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Relationship between sedentary behavior and depression: A mediation analysis of influential factors across the lifespan among 42,469 people in low- and middle-income countries

Research output: Contribution to journalArticle

Brendon Stubbs, Davy Vancampfort, Joseph Firth, Felipe B. Schuch, Mats Hallgren, Lee Smith, Benjamin Gardner, Kai G. Kahl, Nicola Veronese, Marco Solmi, André F. Carvalho, Ai Koyanagi

Original languageEnglish
Pages (from-to)231-238
Number of pages8
JournalJournal of Affective Disorders
Volume229
Early online date3 Jan 2018
DOIs
StateE-pub ahead of print - 3 Jan 2018

King's Authors

Abstract

Background Sedentary behavior (SB) is associated with diabetes, cardiovascular disease and low mood. There is a paucity of multi-national research investigating SB and depression, particularly among low- and middle-income countries. This study investigated the association between SB and depression, and factors which influence this. Methods Cross-sectional data were analyzed from the World Health Organization's Study on Global Ageing and Adult Health. Depression was based on the Composite International Diagnostic Interview. The association between depression and SB (self-report) was estimated by multivariable linear and logistic regression analyses. Mediation analysis was used to identify influential factors. Results A total of 42,469 individuals (50.1% female, mean 43.8 years) were included. People with depression spent 25.6 (95%CI8.5–42.7) more daily minutes in SB than non-depressed participants. This discrepancy was most notable in adults aged ≥ 65 y (35.6 min more in those with depression). Overall, adjusting for socio-demographics and country, depression was associated with a 1.94 (95%CI1.31–2.85) times higher odds for high SB (i.e., ≥ 8 h/day). The largest proportion of the SB-depression relationship was explained by mobility limitations (49.9%), followed by impairments in sleep/energy (43.4%), pain/discomfort (31.1%), anxiety (30.0%), disability (25.6%), cognition (16.1%), and problems with vision (11.0%). Other health behaviors (physical activity, alcohol consumption, smoking), body mass index, and social cohesion did not influence the SB-depression relationship. Conclusion People with depression are at increased risk of engaging in high levels of SB. This first multi-national study offers potentially valuable insight for a number of hypotheses which may influence this relationship, although testing with longitudinal studies is needed.

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