| Abstract: | Background: Depression, inadequate fruit and/or vegetable (F/V) consumptions, and reduced leisure-time physical activity (LTPA) are common in the elderly. The associations among these factors have not been examined in community living older persons.
Aims: The objectives of the present study were to determine the independent and combined relationships among LTPA, fruit and/or vegetable consumptions, and depressive symptoms in ≥53-year old Taiwanese.
Methods: We analyzed the 1999 and 2003 datasets of the Taiwan Longitudinal Study on Aging (TLSA), a population-based cohort study. The study was conducted in three parts in this study. In part I, we examined the associations of baseline LTPA and F/V consumptions with new-onset depressive symptoms status four-years later; In part II, we examined the associations of depressive symptom status and F/V consumptions with subsequent LTPA; and in part III, we examined the cross-sectional associations of depressive symptoms and LTPA with F/V consumption status. We evaluated the depressive symptoms status using the Center for Epidemiologic Studies Depression scale (CES-D, score range 0-30; ≥10 as having depressive symptoms); LTPA was evaluated by multiplying the frequency, duration, and intensity of participant's routine physical activity; and F/V consumptions were rated using semi-quantitative food frequency method. We excluded participants who had depressive symptoms at the baseline in Part I study; those who were physically inactive, unable to walk 200-300m, or had stroke or cancer in Part II study, and those who had incomplete F/V consumption data in Part III study. Multiple logistic regression analyses were conducted to determine the associations.
Results: High LTPA and higher fruit and vegetable consumptions appeared to be independently associated with reduced new depressive symptoms four years later, however, only LTPA was significantly (OR=0.75, 95%CI=0.57-0.99, p=0.043) associated with increased depressive symptoms status, higher fruit or vegetable consumption was not. Combining higher fruit (0.61, 0.41-0.89, p=0.010), higher vegetable (0.49, 0.26-0.93, p=0.0029), or higher fruit and vegetable (0.39, 0.20-0.77, p=0.006) consumptions with high LTPA all reduced the likelihood of developing new depressive symptoms four-years later beyond high LPTA alone.
Depressive symptoms status was associated with subsequent LTPA decline, while fruit and vegetable consumptions were not. Persons with constant depressive symptoms were 206% (2.06, 1.22-3.47, p=0.007); those who had lessened symptoms were 157% (1.57, 1.18-2.07, p=0.002), and those who had worsening depressive symptoms were 175% (1.75, 1.31-2.35, p<0.001) as likely to experience a decline in LTPA as those who had no depressive symptoms. Persons with depressive symptoms status were 38% (0.62, 0.50-0.76, p<0.001) less likely to experience a high frequency of fruit-vegetable consumption compared to those who had no depressive symptoms; subjects who were physically moderately active were 1.44 times (1.44, 1.18-1.77, p<0.001), and those who were physically active were 1.83 times (1.83, 1.52-2.21, p<0.001) as likely to have higher frequency of fruit-vegetable consumption compared to those who were inactive.
Conclusion: Simultaneous presence of good lifestyle habits increases the beneficial effect of reducing the risk of developing depressive symptoms in older adults. Depressive symptoms and cognitive decline, but not fruit and vegetable consumptions were longitudinally associated with LTPA decline in older adults. Depressive symptoms and LTPA were associated with concurrent fruit-vegetable consumption in older Taiwanese. Depressive symptoms were associated with lower whereas higher LTPA was associated with higher frequency of fruit-vegetable consumption. These findings suggest that it is important to encourage older adults to have as many good lifestyle habits as possible in order to reduce the risk of depressive symptoms. Our results should be useful for designing effective health promotion strategies for reducing the risk of depressive symptoms in older adults. |
