Leisure Activities are Associated with Physical and Mental Health.

To describe leisure participation in adolescents with congenital heart defects (CHD) and identify factors associated with intensity of participation. Eighty adolescents with CHD were recruited (39 males, 41 females; mean age [SD] 15y 8mo [1y 8mo] range 11y 5mo-19y 11mo) of whom 78 completed the Children's Assessment of Participation and Enjoyment (CAPE) outcome measure of leisure participation. The measure has five subscales: recreational, active-physical, social, skill-based, and self-improvement. Associations between the CAPE and age, sex, and development were examined. Motor ability (Movement Assessment Battery for Children, Second Edition), cognition (Leiter International Performance Scale-Revised), behavior (Strengths and Difficulties Questionnaire), and motivation (Dimensions of Mastery Questionnaire) were assessed. Participants exhibited impaired motor (43.5%), behavioral (23.7%), and cognitive (29.9%) development. The most intense participation was in social (mean [SD] 3.3 [0.99]) and recreational (2.9 [0.80]) activity types on the CAPE. Male sex (p<0.05) and younger age were associated with greater physical activity (<15y: 1.87; ≥15y: 1.31, p<0.05). Greater engagement in social activities was related to better cognition (r=0.28, p<0.05), higher motor function (r=0.30-0.36, p<0.01), and fewer behavioral difficulties (r=-0.32 to -0.47, p<0.01). Cognitive ability (r=0.27, p<0.05), dexterity and aiming/catching (r=0.27-0.33, p<0.05), and behavior problems (r=0.38-0.49, p=0.001) were correlated with physical activity participation. Persistence in tasks, an aspect of motivation, correlated with physical (r=0.45, p<0.001) and social activity involvement (r=0.28, p<0.05). Ongoing developmental impairments in adolescents with CHD are associated with decreased active-physical and social engagement, putting them at risk of poor physical and mental health. Health promotion strategies should be considered. Adolescents with congenital heart defects (CHD) have limited engagement in active-physical leisure activities. Cognitive, motor, and behavioral impairments are associated with decreased participation in leisure in children with CHD. Female sex and older age are associated with less engagement in leisure. Mastery motivation correlates with participation, suggesting an avenue for intervention.

BackgroundIdentifying people with early and late onset of chronic conditions might help target the subpopulations that are more vulnerable to negative mental, physical and functional health outcomes. The current study aimed to examine the association of early and late onset of chronic single and multiple morbidities with self-perceived physical and mental health, functional limitations and physical inactivity among older Indian adults.MethodsCross-sectional study was conducted using data from the Longitudinal Ageing Study in India (LASI) Wave 1 (2017–2018). The total sample size for the present study was 31,386 older adults age 60 years or older. Multivariable binary logistic regression analysis was used to establish the association between the outcomes (poor perceived physical/mental health, functional difficulty and physical inactivity) and explanatory variables (early [ = < 50 years of age] and late [> 50 years]) onset of chronic illnesses such as hypertension, diabetes, heart attack, heart disease, stroke, cancer, lung disease, arthritis, osteoporosis and psychiatric disease).ResultsOverall, 24.21% of the sample population had poor self-perceived physical health, whereas 8.67% of participants had poor self-perceived mental health. The prevalence of difficulty in ADL, difficulty in IADL, and physical inactivity was 23.77%, 48.36%, and 68.9%, respectively. Odds of poor perceived mental health were higher for the respondents with early as well as late onset of hypertension, stroke, and arthritis; while individuals with late onset of diabetes, and heart disease had higher odds of poor perceived mental health than those without chronic disease. Individuals with early onset of single morbidity were more likely to report ADL difficulty (adjusted odds ratio [AOR]: 1.33, confidence interval [CI]: 1.06–1.67); while those with late onset of single (AOR: 1.34, CI: 1.17–1.53) and multimorbidity (AOR: 1.91, CI: 1.63–2.24) were more likely to report ADL difficulty compared with individuals without morbidity. Individuals with early as well as late-onset of multimorbidity had more than two times higher odds of reporting poor physical health, poor mental health and IADL difficulty compared with individuals without chronic disease.ConclusionsThe present study revealed that early and/or late onset of chronic single and/or multiple morbidities significantly predicted poor self-perceived physical and mental health, functional limitations and physical inactivity among older Indian adults. The findings further suggest that late onset of chronic diseases such as cancer and stroke and multi-morbidity had stronger associations with physical inactivity that may help identify high risk groups for screening and support.

