Abstract
Background: Major depressive episodes have a negative effect on health-related quality of life (HRQoL). The objective of this study was to determine whether recreational physical activity can ameliorate some of this negative impact.Methods: The data source for the study was the Canadian National Population Health Survey (NPHS). The NPHS is a longitudinal study that has collected data from a representative cohort of 15,254 community residents. Sixteen years of follow-up data are available. The NPHS included: an instrument to assess MDE (the Composite International Diagnostic Interview Short Form for Major Depression), an inventory of recreational activities (each associated with hours of participation and estimated metabolic expenditures), and a HRQoL instrument (the Health Utility Index, Mark 3, or HUI3). Proportional hazard and linear regression models were used in this study to determine whether MDE-related declines in HRQoL were lessened by participation in an active recreational lifestyle.Results: Consistent with expectation, major depression was associated with a significant decline in HRQoL over time. While no statistical interactions were observed, the risk of diminished HRQoL in association with MDE was reduced by physical activity. In a proportional hazards model, the hazard ratio for transition to poor HRQoL was 0.7 (95% CI: 0.6–0.8, p < 0.0001). In linear regression models, physical activity was significantly associated with more positive HRQoL (β = 0.019, 95% CI 0.004 to −0.034, p = 0.02).Conclusion: Recreational physical activity appears to ameliorate some of the decline in HRQoL seen in association with MDE. Physical activity may be an effective tertiary preventive strategy for this condition.
Highlights
Depressive disorders are among the most important contributors to disease burden in developed countries (World Health Organization, 2001; Wittchen et al, 2011)
While no statistical interactions were observed, the risk of diminished health-related quality of life (HRQoL) in association with major depressive episode (MDE) was reduced by physical activity
Physical activity was significantly associated with more positive HRQoL (β = 0.019, 95% CI 0.004 to −0.034, p = 0.02)
Summary
Depressive disorders are among the most important contributors to disease burden in developed countries (World Health Organization, 2001; Wittchen et al, 2011) These disorders affect mortality (Wulsin et al, 1999; Lawrence et al, 2010; Patten et al, 2011), but their main impact is through diminished functioning and lower health-related quality of life (HRQoL). The most important depressive disorder, Major Depressive Disorder has an annual prevalence in North America of approximately 5% (Kessler et al, 2003; Patten et al, 2006) As these conditions are so common, effective strategies to reduce their impact will have a substantially positive effect on HRQoL at the population level. The objective of this study was to determine whether recreational physical activity can ameliorate some of this negative impact
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