Lower Odds of Poststroke Symptoms of Depression When Physical Activity Guidelines Met: National Health and Nutrition Examination Survey 2011–2012

Abstract

Background One-third of individuals with stroke report symptoms of depression, which has a negative impact on recovery. Physical activity (PA) is a potentially effective therapy. Our objective was to examine the associations of subjectively assessed PA levels and symptoms of depression in a nationally representative stroke sample. Methods We conducted a cross-sectional study of 175 adults in the National Health and Nutrition Examination Survey 2011–2012 cycle. Moderate, vigorous, and combination equivalent PA metabolic equivalent (MET)-minutes per week averages were derived from the Global Physical Activity Questionnaire, and .the 2008 Physical Activity Guidelines/American College of Sports Medicine recommendations of ≥500 MET-minutes per week of moderate, vigorous, or combination equivalent PA were used as cut points. Depression symptoms were measured using the Patient Health Questionnaire-9. Results Meeting moderate PA guidelines resulted in 74% lower odds of having depression symptoms (P < .0001) and 89% lower odds of major symptoms of depression (P = .0003). Meeting vigorous guidelines showed a 91% lower odds of having mild symptoms of depression (P = .04). Participating in some moderate, vigorous, or combination equivalent PA revealed the odds of depression symptoms 13 times greater compared with meeting guidelines (P = .005); odds of mild symptoms of depression were 9 times greater (P = .01); and odds of major symptoms of depression were 15 times greater (P = .006). Conclusions There is a lower risk of developing mild symptoms of depression when vigorous guidelines for PA are met and developing major symptoms of depression when moderate guidelines met. Participating in some PA is not enough to reduce the risk of depression symptoms.

Physical activity and depression in Indonesian adults with stroke: A nationwide survey

“…This research extends previous findings of depression in the general population (Belvederi Murri et al, 2019;López-Torres Hidalgo et al, 2019) as well as in nationwide stroke populations of all age ranges (Aaron et al, 2016;Hong et al, 2017).…”

“…Variables previously determined to be associated with depression occurrence in individuals with stroke (Aaron et al, 2016; Bovim et al, 2019; Ghazizadeh et al, 2020; Hong et al, 2017; Kroeders et al, 2013) were included as confounders. Sociodemographic factors included age, sex, education level, marital status, occupation, and urbanization level.…”

“…A previous meta‐analysis reported that physical activity appeared to have a beneficial effect on depressive symptoms in both subacute and chronic stages of stroke recovery (Eng & Reime, 2014). While physical activity appears to be associated with fewer depressive symptoms in individuals with stroke (Aaron et al, 2016; Bovim et al, 2019; Hong et al, 2017; Kroeders et al, 2013), the results have been inconsistent, few studies have been conducted using a nationally representative sample.…”

Development and Preliminary Validation of a Stroke Physical Activity Questionnaire

“…One aim of stroke rehabilitation is to enable the stroke survivor to develop and maintain an active lifestyle that meets the recommended physical activity and exercise guidelines, so as to improve physical function and prevent stroke recurrence and other cardiac events [8]. Physical activity in patients after stroke has been shown to have a positive effect on poststroke depression [9, 10], social participation [11], health related quality of life [12], and cognitive function [13, 14]. Physical activity may prevent recurrent stroke and decrease poststroke mortality by modifying stroke risk factors (e.g., by decreasing blood pressure, decreasing the total cholesterol/HDL ratio, decreasing BMI, and improving aerobic capacity [15]).…”

Exercise for stroke prevention

“…Meta-analytic evidence suggests that structured exercise programming, particularly at higher intensities, improves poststroke depressive symptoms in both subacute and chronic periods 61. Meeting PA guidelines has been associated with lower risk of mild depressive symptoms 62. Among patients post-TIA/mild non-disabling stroke in comprehensive CR, psychological service recipients, referred in part on the basis of psychometric results at intake, improved significantly more than non-recipients in mean depression score 63…”