Gender-specific dual effects of physical activity on depression and mortality: a nine-year cohort study in Chinese adults aged 45 and above

BackgroundRegular participation in physical activity (PA) reduces all-cause mortality (ACM) in the general population. However, the effects of PA on depressed patients and potential gender-specific responses have not been fully elucidated. In this study, we aimed to investigate the role of PA on new...

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Main Authors: Dan Shan, Meina Yang, Kunyan Zhou
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1510044/full
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author Dan Shan
Dan Shan
Meina Yang
Meina Yang
Kunyan Zhou
Kunyan Zhou
author_facet Dan Shan
Dan Shan
Meina Yang
Meina Yang
Kunyan Zhou
Kunyan Zhou
author_sort Dan Shan
collection DOAJ
description BackgroundRegular participation in physical activity (PA) reduces all-cause mortality (ACM) in the general population. However, the effects of PA on depressed patients and potential gender-specific responses have not been fully elucidated. In this study, we aimed to investigate the role of PA on new-onset depression and ACM in Chinese adults aged 45 year and older, with particular emphasis on gender differences.MethodsThis was a longitudinal cohort study that took place over a nine-year period and featured 2,264 participants drawn from the China Health and Retirement Longitudinal Study (CHARLS). PA levels were categorized into quartiles using metabolic equivalents (MET; minutes/week), and depression was evaluated according to the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10) scale. Specific relationships between PA, depression, and mortality were then investigated by applying multivariate logistic regression and Cox proportional hazards models.ResultsHighest quantile levels of PA were correlated with a 37% increase in the risk of new-onset depression in middle-aged (45–59 years) and older adults (>60 years). This association was predominantly influenced by a significant increase in the risk of mild depression (a score of 10–14 on the CESD-10) (odds ratio [OR]: 1.76; 95% confidence interval [CI]: 1.29–2.42, p < 0.001), with a more pronounced effect observed in women (OR: 1.83; 95% CI: 1.26–2.66, p = 0.002). A critical threshold for PA was identified at 4536 MET-minutes/week, beyond which the risk of depression increased significantly (p < 0.05). Conversely, higher levels of PA were linked to a 90% reduction in ACM (HR: 0.10; 95% CI: 0.02–0.44, p = 0.002), with the effect being more pronounced in men.ConclusionWhile PA reduces mortality, excessive activity may increase the risk of mild depression, particularly in women. These findings highlight the need for gender-specific PA guidelines that balance physical and mental health outcomes.
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spelling doaj-art-5c9a3fb081aa49a588e7e2185a8481972025-01-21T13:14:41ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-01-011310.3389/fpubh.2025.15100441510044Gender-specific dual effects of physical activity on depression and mortality: a nine-year cohort study in Chinese adults aged 45 and aboveDan Shan0Dan Shan1Meina Yang2Meina Yang3Kunyan Zhou4Kunyan Zhou5Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, ChinaKey Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, ChinaDepartment of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, ChinaKey Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, ChinaDepartment of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, ChinaKey Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, ChinaBackgroundRegular participation in physical activity (PA) reduces all-cause mortality (ACM) in the general population. However, the effects of PA on depressed patients and potential gender-specific responses have not been fully elucidated. In this study, we aimed to investigate the role of PA on new-onset depression and ACM in Chinese adults aged 45 year and older, with particular emphasis on gender differences.MethodsThis was a longitudinal cohort study that took place over a nine-year period and featured 2,264 participants drawn from the China Health and Retirement Longitudinal Study (CHARLS). PA levels were categorized into quartiles using metabolic equivalents (MET; minutes/week), and depression was evaluated according to the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10) scale. Specific relationships between PA, depression, and mortality were then investigated by applying multivariate logistic regression and Cox proportional hazards models.ResultsHighest quantile levels of PA were correlated with a 37% increase in the risk of new-onset depression in middle-aged (45–59 years) and older adults (>60 years). This association was predominantly influenced by a significant increase in the risk of mild depression (a score of 10–14 on the CESD-10) (odds ratio [OR]: 1.76; 95% confidence interval [CI]: 1.29–2.42, p < 0.001), with a more pronounced effect observed in women (OR: 1.83; 95% CI: 1.26–2.66, p = 0.002). A critical threshold for PA was identified at 4536 MET-minutes/week, beyond which the risk of depression increased significantly (p < 0.05). Conversely, higher levels of PA were linked to a 90% reduction in ACM (HR: 0.10; 95% CI: 0.02–0.44, p = 0.002), with the effect being more pronounced in men.ConclusionWhile PA reduces mortality, excessive activity may increase the risk of mild depression, particularly in women. These findings highlight the need for gender-specific PA guidelines that balance physical and mental health outcomes.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1510044/fullphysical activitydepressionall-cause mortalityCHARLSmenopause
spellingShingle Dan Shan
Dan Shan
Meina Yang
Meina Yang
Kunyan Zhou
Kunyan Zhou
Gender-specific dual effects of physical activity on depression and mortality: a nine-year cohort study in Chinese adults aged 45 and above
Frontiers in Public Health
physical activity
depression
all-cause mortality
CHARLS
menopause
title Gender-specific dual effects of physical activity on depression and mortality: a nine-year cohort study in Chinese adults aged 45 and above
title_full Gender-specific dual effects of physical activity on depression and mortality: a nine-year cohort study in Chinese adults aged 45 and above
title_fullStr Gender-specific dual effects of physical activity on depression and mortality: a nine-year cohort study in Chinese adults aged 45 and above
title_full_unstemmed Gender-specific dual effects of physical activity on depression and mortality: a nine-year cohort study in Chinese adults aged 45 and above
title_short Gender-specific dual effects of physical activity on depression and mortality: a nine-year cohort study in Chinese adults aged 45 and above
title_sort gender specific dual effects of physical activity on depression and mortality a nine year cohort study in chinese adults aged 45 and above
topic physical activity
depression
all-cause mortality
CHARLS
menopause
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1510044/full
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