the role of greenspace in protecting against decline in physical activity over time in older adults.Data from the European Prospective Investigation of Cancer Norfolk, UK, cohort 1993–2009 (N=15,672) was used. Linear regression modelling was used to examine the association between exposure to greenspace in the home neighbourhood and change in overall, recreational and outdoor physical activity measured in terms of metabolic equivalent cost (MET) in hours/week. Mediation analysis was conducted to assess if dog walking explained the relationship between greenspace and physical activity change. Models were adjusted for known and hypothesised confounders.People living in greener neighbourhoods experienced less of a decline in physical activity than those living in less green areas. Comparing change for those living in the greenest versus least green quartiles, participants showed a difference in overall physical activity of 4.21 MET hours/week (trend P=0.001), adjusted for baseline physical activity, age, sex, BMI, social class and marital status. This difference was 4.03 MET hours/week for recreational physical activity (trend P<0.001) and 1.28 MET hours/week for outdoor physical activity (trend P=0.007). Dog walking partially mediated the association between greenspace and physical activity change, by 22.6% for overall, 28.1% for recreational and 50.0% for outdoor physical activity (all P<0.001).Greenspace in the home neighbourhood may be protective against decline in physical activity among older people as they age. Dog walking is a potential mechanism in this relationship, and warrants further investigation as a way of maintaining physical activity in later life.

PURPOSE: Approximately 20% of adolescents meet the minimal standards of moderate to vigorous physical activity (PA) national guidelines. Adolescents that accrue lower PA have greater depression and anxiety symptoms when compared to adolescents that engage in higher amounts of PA. Musculoskeletal injuries are common in adolescents and may exacerbate depression or anxiety symptoms that were decreased due to the ability to partake in PA. In addition, injuries may cause new anxiety and depression symptoms. While PA has generally been shown to help decrease and protect against both depression and anxiety symptoms in adolescents, some recent work has questioned the impact of PA on adolescent mental health. The purpose of this study was to determine if adequate levels of PA in adolescents that have experienced an injury had less anxiety and depression symptoms. METHODS: A total of 63 adolescents (59% female; mean age = 14.57 ± 1.52 years) between the ages of 12-18 that were being treated by a tertiary sports medicine clinic were enrolled. Participants filled out the Patient Health Questionairre-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7) to measure depression and anxiety symptoms, respectively. Scores greater than 5 were considered elevated for each scale and prompted further evaluation by the attending physician. PA was self-reported by asking exercise vital sign questions to obtain days per week and minutes per day of moderate to vigorous physical activity from the past week. RESULTS: Average PHQ-9 score was 3.63 ± 4.11, average GAD-7 score was 3.33 ± 3.60 and average weekly PA was 319.37 ± 261.12 minutes. There were 22% with elevated PHQ-9 scores, nearly 24% with elevated GAD-7 scores and 35% reported meeting the PA guidelines in the last week. There were no differences between those who met or did not meet PA guidelines on the proportion of those with elevated depression or anxiety scores (p = .47, p = .93, respectively). CONCLUSIONS: While there were no differences between the prevalence of elevated depression or anxiety scores between those who met or did not meet PA guidelines, injured adolescents had high rates of elevated scores for anxiety and depression. Clinicians should consider screening injured adolescents for anxiety and depression to aid in early intervention.

Regular physical activity (PA) lowers the risk of cardiovascular disease (CVD), but few US adults meet PA guidelines. The United States Preventive Services Task Force (USPSTF) recommends primary care providers offer PA counselling for CVD prevention. We examined the association between adherence to PA guidelines and reported provider advice to increase PA among US adults with overweight/obesity and ≥1 additional CVD risk factor. Cross-sectional data from the National Health and Nutrition Examination Survey (2011-2014) on PA and provider advice to increase PA were analysed for 4158 adults (≥20 years old) with overweight/obesity who reported ≥1 of hypertension, high cholesterol or impaired fasting glucose. Adherence to federal PA guidelines was determined using self-reported PA data from the Global Physical Activity Questionnaire. Meeting PA guidelines was defined as ≥150 minutes/week moderate intensity PA, ≥75 minutes/week vigorous intensity, or an equivalent combination. Participants self-reported provider advice to increase PA. In total, 57.7% of US adults with overweight/obesity and ≥1 additional CVD risk factor who did not meet PA guidelines reported provider advice to increase PA compared to 49.7% of adults who met PA guidelines. Adults who did not meet PA guidelines were more likely to report provider PA advice (aOR = 1.21; 95% CI = 1.00-1.47). US adults with CVD risk factors who do not meet PA guidelines are more likely to receive provider advice to increase PA, but only half receive such advice. Strategies to increase provider advice are needed to improve adherence to USPSTF guidelines among US adults with overweight/obesity and additional CVD risk factors.

