Walking Frequency and Depressive Symptoms in Older Adults
Walking Frequency and Depressive Symptoms in Older Adults
Background Cross-sectional studies show that walking is associated with depression among older adults, but longitudinal associations have rarely been examined. The aim of this study was to investigate longitudinal associations between walking frequency and depressive symptoms in older adults to determine which variable is the stronger prospective predictor of the other.
Design Longitudinal; four repeated measures over 5 years.
Setting Population-based sample of urban-dwelling older adults living in the Montreal metropolitan area.
Participants Participants from the VoisiNuAge study aged 68 to 84 (N = 498).
Measurements Main exposures: depressive symptoms (Geriatric Depression Scale) and number of walking days in previous week (Physical Activity Scale for the Elderly). Covariates: age, education, and number of chronic illnesses. Cross-lagged panel analyses were performed in the entire sample and in sex-stratified subsamples.
Results Depressive symptoms predicted walking frequency at subsequent time points (and more precisely, higher depressive symptoms were related to fewer walking days), but walking frequency did not predict depressive symptoms at subsequent time points. Stratified analyses revealed that prospective associations were statistically significant in women but not men.
Conclusion The longitudinal association between walking frequency and depressive symptoms is one in which depressive symptoms predict reduced walking frequency later. Higher depressive symptoms are more likely a cause of reduced walking because of time precedence than vice versa. Future research on longitudinal relationships between meeting physical activity recommendations and depression are warranted.
Depression is frequent in older adults, affecting between 1% and 5% of people aged 65 and older. Depression is associated with mental suffering; risk of suicide; and poor physical, cognitive, and social functioning. Older adults with depression use health and medical services two to three times as often as those without depression. With the aging of the global population, it is important to identify factors that may alleviate depressive symptoms in elderly people.
Cross-sectional studies have reported significant associations between walking and depression in older adults but do not provide any information on the direction of the causality. To the knowledge of the authors of the current study, three longitudinal studies have examined prospective relationships between walking and depression in older adults, and results were mixed. In one study, walking was not associated with future depression, whereas in another, walking distance predicted future depression. In a third study, walking was not associated with future depression, but depression was related to future walking habits. One of these studies focused on older Japanese-American men and another on older Hispanic adults, so results may not generalize to other populations of older adults. Two of these studies used regression analyses, which may not be well suited to the study of phenomena that change across time.
Cross-lagged panel analysis is a better approach to investigating longitudinal associations between two variables than regression analysis because it allows for examining prospective associations between variables at multiple time points in a single analysis. Moreover, although cross-lagged panel analyses are not intended to determine causality per se, they examine prospective relationships in a way that establishes which variable is the stronger prospective predictor of the other, thereby suggesting which variable is a more likely cause of the other because of time precedence (the cause occurring before the effect).
Prospective associations between walking and depression in older adults have not been extensively examined, so additional research is needed to clarify the plausible direction of associations. Uncovering these associations is important for health promotion professionals, clinical psychologists, physicians, and nurses. For example, if walking habits predict future depression, with more walking being associated with lower depression, then promoting walking may be an effective strategy for preventing depression in elderly adults. In contrast, if walking is a consequence of depression, poor mental health may interfere with walking and therefore negatively affect physical health. Thus, helping to alleviate depressive symptoms may also affect physical health. The aim of this study was to investigate longitudinal associations between walking and depressive symptoms in a population-based sample of urban-dwelling older adults in an effort to determine which variable is the stronger prospective predictor of the other.
Abstract and Introduction
Abstract
Background Cross-sectional studies show that walking is associated with depression among older adults, but longitudinal associations have rarely been examined. The aim of this study was to investigate longitudinal associations between walking frequency and depressive symptoms in older adults to determine which variable is the stronger prospective predictor of the other.
Design Longitudinal; four repeated measures over 5 years.
Setting Population-based sample of urban-dwelling older adults living in the Montreal metropolitan area.
Participants Participants from the VoisiNuAge study aged 68 to 84 (N = 498).
Measurements Main exposures: depressive symptoms (Geriatric Depression Scale) and number of walking days in previous week (Physical Activity Scale for the Elderly). Covariates: age, education, and number of chronic illnesses. Cross-lagged panel analyses were performed in the entire sample and in sex-stratified subsamples.
Results Depressive symptoms predicted walking frequency at subsequent time points (and more precisely, higher depressive symptoms were related to fewer walking days), but walking frequency did not predict depressive symptoms at subsequent time points. Stratified analyses revealed that prospective associations were statistically significant in women but not men.
Conclusion The longitudinal association between walking frequency and depressive symptoms is one in which depressive symptoms predict reduced walking frequency later. Higher depressive symptoms are more likely a cause of reduced walking because of time precedence than vice versa. Future research on longitudinal relationships between meeting physical activity recommendations and depression are warranted.
Introduction
Depression is frequent in older adults, affecting between 1% and 5% of people aged 65 and older. Depression is associated with mental suffering; risk of suicide; and poor physical, cognitive, and social functioning. Older adults with depression use health and medical services two to three times as often as those without depression. With the aging of the global population, it is important to identify factors that may alleviate depressive symptoms in elderly people.
Cross-sectional studies have reported significant associations between walking and depression in older adults but do not provide any information on the direction of the causality. To the knowledge of the authors of the current study, three longitudinal studies have examined prospective relationships between walking and depression in older adults, and results were mixed. In one study, walking was not associated with future depression, whereas in another, walking distance predicted future depression. In a third study, walking was not associated with future depression, but depression was related to future walking habits. One of these studies focused on older Japanese-American men and another on older Hispanic adults, so results may not generalize to other populations of older adults. Two of these studies used regression analyses, which may not be well suited to the study of phenomena that change across time.
Cross-lagged panel analysis is a better approach to investigating longitudinal associations between two variables than regression analysis because it allows for examining prospective associations between variables at multiple time points in a single analysis. Moreover, although cross-lagged panel analyses are not intended to determine causality per se, they examine prospective relationships in a way that establishes which variable is the stronger prospective predictor of the other, thereby suggesting which variable is a more likely cause of the other because of time precedence (the cause occurring before the effect).
Prospective associations between walking and depression in older adults have not been extensively examined, so additional research is needed to clarify the plausible direction of associations. Uncovering these associations is important for health promotion professionals, clinical psychologists, physicians, and nurses. For example, if walking habits predict future depression, with more walking being associated with lower depression, then promoting walking may be an effective strategy for preventing depression in elderly adults. In contrast, if walking is a consequence of depression, poor mental health may interfere with walking and therefore negatively affect physical health. Thus, helping to alleviate depressive symptoms may also affect physical health. The aim of this study was to investigate longitudinal associations between walking and depressive symptoms in a population-based sample of urban-dwelling older adults in an effort to determine which variable is the stronger prospective predictor of the other.
