Adherence to a Mediterranean diet and leisure-time physical activity are associated with reduced initiation of antidepressant, anxiolytic, antipsychotic and antiseizure drug use in older adults: a cohort study

IF 6 2区医学 Q1 GERIATRICS & GERONTOLOGY

Age and ageing Pub Date : 2025-04-13 DOI:10.1093/ageing/afaf088

Marta H Hernandez, Eleonora Fornara, Camille Lassale, Olga Castañer-Niño, Ramón Estruch, Emilio Ros, Miguel Ángel Martínez-González, Dolores Corella, Nancy Babio, José Lapetra, Enrique Gómez-Gracia, Fernando Arós, Miquel Fiol, Lluís Serra-Majem, Antonio Riera-Mestre, Alfredo Gea, Carolina Ortega-Azorín, Andrés Díaz-López, Montserrat Fitó, Álvaro Hernáez

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引用次数: 0

Abstract

Background We explored how adherence to the Mediterranean diet (MedDiet) and leisure-time physical activity (LTPA) impact psychoactive medication use in older adults. Methods We assessed the cumulative MedDiet adherence and LTPA’s impact on mental health medication initiation in older individuals at high risk of chronic disease. Associations between the cumulative average of MedDiet adherence (per one-point increase in the adherence score) and LTPA (per increase in 20 metabolic equivalents of task-minute/day [METs-min/day]) with drug initiation were assessed by multivariable Cox regressions. We explored non-linear exposure-outcome associations using smoothed cubic splines and the multiplicative interaction between MedDiet and LTPA. Results A total of 5940–6896 participants (mean age 67, 58% women) over 4.2–4.7 years, each point increase in MedDiet adherence decreased the initiation of antidepressants by 23–28% (HR 0.72, 95% CI 0.67–0.77), anxiolytics (HR 0.75, 0.70–0.81), antipsychotics (HR 0.77, 0.65–0.91), and antiseizures (HR 0.77, 0.69–0.85). Associations for anxiolytics and antiseizures were strong at low MedDiet adherence levels. Relationships between LTPA and initiation of antidepressants and anxiolytics were linear in the lowest LTPA values (0–150 METs-min/day); every 20 METs-min/day increases were associated with 20% lower risk of initiating antidepressants (HR 0.80, 0.75–0.86) and 15% less risk in anxiolytics (HR 0.85, 0.79–0.90). Association with antiseizures was linear (+20 METs-min/day: HR 0.96, 0.94–0.99), and no associations were found for antipsychotics. High MedDiet adherence (≥10) and LTPA (≥150 METs-min/day) reduced psychoactive drug initiation by 42%–59%. Combination was additive for antidepressants, antipsychotics and antiseizures and synergistic for anxiolytics. Conclusions MedDiet and LTPA adherence reduced psychoactive drugs initiation in older adults.

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坚持地中海饮食和业余体育锻炼与减少老年人开始使用抗抑郁药、抗焦虑药、抗精神病药和抗癫痫药有关：一项队列研究

背景我们探讨了坚持地中海饮食（MedDiet）和闲暇时间体育锻炼（LTPA）对老年人精神药物使用的影响。方法我们评估了慢性病高风险老年人坚持地中海饮食和闲暇时间体育锻炼对精神健康药物使用的累积影响。我们通过多变量 Cox 回归评估了 MedDiet 依从性（依从性得分每增加一分）和 LTPA（任务分钟/天 [METs-min/day] 的 20 个代谢当量每增加一分）的累积平均值与用药的相关性。我们使用平滑立方样条和 MedDiet 与 LTPA 之间的乘法交互作用探讨了非线性暴露-结果关联。结果在 4.2-4.7 年的时间里，共有 5940-6896 名参与者（平均年龄 67 岁，58% 为女性）参加了研究，坚持 "健康饮食 "每增加一个点，抗抑郁药的使用就会减少 23-28%（HR 0.72，95% CI 0.67-0.77）、抗焦虑药（HR 0.75，0.70-0.81）、抗精神病药（HR 0.77，0.65-0.91）和抗癫痫药（HR 0.77，0.69-0.85）。抗焦虑药和抗癫痫药的相关性在医疗饮食依从性较低时很强。最低LTPA值（0-150 METs-min/天）与开始服用抗抑郁药和抗焦虑药之间呈线性关系；每增加20 METs-min/天，服用抗抑郁药的风险降低20%（HR 0.80，0.75-0.86），服用抗焦虑药的风险降低15%（HR 0.85，0.79-0.90）。与抗癫痫的关系是线性的（+20 METs-min/天：HR 0.96，0.94-0.99），与抗精神病药物没有关系。高度坚持 "健康饮食"（≥10）和LTPA（≥150 METs-min/天）可将精神活性药物的使用率降低42%-59%。对于抗抑郁药、抗精神病药和抗癫痫药而言，两者的结合具有相加作用，而对于抗焦虑药而言，两者的结合具有协同作用。结论坚持膳食治疗和长效精神药物治疗可减少老年人开始服用精神药物。

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来源期刊

Age and ageing 医学-老年医学

CiteScore

9.20

自引率

6.00%

发文量

796

审稿时长

4-8 weeks

期刊介绍： Age and Ageing is an international journal publishing refereed original articles and commissioned reviews on geriatric medicine and gerontology. Its range includes research on ageing and clinical, epidemiological, and psychological aspects of later life.