BackgroundIn Korea, chronic kidney disease (CKD) is increasingly prevalent among adults with hypertension, of which approximately 30% of the population is affected. Despite the recognized benefits of adherence to physical activity (PA) recommendations, including aerobic and muscle-strengthening activities (MSA), the impact of such adherence on the prevalence of CKD in individuals with hypertension has not been extensively studied. This study aimed to investigate the association between aerobic PA and MSA levels, and the prevalence of CKD in individuals with hypertension.MethodsThis study included 5,078 individuals with hypertension using data from the Korean National Health and Nutrition Examination Survey (2019–2021). PA levels were measured as min/week of moderate-to-vigorous PA (MVPA) based on self-reports, and MSA was quantified as the number of days per week. CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m². Logistic regression analysis evaluated the association between meeting PA guidelines and CKD after adjusting for potential confounders. Additionally, a joint analysis was conducted to assess the combined effects of MVPA and MSA on CKD.ResultsAfter adjusting for all covariates, higher MVPA was associated with a lower prevalence of CKD. Compared to the group with inactive, the group with MVPA 1–149 min/week had an odds ratio (OR) of 0.80 (95% confidence interval [CI], 0.61–1.05), the group that met the MVPA 150–299 min/week criteria had an OR of 0.85 (95% CI, 0.62–1.17), and the group that met the MVPA ≥ 300 min/week criteria had an OR of 0.53 (95% CI, 0.37–0.76). MSA alone did not show a significant association with CKD. In the joint analysis, the group that met the MVPA and MSA guidelines had the lowest OR of 0.54 (95% CI, 0.34–0.86), compared to the group that did not meet either.ConclusionsMVPA was associated with the prevalence of CKD in participants with hypertension but not in those with MSA alone. However, compared with the group that did not meet both guidelines, the group that met both guidelines showed the lowest prevalence of CKD.

Sleep quality among community-dwelling elderly people and its demographic, mental, and physical correlates

Regular physical activity is essential for healthy aging, yet sustaining long-term engagement remains a challenge for many older adults. Emerging research highlights habit formation as a promising mechanism for maintaining physical activity, particularly when supported by contextual cues and digital technology. This qualitative study explores how community-dwelling older adults incorporate physical activity into their daily lives, focusing on the processes of habit formation and maintenance, and the role of technology in supporting these behaviours. Data were collected through three focus group interviews, one dyadic interview, and two workshop sessions conducted in Umeå, Sweden. Fifteen participants (mean age 73.3 years) with previous experience with regular physical activity contributed to the study. Reflexive thematic analysis was used to interpret the data, following Braun and Clarke's six-phase approach. The analysis generated one overarching theme "Staying active through life's shifting seasons" which captures how participants adapted their physical activity routines in response to aging, health changes, and life transitions. Two interwoven subthemes were identified: "Building the habit scaffold" and "Cultivating a movement mindset". The first describes how participants constructed supportive frameworks for activity through routines, environmental adjustments, social contracts, and digital technology. The second highlights internal strategies such as emotional reframing, identity alignment, and the development of a personal philosophy around physical activity. Participants emphasized the importance of flexibility, self-awareness, and emotional engagement in sustaining activity. Technology, including smartwatches and fitness apps, was described as both a motivational aid and a feedback system, reinforcing routines and providing a sense of accountability. Seasonal variation and life events were common disruptions, requiring participants to renegotiate their habits and find new forms of physical activity. Sustaining physical activity in later life is a multifaceted and adaptive process, maintained through the interplay of external scaffolding such as routines, cues, and supportive structures and internal orientations rooted in identity, emotion and meaning. Interventions that are practical, motivational, and flexible are likely to be most supportive. Digital technology can offer valuable support if embedded into personally meaningful and adaptable routines. NA.

Dog ownership and physical activity in later life: A cross-sectional observational study

Isotemporal substitution of sedentary behavior with physical activity and its influence on depressive symptoms among adults with overweight/obesity in the United States: A cross-sectional study