There is little large-scale evidence on the effect of alcoholic beer consumption on physical, mental and, above all, socio-emotional health. Here, we conducted a secondary data analysis of the 2012 and 2017 National Health Surveys with 33,185 individuals aged 18 years and older to assess beer consumption in relation to self-perceived health, functional limitations, mental health, and social support. Logistic regression models assessed the association of alcohol consumption (abstainers, ex-drinkers, occasional drinkers, moderate beer drinkers, and heavy beer drinkers) with self-perceived health (poor or good), limitations of type (none, physical, mental, or both) and intensity (none, mild, or severe), mental health (poor, average, or good) and social support (poor, average, or good). Analyses were adjusted for sex, age, occupational social class, educational level, place of residence, survey, part-time physical activity, dietary information, smoking, and body mass index. Compared to abstainers, occasional and moderate beer drinkers were associated with better mental and self-perceived health and social support, and were less likely to report mild or severe physical limitations. In contrast, former drinkers were associated with worse indicators of self-perceived health, physical health, mental health, and social support than abstainers. Alcoholic beer consumption showed a J-shaped relationship with self-perceived, physical, mental, and social-emotional health, with better values at moderate levels.

BackgroundThe annual cost of mental illnesses in Canada is estimated to be $50 billion. Research from other countries have suggested that employment status is associated with mental and physical health. Within the Canadian context, there is a dearth of research on the relationship between employment and mental health.ObjectiveTo explore the relationships between age, gender, income, and employment status on mental and physical health.MethodsThe 2021 Canadian Digital Health Survey dataset was used for this study. Data records, which included responses for the questions on age, gender, income, employment status, mental, and physical health, were used in the analysis. Ordinal logistics regression was applied to investigate the associations that may exist between mental and physical health with the various sociodemographic factors. Descriptive statistics were also provided for the data.ResultsThe total sample size included in the analysis was 10,630. When compared to respondents who had full-time employment, those who were unemployed were more likely to have lower self-perceived mental health (OR: 1.91; 95% CI: 1.55–2.34). Retired respondents were less likely to have worse mental health than respondents who were employed full-time (OR: 0.78; 95% CI: 0.68–0.90). Self-perceived physical health was more likely to be lower for those who were unemployed (OR: 1.74; 95% CI: 1.41–2.14) or retired (OR: 1.28; 95% CI: 1.12–1.48) when compared to respondents employed full-time. The likelihood of worsening mental and physical health was also found to be associated with age, gender, and income.ConclusionOur findings support the evidence that different factors contribute to worsening mental and physical health. Full-time employment may confer some protective effects or attributes leading to an increased likelihood of having improved mental health compared to those who are unemployed. Understanding the complex relationships on how various factors impact mental health will help better inform policymakers, clinicians, and other stakeholders on how to allocate its limited resources.

BackgroundPsychiatrists are at high risk of developing burnout and mental health problems mainly due to their emotionally demanding jobs, difficult working conditions, long working hours, and poor work-life balance. As leisure activities are associated with better physical and mental health, engaging in these activities has been recommended as a measure to improve the wellbeing of healthcare workers. However, it is unclear the extent of which psychiatrists and trainees are involved in leisure activities, what type of activities they prefer, or how these impact their self-perceived health, stress, confidence in stress management, and satisfaction with their social support.ObjectiveThe aim of this study was to identify differences in self-perceived health, perceived stress, confidence in stress management, and satisfaction with social support, between psychiatrists and trainees who engage in different leisure activities, compared with those who do not.MethodsThis was a cross-sectional study, including Mexican psychiatrists (n = 355) and trainees (n = 330) who agreed to participate through an online survey.Results73.1% of participants engaged in some leisure activity, being solitary-passive activities the most reported. Those who have a leisure activity reported lower stress, greater confidence in stress management, and more satisfaction with their social support. Passive-solitary activities were associated with less perceived stress and better confidence in stress management, while active-solitary and social activities were associated with better satisfaction with social support.ConclusionPsychiatrists' and trainees' wellbeing benefits from engagement in leisure activities, which should be part of their daily schedules to reduce stress, and potentially improve their mental health.

Older adults engage in approximately 7.1 hours/day in leisure activities; however, much of the leisure activity engagement comprises of passive activity engagement (e.g., watching TV). An increasing amount of literature suggests that regular engagement in cognitively and physically stimulating activities, rather than strictly passive activity engagement, is associated with better physical and mental health as well as maintenance of social networks. As the aging population continues to increase and levels and types of activity engagement are shifting across our more diverse older adult populations, it is imperative to understand levels and types of activities older adults are participating in, as well as the psychosocial and contextual factors related to leisure activity engagement. This symposium will include presentations from studies that explore the following: (1) leisure activity interests, engagement, and constraints; and (2) determinants and/or consequences of leisure activity engagement. Specifically, Sardina and colleagues examined daily variability between affect and leisure engagement, and explored potential sociodemographic moderators for these associations. Tian and colleagues explored the association between leisure activities and modes of transportation. Tian and colleagues explored leisure activity engagement with prospective daily diary methods, and examined associations between leisure activities and physical health. Janke and colleagues explored associations between facilitators, constraints, and constraint negotiation and self-reported physical activity levels for older adults with arthritis.

