Association of Physical Activity and Sedentary Behavior With Depressive Symptoms in Older Adults: A Structural Equation Modeling in Cross-Sectional Study.

Background/objectives: Few conceptual models demonstrate how the relationship between behavioral factors, especially physical activity (PA) and sedentary behavior (SB), and depressive symptoms occurs in older adults. In this regard, understanding how these relationships occur may help in designing future behavior change interventions. The aim of the present study was to evaluate the associations of PA and SB with depressive symptoms in older adults, accounting for functional capacity, sleep quality, self-esteem, and self-efficacy as possible mediators.

Methods: In overall, 466 older adults aged ≥60 years participated in the study with a cross-sectional design. We subjectively assessed depressive symptoms, PA and SB, self-efficacy for walking and PA, instrumental activities of daily living, sleep quality, and self-esteem. Structural equation modeling was used to investigate the direct and indirect associations of PA and SB with depressive symptoms.

Results: Although PA and SB do not have a direct association with depressive symptoms, these behaviors seem to have total effects on the outcome. The association of SB with depressive symptoms was mediated by functional capacity and sleep quality. And the association of PA was mediated by functional capacity and self-esteem.

Conclusion: To reduce depressive symptoms in older adults, PA and SB interventions need to promote sleep quality, functional capacity, and self-esteem. Significance/Implications: Interventions that promote the continuation of regular PA and the reduction of time spent in SB should be encouraged, seeking to improve sleep quality and increase functional capacity, in order to reduce the rates of depressive symptoms in older adults.