Relationship of the perceived social and physical environment with mental health-related quality of life in middle-aged and older adults: mediating effects of physical activity.

Delfien Van Dyck,Megan Teychenne,Ilse De Bourdeaudhuij,Jo Salmon,Sarah A Mcnaughton,Rodrigo Huerta-Quintanilla

doi:10.1371/journal.pone.0120475

Delfien Van Dyck, Megan Teychenne + Show 4 more

Open Access

https://doi.org/10.1371/journal.pone.0120475

Copy DOI

Abstract

BackgroundMental health conditions are among the leading non-fatal diseases in middle-aged and older adults in Australia. Proximal and distal social environmental factors and physical environmental factors have been associated with mental health, but the underlying mechanisms explaining these associations remain unclear. The study objective was to examine the contribution of different types of physical activity in mediating the relationship of social and physical environmental factors with mental health-related quality of life in middle-aged and older adults.MethodsBaseline data from the Wellbeing, Eating and Exercise for a Long Life (WELL) study were used. WELL is a prospective cohort study, conducted in Victoria, Australia. Baseline data collection took place in 2010. In total, 3,965 middle-aged and older adults (55–65 years, 47.4% males) completed the SF-36 Health Survey, the International Physical Activity Questionnaire, and a questionnaire on socio-demographic, social and physical environmental attributes. Mediation analyses were conducted using the MacKinnon product-of-coefficients test.ResultsPersonal safety, the neighbourhood physical activity environment, social support for physical activity from family or friends, and neighbourhood social cohesion were positively associated with mental health-related quality of life. Active transportation and leisure-time physical activity mediated 32.9% of the association between social support for physical activity from family or friends and mental health-related quality of life. These physical activity behaviours also mediated 11.0%, 3.4% and 2.3% respectively, of the relationship between the neighbourhood physical activity environment, personal safety and neighbourhood social cohesion and mental health-related quality of life.ConclusionsIf these results are replicated in future longitudinal studies, tailored interventions to improve mental health-related quality of life in middle-aged and older adults should use a combined strategy, focusing on increasing physical activity as well as social and physical environmental attributes.

Highlights

Mental health conditions including depression and anxiety, are among the leading non-fatal diseases in Australia and are associated with high direct and indirect health care costs, and increased risk of mortality from cardio-vascular disease and other chronic diseases, as well as suicide [1,2,3,4]
Physical activity mediated 32.9% of the association between social support for physical activity from family or friends and mental health-related quality of life. These physical activity behaviours mediated 11.0%, 3.4% and 2.3% respectively, of the relationship between the neighbourhood physical activity environment, personal safety and neighbourhood social cohesion and mental health-related quality of life. If these results are replicated in future longitudinal studies, tailored interventions to improve mental health-related quality of life in middle-aged and older adults should use a combined strategy, focusing on increasing physical activity as well as social and physical environmental attributes
The present study showed that proximal social, distal social, as well as broader physical environmental attributes were associated with mental health-related quality of life in middle-aged and older adults

Summary

Introduction

Mental health conditions including depression and anxiety, are among the leading non-fatal diseases in Australia and are associated with high direct and indirect health care costs, and increased risk of mortality from cardio-vascular disease and other chronic diseases, as well as suicide [1,2,3,4]. Most previous research has focused on the individual and proximal (i.e. close to the individual) social determinants of mental health. Longitudinal studies showed that social support from family/friends and interactions with family and friends are two proximal social factors that influence mental health in (older) adults [12,13]. Mental health conditions are among the leading non-fatal diseases in middle-aged and older adults in Australia. The study objective was to examine the contribution of different types of physical activity in mediating the relationship of social and physical environmental factors with mental health-related quality of life in middle-aged and older adults

Objectives

Methods

Results

Conclusion