Abstract

BackgroundDepressive symptomatology may act as a barrier to enhance physical activity. This phenomenon is predominantly found in patients with an established cardiovascular disease (CVD) and in female patients. This cross-sectional study investigated (1) the association between symptoms of depression and physical inactivity, and (2) whether this association is different between primary and secondary prevention patients, and between men and women.MethodsThe study design concerns a secondary analysis of baseline data from a randomized clinical trial, including primary and secondary prevention patients (n = 2184; mean age 71.6 ± 8.94), from 34 general practitioner panels. The Rapid Assessment of Physical Activity questionnaire (RAPA) was used to measure patient reported activity levels. Symptoms of depression were determined using the Patient Health Questionnaire (PHQ-9). Multilevel linear regression analysis was used to explore the association between symptoms of depression and physical activity while adjusting for confounders. Gender and whether or not having a CVD were considered as potential effect modifiers for the association between symptoms of depression and inactivity.ResultsSymptoms of depression were associated with lower levels of physical activity. This association was neither different for men and women nor for primary and secondary prevention patients.ConclusionIn primary care patients’ symptoms of depression were associated with physical inactivity. This association was not modified by gender or the presence of a CVD. Future research should focus on lifestyle interventions aiming at the increase of physical activity levels, while emphasizing on improving symptoms of depression in men, women, and patients both with and without a history of CVD.

Highlights

  • Depressive symptomatology may act as a barrier to enhance physical activity

  • Quantitative variables All patients filled out the Rapid Assessment of Physical Activity questionnaire (RAPA), Patient Health Questionnaire-9 (PHQ-9), Patient Activation Measure questionnaire (PAM) and a smoking questionnaire

  • 2184 patients were included in our study (1250 primary and 934 secondary prevention patients), consisting of 761 female patients and 1423 male patient

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Summary

Introduction

Depressive symptomatology may act as a barrier to enhance physical activity This phenomenon is predominantly found in patients with an established cardiovascular disease (CVD) and in female patients. Exercise capacity is mentioned as one of the strongest modifiable predictors of mortality among patients at risk for developing a cardiovascular disease (CVD) [2] Despite this well-documented effect, exercise activity is limited among many patients at high. Independent from experiencing symptoms of depression, associated with lower activity levels [20, 21]. This might, for instance, be caused by lower perceived self-efficacy and self-management levels in women [22]. More attention for female gender during CVRM in clinical practice is advocated in the literature [9, 10]

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