This study aimed at quantifying the healthy donor effect by comparing self-perceived mental and physical health between blood donors and non-donors. In theory, the selection process known as the healthy donor effect should result in better self-perceived, health-related quality of life in donors than in non-donors. The Short Form-12 data from the Danish Twin Registry (DTR) was compared with the data from the Danish Blood Donor Study (DBDS). Data on age, sex and smoking status were included in the analyses. The multivariable linear regression analysis was stratified by sex and age group intervals. Outcome variables were the mental component score (MCS) and the physical component score (PCS). A total of 28 982 and 36 913 participants from the DTR and the DBDS, respectively, were included in this study. Younger donors had higher MCS than non-donors, whereas MCS was only marginally high in older donors compared with non-donors. In contrast, PCS was almost similar for both young donors and non-donors. With the increase in age, non-donors had lower PCS than donors. Two selection patterns were revealed. Among young individuals, better self-perceived mental health was associated with a blood donor. With the increase in age, better self-perceived physical health was associated with blood donation.

Mental and physical health among the French population before and during the first and second COVID-19 lockdowns: Latent class trajectory analyses using longitudinal data

Middle-aged and older adults with human immunodeficiency virus (HIV) are at risk for decreased health-related quality of life (HRQoL), which may be improved by engaging in leisure activities. We examined associations between HRQoL and participation in cognitive, physical, social, and passive leisure activities, and whether depressive symptoms mediated these relationships. Wilson and Cleary's conceptual model of HRQoL guided this study. In this cross-sectional observational study, we enrolled 174 adults living with HIV aged 40 and older (M = 51.3, SD = 7.03). Participants completed assessments of leisure activities, depressive symptoms, and HRQoL. Data were analyzed using Spearman's rho correlations, hierarchal multiple regression, and mediation analyses. Greater engagement in physical activities was associated with higher physical HRQoL (b = 2.02, p < .05). Greater engagement in social activities was associated with both higher physical (b = 1.44, p < .05) and mental HRQoL (b = 1.95, p < .01). However, all associations between leisure activities and HRQoL were fully attenuated by depressive symptoms. Cognitive and passive leisure activities were not significantly correlated with HRQoL. Mediation analyses confirmed that depressive symptoms were the mediator mechanism by which social activities affected mental and physical HRQoL. More frequent engagement in physical and social leisure activities is associated with better HRQoL, and social leisure activities improve HRQoL via their impact on mood. Interventions to increase leisure activities, especially among people living with HIV who have poorer affective functioning, may be the most effective approach to improving HRQoL.

IntroductionInternet use has become an increasingly common leisure time activity among Chinese citizens. The association between Internet use and engagement in leisure activities is especially unclear among China population. This study aims to investigate Internet usage and to determine whether active Internet use is a marker for low or high levels of leisure time activities.Methods/Principal FindingsWith the use of a face-to-face structured questionnaire interview, a total of 2,400 respondents who met all screening requirements were surveyed to answer the questions in eight major cities in China. 66.2% (n = 1,589) of all respondents were identified as Internet users. Of these Internet users, 30.0%, 24.1%, 26.4%, and 19.6% were clustered as “informative or instrumental users,” “entertainment users,” “communication users,” and “advanced users,” respectively. Regarding time spent on Internet use in leisure time, more than 96% reported going online in non-work situations, and 26.2% (n = 416) were classified as “heavy Internet users.” A logistic regression analysis revealed that there were significant differences in some leisure activities between non-Internet users and Internet users, with an observed one-unit increase in the leisure time dependence category increasing the probability of engaging in mental or social activities. In contrast, Internet users were less engaged in physical exercise-related activities. In addition, advanced Internet users were generally more active in leisure time activities than non-Internet users and other types of users.Conclusion/SignificanceInternet use is one of very common leisure activities in Chinese citizens, and age, gender, income, and education are the key factors affecting Internet access. According to different types of leisure activities, Internet usage has different impacts on leisure activity engagement. High Internet dependence has no significant negative influence on engagement in mental or social leisure activities, but this group respondent tended to be less engaged in physical activities.

