Abstract
Objective: To examine the influence of depression and cognitive impairment at baseline on the subsequent levels of cardiorespiratory fitness at 7 years and to compare maximal oxygen uptake (VO2max), the distance walked in the 6-minute walk test (6MWD) and self-reported physical activity in relation to depression and cognitive impairment. Methods: A total of 1,179 Chinese older adults aged 65 and above who participated in the MrOs (Hong Kong) and MsOs (Hong Kong) study during 2001-2003 were re-assessed after 7 years of follow-up. Baseline information on depression, cognitive function and a number of health-related variables were obtained through interview. The outcome variables were cardiorespiratory fitness as measured by VO2max, 6MWD, and physical activity as measured with the Physical Activity Scale of the Elderly (PASE) at 7 years. Results: Subjects with depression at baseline were associated with lower VO2max during a follow-up period of approximately 7 years and this relationship remained significant after adjustment for physical activity, gait speed, and other potential confounders for men only (P<0.05) but not for women. Cognitive impairment at baseline was also associated with shorter 6MWD during the follow-up (P<0.05); however, the association was eliminated in sexstratified analyses. There was no relationship between baseline depression and cognitive impairment with the subsequent levels of physical activity. Conclusions: Among older men, baseline depression was associated with lower VO2max but not 6MWD or PASE score over 7 years. Our findings reinforce that VO2max is better than 6MWD or self-reported physical activity as a measurement of cardiorespiratory fitness in relation to depression in elderly population.
Highlights
A decline in cardiorespiratory fitness is an important physiological change that occurs during the ageing process because of its influence on functional independence [1] and quality of life [2]
Using data from the MrOs (Hong Kong) and MsOs (Hong Kong) cohort of elderly Chinese aged 65 years and above, we examined the influence of depression and cognitive impairment at baseline on the subsequent levels of cardiorespiratory fitness as measured with VO2max and the distance walked in the 6-minute walk test (6MWD), a surrogate measure of fitness level and disability [18], over 7 years
This study showed that older adults with depression at baseline were associated with lower VO2max during a follow-up period of approximately 7 years
Summary
A decline in cardiorespiratory fitness is an important physiological change that occurs during the ageing process because of its influence on functional independence [1] and quality of life [2]. Accumulating evidence suggested that higher cardiorespiratory fitness (as quantified by exercise test duration or walking distance) is associated with lower risk of incident depressive symptoms in middleaged and older adults [5,6,7]. It seems that depressive symptoms are related to the decline in various measures of cardiorespiratory fitness, including exercise test duration, oxygen consumption (VO2), and oxygen uptake efficiency slope in older women [8] via reduced physical activity [9]. There are relatively few studies that are available to examine the role of depression on the subsequent levels of maximal oxygen uptake (VO2max), the widely accepted “gold standard” measure of cardiorespiratory fitness [12], in older adults
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