Depressive symptoms as a barrier to engagement in physical activity in older adults with and without Alzheimer's disease.

Amber S. Watts,Jeffrey M. Burns,Moyra E. Mortby,Stephen D. Ginsberg

doi:10.1371/journal.pone.0208581

Amber S. Watts, Jeffrey M. Burns

Open Access

https://doi.org/10.1371/journal.pone.0208581

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Abstract

ObjectivesPhysical activity shows promise for reduced risk of Alzheimer’s disease (AD) and protection against cognitive decline among individuals with and without AD. Older adults face many barriers to adoption of physically active lifestyles and people with AD face even further challenges. Physical activity is a promising non-pharmacological approach to improve depressive symptoms, but little is known about the impact of depressive symptoms as a potential barrier to engagement in physical activity. The present study aimed to investigate depressive symptoms as a potential barrier for participation in physical activity across a range of dementia severity.MethodWe used longitudinal structural equation modelling to investigate the bi-directional relationship between depressive symptoms and physical activity in 594 older adults with and without AD over a 2 year longitudinal follow up. Participants ranged from no cognitive impairment to moderately severe AD.ResultsWe found that depressive symptoms predicted reduced engagement in subsequent physical activity, but physical activity did not predict subsequent reductions in depressive symptoms.ConclusionWe conclude that depressive symptoms may be an important barrier to engagement in physical activity that may be addressed in clinical practice and intervention research.

Highlights

Older adults spend 65–80% of waking time in sedentary activities [1,2], and individuals with Alzheimer’s disease (AD) are even less active [3,4]
We found that depressive symptoms predicted reduced engagement in subsequent physical activity, but physical activity did not predict subsequent reductions in depressive symptoms
We conclude that depressive symptoms may be an important barrier to engagement in physical activity that may be addressed in clinical practice and intervention research

Summary

Introduction

Older adults spend 65–80% of waking time in sedentary activities [1,2], and individuals with Alzheimer’s disease (AD) are even less active [3,4]. People with AD likely face even further challenges to engaging in physical activity. Aside from a few small qualitative studies [9,10,11], there is little research addressing the barriers to physical activity specific to individuals with dementia [7]. The barriers reported in qualitative studies fall into several categories including physical, social, emotional, environmental, and cognitive. Malthouse and Fox [9] reported that people with AD generally had positive attitudes about the benefits of physical activity, few of them were willing to push themselves hard enough to sweat and did not like the feeling of being forced to exercise

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