The purpose of this study was to evaluate the performance of the Centers for Disease Control and Prevention's core Health-Related Quality of Life (HRQOL) scale using data from 5,520 public high school students. The 1997 South Carolina Youth Risk Behavior Survey was the source of data. Chi-square analysis was applied to assess scale construct validity. Adjusted multiple logistic regression with selected tobacco and substance use variables was used to assess known-groups validity of the scale's Healthy Days index (items regarding poor physical and mental health days during the past 30 days). Construct validity was supported for the core HRQOL scale by the associations between self-perceived health and physical health, mental health, and activity limitation days. A greater number of poor physical health days, poor mental health days, or activity limitation days was associated with poorer self-perceived health (p<0.0001); however, correlation coefficients for the associations between self-perceived health and physical health days (r=0.24; p<0.001), self-perceived health and mental health days (r=0.26; p<0.0001), and self-perceived health and activity limitation days (r=0.23; p<0.0001), although significant, were low in magnitude. Logistic regression analyses conducted with the Healthy Days index revealed significant (p<0.05) HRQOL differences between users and non- users of tobacco and other substance use variables. As hypothesized, as the usage of each substance increased, reported poor HRQOL days increased, supporting the known- groups validity of the scale. This study provides preliminary evidence that the HRQOL scale items are valid and potentially useful for adolescent surveillance. The results, however, are mixed regarding the inclusion of self-perceived health as a measure of HRQOL for adolescents, given the low correlation coefficients for the associations between self-perceived health and the other HRQOL scale items. These results suggest that adolescents may be rating two separate dimensions of health when rating their self-perceived health and HRQOL. Further research is needed to confirm these findings in different adolescent populations.

Rx Exercise: Physical Activity Is Good Medicine

The purpose of this study was to investigate the changes in engagement in physical, leisure and social activities in older adults following primary TKA. A prospective study of 106 patients with a mean age of 72.6 (SD 7.4) years undergoing primary TKA was performed. Physical, social and leisure activities performed by the patients preoperatively and postoperatively at 3-year were recorded. Activities were selected according to the age, and grouped as passive, moderate and high intensity. The energy spent in each activity was expressed in Metabolic Equivalent of Task (MET) units. Charlson Comorbidity Index, Mini-mental test and Western Ontario and McMaster Universities (WOMAC) scores were also used. Multivariate analysis was used to identify predictors of active patients. Mean WOMAC significantly improved from preoperative (34.8, SD 11.8) to final follow-up (74.4, SD 11.1) (p = 0.001), and the mean energy spent increased from 10.7 (SD 13.6) to 28.2 (SD 16.2) MET-hour weekly (p = 0.001) with a decrease in the passive activities and increase in the moderate activities. However, the participation in high-intensity activities according to age was negligible. Only 65 (61.3%) patients were considered active postoperatively (weekly spending ≥ 40 MET), although the WOMAC scores were not significantly different between active and sedentary patients. Active patients compared with sedentary patients had a significant increase in engagement in physical, social and leisure activities, and a decrease in passive activities. Female gender (p = 0.037), less preoperatively participation in passive activities (p = 0.042), and greater participation in social activities (p = 0.027) were significant predictors of active patients at the final follow-up. Overall, most patients increased their activity level postoperatively. However, 38.6% of patients had no increased engagement in moderate physical, social or leisure activities at the medium-term despite improvements in pain and function provided by TKA. II.

Environment (i.e., rural vs. urban) and socioeconomic status (SES) are moderating factors of physical (i.e., obesity and/or physical activity) and internalizing mental health (i.e., stress, anxiety, and depressive symptoms) in adolescents. Relationships between physical and mental health have been shown in adolescents; however, research has not addressed these relationships in those from low-income, rural backgrounds. Thus, the present study characterized physical and mental health in rural, low-SES adolescents and investigated relationships between physical and mental health in this population. Data were collected from 253 10th and 11th-grade students from Title I schools in rural Alabama. Self-report measures of mental health, self-esteem, body image, and physical activity were obtained, in addition to functional fitness and physical health assessments completed at each school. Relationships between mental and physical health were assessed using Pearson correlations and multivariate data-driven cluster analysis. Positive correlations were observed between body composition and mental health symptoms, while negative correlations were observed between body image and mental health and body composition. However, sex differences were present in these relationships. The multivariate cluster analysis identified groups of individuals based on profiles of mental and physical health. This individual-level analysis identified students with greater mental and/or physical health burdens (n = 53 and n = 40) who may benefit from targeted interventions. Overall, these results provide evidence of elevated mental and physical health burdens among rural, low-income adolescents. Moreover, targeted programs are needed to provide education about the relationship between physical and mental health to reduce health burdens in both domains in this population.

Engagement in leisure activities has been claimed to be highly beneficial in the elderly. Practicing such activities is supposed to help older adults to preserve cognitive function, physical function, and mental health, and thus to contribute to successful aging. We used structural equation modeling (SEM) to analyze the impact of leisure activities on these constructs in a large sample of Japanese older adults (N = 809; age range 72–74). The model exhibited an excellent fit (CFI = 1); engaging in leisure activities was positively associated with all the three successful aging indicators. These findings corroborate previous research carried out in Western countries and extend its validity to the population of Eastern older adults. Albeit correlational in nature, these results suggest that active engagement in leisure activities can help older adults to maintain cognitive, physical, and mental health. Future research will clarify whether there is a causal relationship between engagement in leisure activities and successful aging.