Compositional associations of 24-h physical activities, sedentary time and sleep with depressive symptoms in urban and rural residents: a cross-sectional study

Abstract

Background: Studies investigating the associations of 24-h movement behaviours (including moderate-to-vigorous-intensity physical activity (MVPA), light-intensity PA (LPA), sedentary time (ST) and sleep) with depressive symptoms are scarce. It is also unclear whether possible associations differ between urban and rural residents. Hence, we aimed to investigate these associations in a population-based sample of middle-aged Finnish adults.

Methods: The study population consisted of 4295 adults, aged 46 years, from the Northern Finland Birth Cohort 1966. The participants wore a hip-worn accelerometer for 14 days. Time spent in sedentary, LPA and MVPA was obtained from accelerometer data and then combined with self-reported sleep duration to obtain the 24-h composition. The residential environment was classified as urban or rural based on the participants' home addresses. Depressive symptoms were assessed using the Beck Depression Inventory-II (BDI-II). Multivariable adjusted regression analysis using a compositional data analysis approach based on isometric log-ratio transformation was used to determine the associations between movement behaviours and depressive symptoms in urban and rural residential environments.

Results: The 24-h movement behaviour composition was significantly associated with the BDI-II score both in urban and rural residential environment. More time spent in sleep relative to other behaviours was associated with lower BDI-II score in rural residential environments. More time spent in ST among urban residents and in LPA among rural residents was associated with higher BDI-II scores. When modelling pairwise reallocations of time, more MVPA or more sleep at the expense of LPA or ST was associated with lower BDI-II score among rural residents. For urban residents, reallocating time from ST to any other behaviour was associated with lower BDI-II score.

Conclusions: Our findings showed that more relative time spent in MVPA and sleep was associated with lower levels of depressive symptoms among rural residents, and more relative time spent in any other behaviour at the expense of ST was associated with lower levels of depressive symptoms among urban residents. These differences should be considered in the prevention and treatment of depressive symptoms. Due to the cross-sectional design of this study, causality cannot be inferred, and further research exploring the mechanisms underlying these associations in diverse populations and longitudinal study settings are needed.

Keywords: Compositional data analysis; Depressive symptoms; Physical activity; Rural; Sedentary time; Sleep; Urban.

Fig. 1

Differences with 95% bootstrap percentile CIs between urban and rural residents in the log-ratio of geometric mean values for MVPA, LPA, ST and sleep in all eligible participants (n = 4295). Notes: Urban was used as the numerator and rural as the denominator when calculating the log-ratios. A positive value of the log-ratio indicates that urban residents spent more time in that behaviour compared to rural residents, whereas a negative value indicates that urban residents spent less time in that behaviour compared to rural residents. A particular behaviour is considered significantly different between groups if its CI does not include zero. MVPA, moderate-to-vigorous-intensity physical activity; LPA, light-intensity physical activity; ST, sedentary time; CIs, confidence intervals

Fig. 2

Estimated %differences (95% CI) in BDI-II score from pairwise time reallocations between movement behaviours among the urban (n = 2364), rural (n = 1134) and total population (n = 3498). Note that the scale of the x-axis varies. BDI-II, Beck Depression Inventory-II