Association of Mental Health and Physical Activity with All-cause Mortality in Persons with Disability: Based on 14-year Follow-up Data from the Korean Longitudinal Study of Aging

PURPOSE This study investigated the associations between mental health and physical activity with all-cause mortality in persons with disability. METHODS A total of 595 participants (39.3% women) aged 45≥ years, who participated in the Korean longitudinal study of aging (KLoSA) were included in this study. The Korean version of mini-mental state examination (K-MMSE) and the center for epidemiologic studies depression scale (CES-D) were used to assess cognitive impairment and depressive symptoms, respectively. The participants were classified into active and inactive groups based on physical activity of 150 min/week. Cox’s proportional regression analyses were used to determine the hazard ratio (HR) and 95% confidence interval (CI) of mental health and physical activity relating to all-cause mortality. RESULTS During the follow-up period (11.8±4.1 years), a total of 218 (36.6%) deaths occurred from all-causes. Participants in the inactive group had significantly higher cognitive impairment (p =0.046), depressive symptoms (p =0.001), and all-cause mortality (p=0.037) than those in the active group. Compared to participants in the normal (HR=1), cognitive impairment (HR=2.229, 95% CI=1.645-3.020, p<0.001), and depressive symptoms groups (HR=1.542, 95% CI=1.136-2.091, p<0.001), those in the inactive group had significantly higher HR related to all-cause mortality. However, in the active group, cognitive function and depressive symptoms were not associated with all-cause mortality. CONCLUSIONS The current finding suggests that the promotion of physical activity may play an important role in preventing premature death from all-causes in persons with disability, especially among those with mental health problems.