A cohort study of leisure time physical activity and depression

doi:10.1016/j.ypmed.2010.09.008

Preventive Medicine

Volume 51, Issue 6, December 2010, Pages 471-475

https://doi.org/10.1016/j.ypmed.2010.09.008 Get rights and content

Abstract

Objective

The objective of the study was to examine the role of leisure time physical activity on the risk of developing depression in a large longitudinal setting.

Methods

A prospective cohort study was used, comprising three updated measures of leisure time physical activity and covariates and 26 years of follow-up data on 18,146 individuals from the Copenhagen City Heart Study, Denmark. The study population was linked to two Danish hospital registers for information on depression. Data were collected in three rounds, namely, 1976–1978, 1981–1983, and 1991–1994, and analyses were conducted in 2010.

Results

Compared to women with a high physical activity level, women with a moderate level had a hazard ratio of 1.07 (95% confidence interval: 0.80–1.44) for developing depression while women with a low level had a hazard ratio of 1.80 (95% confidence interval: 1.29–2.51). Compared to men with a high physical activity level, men with a moderate level had a hazard ratio of 1.11 (95% confidence interval: 0.73–1.68) for developing depression, while men with a low level had a hazard ratio of 1.39 (95% confidence interval: 0.83–2.34).

Conclusion

Among women, a low level of physical activity was significantly associated with a greater risk of depression.

Introduction

Depression, associated with both increased mortality and co-morbidity, is a major public health issue. According to the World Health Organization, depression is third on the list of the leading causes of disability worldwide and is predicted to top the list in the year 2030 (World Health Organization, 2008).

Studies have consistently shown that physical activity can reduce symptoms of depression (Greer and Trivedi, 2009), and if more focus is put on factors that may potentially prevent the disorder, the future disability and treatment burden might be reduced. Cross-sectional studies have demonstrated an inverse association between physical activity and depression (Goodwin, 2003, Teychenne et al., 2008b). However, the evidence of a preventive role of physical activity on depression has been less consistent (Dunn et al., 2001, Teychenne et al., 2008b). Most studies have found an association between leisure time physical activity and a reduced risk of depression (Augestad et al., 2008, Bernaards et al., 2006, Brown et al., 2005, Camacho et al., 1991, Farmer et al., 1988, Ku et al., 2009, Paffenbarger et al., 1994, Strawbridge et al., 2002, van Gool et al., 2007, Wise et al., 2006), while some found no preventive role of leisure time physical activity on depression (Cooper-Patrick et al., 1997, De Moor et al., 2008, Kritz-Silverstein et al., 2001, Strohle et al., 2007, Weyerer, 1992). However, several of the longitudinal studies had only few years of follow-up (Bernaards et al., 2006, Brown et al., 2005, Strawbridge et al., 2002, Strohle et al., 2007, Weyerer, 1992, Wise et al., 2006). Furthermore, many of the studies had relatively small study populations (Cooper-Patrick et al., 1997, Kritz-Silverstein et al., 2001, van Gool et al., 2007), and some did not stratify the results by sex (Bernaards et al., 2006, Cooper-Patrick et al., 1997, Strawbridge et al., 2002, Strohle et al., 2007, van Gool et al., 2007, Weyerer, 1992), making it difficult to assess whether the results were the same for women and men. Therefore, further exploration of the preventive role of physical activity on depression is needed, which was the aim of the present study.

Section snippets

The study population

Data from the ongoing Copenhagen City Heart Study (CCHS) were used (Appleyard et al., 1989). From 1976 to 1978 (CCHS-I), an age-stratified sample of 19,698 women and men aged 20–93 years were randomly drawn from The Central Population Register and invited to answer a questionnaire. A total of 14,223 (74%) returned the questionnaire. In the first follow-up (CCHS-II), conducted from 1981 to 1983, all participants from CCHS-I and additionally 500 were invited (response rate 70%). In the second

Results

Of the 23,189 invited individuals, 2.5% were registered at least once with depression during follow-up, and among the 18,146 individuals who completed at least one of the three questionnaires, the number was 2.7% (3.5% of the women and 1.7% of the men). Of the 18,146 participants, 188 were excluded due to depression prior to baseline. The incidence rate for depression was 3.0% for those participating in CCHS-I and at least one more round and 2.1% for those only participating in CCHS-I.

Discussion

The present study found that women with a low level of physical activity had an increased risk of depression compared to women with a high level of physical activity. Among men, the association was not statistically significant. Adjusting for various confounding factors did not change the results notably and neither did any of the sensitivity analyses aiming at evaluating the possibility of reverse causation.

Conclusion

The present study found a greater risk of depression among women with a low level of physical activity compared to women with a high level. Among men, the association was not statistically significant. Further evidence from longitudinal studies is needed to be able to conclude unambiguously concerning the potential preventive role of physical activity on depression.

Physical activity is already known to have positive effects on several diseases like heart diseases, diabetes, and cancer (Kruk,

Conflict of interest statement

The authors declare that there are no conflicts of interests.

Acknowledgments

We thank the steering committee of the Copenhagen City Heart Study for kindly providing the data necessary for our analyses. Funding for this study was provided by a research grant from the IMK Almene Fond, grant number: 30206-224. The IMK Almene Fond had no further role in study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication.

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Citation Excerpt :
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Depression is a serious mental condition and physical activity is known to be effective in alleviating it. This study for rural residents of South Korea investigated whether meeting the recommended amount of physical activity during leisure time (LTPA) can reduce the depressive symptoms.
A prospective study was conducted with 5,178 participants aged 20 years and over, and we analyzed 1,888 participants excluding those diagnosed with depression at baseline and those with insufficient data after an average of 5.3 years of follow-up. LTPA was quantified by the MET (metabolic equivalent of task) and categorized according to whether the recommended physical activity was met (0, 0.1 to < 7.5, ≥ 7.5 MET h/wk). The relationship with depressive symptoms (CES-D ≥ 41) was generated by adjusted relative risks (RRs) and 95% CIs through multivariate logistic regression.
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A cohort study of leisure time physical activity and depression

Abstract

Objective

Methods

Results

Conclusion

Introduction

Section snippets

The study population

Results

Discussion

Conclusion

Conflict of interest statement

Acknowledgments

Int. J. Cardiol.

Am. J. Prev. Med.

MENPA

Prev. Med.

Prev. Med.

Am. J. Prev. Med.

Prev. Med.

The Copenhagen City Heart Study. Osterbroundersogelsen. A book of tables with data from the first examination (1976–78) and a five year follow-up (1981–83). The Copenhagen City Heart Study Group

Scand. J. Soc. Med. Suppl.

Physical activity and depressive symptoms among Norwegian adults aged 20–50

Public Health Nurs.

Can strenuous leisure time physical activity prevent psychological complaints in a working population?

Occup. Environ. Med.

Physical activity and depression: evidence from the Alameda County Study

Am. J. Epidemiol.

Differential determinants of men's and women's everyday physical activity in later life

J. Gerontol. B Psychol. Sci. Soc. Sci.

Exercise and depression in midlife: a prospective study

Am. J. Public Health

Testing causality in the association between regular exercise and symptoms of anxiety and depression

Arch. Gen. Psychiatry

Physical activity dose–response effects on outcomes of depression and anxiety

Med. Sci. Sports Exerc.

Physical activity and depressive symptoms: the NHANES I Epidemiologic Follow-up Study

Am. J. Epidemiol.

Physical activity and psychological well-being: knowledge base, current issues, and caveats

Nutr. Rev.

Exercise in the treatment of depression

Curr. Psychiatry Rep.