Is the Sardinian Blue Zone the New Shangri-La for mental health? Evidence on depressive symptoms and its correlates in late adult life span

Abstract

Background An area of extraordinary longevity (i.e., Sardinian Blue Zone) characterized by a very high prevalence of long-lived successful agers has been validated in Sardinia, an Italian island located in the Mediterranean Sea. Aims This study was primarily aimed at examining whether dietary habits (intake of vegetables and fruit, animal-derived proteins, and carbohydrates-rich food), time spent on hobbies, subjective physical health, and socio-cultural context (Sardinian Blue Zone vs. another Sardinian rural area) predicted self-reported depressive symptoms in older adults recruited in the Sardinian Blue Zone and another Sardinian rural area not being characterized by a higher prevalence of long-lived individuals. Methods Three hundred and eighteen community-dwellers, age 65 years and older, 188 females and 130 males (Mage = 79.1 years, SD = 6.9 years) were recruited from the Sardinian Blue Zone and another Sardinian rural area. Each participant individually completed a battery of instruments to assess lifestyle, food habits, perceived physical health, and depressive symptoms through the CES-D inventory. Results Significant associations were found between depressive signs, perceived physical health, time spent gardening, proteins, and carbohydrates intake, respectively. Approximately 17% of the variance in the CES-D condition was predicted by socio-cultural context, perceived physical health, and gardening. Participants recruited in the Sardinian Blue Zone spent more time gardening and self-reported better physical health. Conclusions current results suggest that a socio-cultural context where people age well (i.e., the Sardinian Blue Zone), and a healthy and physically active lifestyle are crucial for promoting well-being in late adulthood.

Cognitive Reserve, Physical Reserve, and Cognitive Efficiency of Older People Living in the Sardinian Blue Zone. An Exploratory Study

“…Specifically, the significant indirect effect of CR—especially the CRIq-Hobby measure—and daily steps on the MMSE score suggests that the cognitive reserve and physical one contribute in preserving the global cognitive functioning of older individuals who age well. Therefore, as suggested elsewhere (e.g., Legrand et al, 2019; Martinčević & Vranić, 2023; Ruiu et al, 2022), the current outcomes seem to support the idea that the maintenance of an active lifestyle in which older people are engaged with moderate but regular physical activity and with cognitively stimulating leisure activities is essential for the promotion of successful aging. Indeed, as suggested by Stern et al (2020), life experiences and lifestyle which enhance CR and physical reserve and therefore increase cognitive flexibility are crucial for coping with age-related cognitive and functional changes.…”

“…Besides, following previous studies (e.g., Calatayud et al, 2022), formal schooling and work occupation were significantly associated with cognitive flexibility and shifting skills (i.e., assessed through TMT-B-A), suggesting that those who were more educated and performed more cognitively demanding jobs empowered their executive functions during their lifespan. Moreover, following Ruiu et al (2022), a small and positive significant relationship has been found between perceived physical health and the CRIq-Hobby measure, suggesting that those who were more engaged with cognitively and physically demanding leisure activities also felt physically better. Extending this and in line with previous evidence (Bherer et al, 2013), we also found that physical reserve (objectively assessed in terms of daily steps) was associated with perceived physical health, CRIq-tot, and CRIq-Hobby.…”

“…A further novelty aspect concerns the fact that in the current investigation physical reserve was concurrently assessed based on both self-reported and objective instrumental measures of PA. This is very important, since thus far, data about PA of older people living in the BZs were mainly assessed through diaries and recall questionnaires (e.g., Fastame, 2022; Panagiotakos et al, 2011; Ruiu et al, 2022; Spencer-Hwang et al, 2018) which represent the most widespread techniques owing to their low cost, easiness of use and versatility but that suffer from poor reliability and validity, participant recall bias and interpretation of questions (Silfee et al, 2018), and usually overestimate amount and intensity of movement performed (Boon et al, 2010). Thus, the integration of the two approaches (i.e., self-reported and objective measures) seems to be important to accurately capture detailed information about PA features.…”

“…First, CR was not evaluated using validated tools; that is, that construct was assessed using single socio-behavioral proxy measures, such as years of formal education and time spent in socio-cultural leisure activities at the time of the interview (e.g., Legrand et al, 2019; Ruiu et al, 2022). Second, in the studies conducted in the BZs, the physical reserve was usually assessed by applying qualitative methods (Spencer-Hwang et al, 2018) or through self-reported dichotomous measures correlated to daily activities implicating moderate-to-intense physical activity (e.g., “do you perform any sport?,” “do you spend time gardening?,” Fastame et al, 2018), or asking participants to self-evaluate their physical health and their lifestyle (e.g., Fastame, 2022; Legrand et al, 2021; Panagiotakos et al, 2011; Ruiu et al, 2022), or inferring the conduction of moderate-to-intense physical activities through some structured interview (e.g., Willcox et al, 2007). Indeed, to our knowledge, there are very few studies in which physical reserve was objectively assessed through instrumental measures in older people of the Sardinian BZ (Fastame et al, 2021) and those living in the Nicoya Peninsula (Madrigal-Leer et al, 2020).…”

Interactions with Nature, Good for the Mind and Body: A Narrative Review

“…Results from their research suggest that intentionally interacting with nature is positively associated with mental wellbeing [ 93 , 94 , 95 , 96 ], mood [ 97 , 98 ], calmness and wakefulness [ 99 ], subjective wellbeing [ 100 , 101 , 102 , 103 ], positive affect [ 95 , 96 , 104 , 105 ], quality of life [ 106 , 107 , 108 ], vigor [ 98 ], mindfulness [ 105 ], satisfaction with life [ 109 , 110 ], vitality [ 111 ], happiness [ 112 , 113 ], relaxation [ 114 ], and restorativeness [ 115 ]. Intentionally interacting with nature has been inversely associated with depressive symptoms [ 116 ], depression [ 95 , 96 , 98 , 106 , 110 , 117 ], anxiety [ 97 , 110 ], stress [ 94 , 95 , 96 , 105 , 118 ], negative affect [ 94 , 95 , 96 , 104 , 105 ], anger [ 97 ], agitation [ 106 ], fatigue […”