Long-term associations between the stability of physical activity trajectories and depressive symptom trajectories among middle-aged and older adults: A multi-trajectory modeling analysis using China Health and Retirement Longitudinal Study data.

BACKGROUND

Although the positive effects of physical activity on depressive symptoms are well established, research on the dynamic relationship between long-term physical activity patterns and depressive symptom trajectories remains limited.

OBJECTIVE

This study examines the long-term associations between physical activity and depressive symptom trajectories in adults aged 50 and older and explores potential gender differences.

METHODS

Data were drawn from the China Health and Retirement Longitudinal Study (2011-2020), comprising 4103 participants aged 50 and older. Physical activity and depressive symptoms were assessed using the International Physical Activity Questionnaire and the 10-item Center for Epidemiologic Studies Depression Scale, respectively. Group-based trajectory modeling was employed to identify long-term patterns of physical activity and depressive symptoms. Multinomial logistic regression was performed to examine associations between trajectory groups, including interaction terms and gender-stratified analyses.

RESULTS

The moderate-stable-increasing and moderate-stable-decreasing trajectories were significantly associated with a reduced risk of high depressive symptom trajectories (OR = 0.58, CI: 0.46-0.73; OR = 0.50, CI: 0.37-0.66). In contrast, the low-fluctuating-increasing trajectory was significantly associated with an elevated risk (OR = 2.48, CI: 1.74-3.52). Gender-stratified analyses revealed that the low-fluctuating-increasing trajectory was associated with a higher risk of high depressive symptoms in both men and women, whereas the moderate-stable-decreasing trajectory was linked to a lower risk across both sexes. Importantly, the moderate-stable-increasing trajectory was associated with reduced risk only in women.

CONCLUSION

Moderate and stable physical activity trajectories are associated with reduced high depressive symptom risk, with stronger associations observed in women.