The Effect of Activity Participation in Middle-Aged and Older People on the Trajectory of Depression in Later Life: National Cohort Study

Abstract

Background: More activity participation is an important means of handling depression and promoting positive aging, but the impact of changes in activity participation on the developmental trajectory of depression has not been fully studied.

Objective: The purpose of this study is to study the relationship between current activity participation and depression in middle-aged and older people (≥45 years old) and the relationship between activity participation and the developmental trajectory of depression in later life in China.

Methods: This study used data from the China Health and Retirement Longitudinal Study (CHARLS) across 7 years and included a total of 4818 middle-aged and older people (≥45 years old). Controlling for relevant control variables, the latent growth curve model and the cross-lag model were used to assess the effect of changes in activity participation on the depression trajectory in later life and the main lag relationship between activity participation and depression. Activity participation as well as depression were measured using the self-reported activity and health status based on the CHARLS questionnaire.

Results: Among the 4818 respondents, the mean values of physical activity participation, social leisure activity participation, and depression ranged from 76.98 (SD 15.16) to 83.95 (SD 5.72), from 7.43 (SD 8.67) to 9.25 (SD 10.16), and from 7.61 (SD 5.72) to 8.82 (SD 6.51), respectively. Our findings revealed that activity participation could be related to depression. Physical activity participation predicted initial depression (β=-0.631, P<.001) and its trajectory (β=0.461, P<.001). However, social leisure activity participation predicted initial depression (β=-0.223, P<.001) but did not predict its trajectory (β=0.067, P=.159). Finally, cross-lag regression analysis further demonstrated the predictive effect of activity participation on depression.

Conclusions: This study demonstrates the prediction of activity participation for future depression in the Chinese middle-aged and older populations. The data showed that activity participation is significantly associated with changes in depression and future depression among middle-aged and older people in China. The Chinese government should encourage middle-aged and older people to participate in various activities, which can effectively prevent the aggravation of depression and also have a positive significance for positive aging.

Keywords: activity participation; cohort study; depression; developmental; middle-aged and older people.

Figure 1

(A) LGCM of activity participation and depression. (B) LGCM of social leisure activity participation and depression. The activity participation intercept, activity participation slope, depression intercept, and depression slope were regressed on the covariates simultaneously. Valid paths and nonsalient paths are plotted as solid and dashed lines, respectively. I: intercept; LGCM: latent growth curve model; S: slope.

Figure 2

(A) Cross-lag model of physical activity participation and depression. (B) Cross-lag model of social leisure activity participation and depression. Note: activity participation and depression in all 4 waves were regressed on the covariates simultaneously.