Skip to main content
Top
Published in: BMC Cardiovascular Disorders 1/2019

Open Access 01-12-2019 | Affective Disorder | Research article

Symptoms of depression are associated with physical inactivity but not modified by gender or the presence of a cardiovascular disease; a cross-sectional study

Authors: Retze Achttien, Jan van Lieshout, Michel Wensing, Maria Nijhuis van der Sanden, J. Bart Staal

Published in: BMC Cardiovascular Disorders | Issue 1/2019

Login to get access

Abstract

Background

Depressive symptomatology may act as a barrier to enhance physical activity. This phenomenon is predominantly found in patients with an established cardiovascular disease (CVD) and in female patients. This cross-sectional study investigated (1) the association between symptoms of depression and physical inactivity, and (2) whether this association is different between primary and secondary prevention patients, and between men and women.

Methods

The study design concerns a secondary analysis of baseline data from a randomized clinical trial, including primary and secondary prevention patients (n = 2184; mean age 71.6 ± 8.94), from 34 general practitioner panels. The Rapid Assessment of Physical Activity questionnaire (RAPA) was used to measure patient reported activity levels. Symptoms of depression were determined using the Patient Health Questionnaire (PHQ-9). Multilevel linear regression analysis was used to explore the association between symptoms of depression and physical activity while adjusting for confounders. Gender and whether or not having a CVD were considered as potential effect modifiers for the association between symptoms of depression and inactivity.

Results

Symptoms of depression were associated with lower levels of physical activity. This association was neither different for men and women nor for primary and secondary prevention patients.

Conclusion

In primary care patients’ symptoms of depression were associated with physical inactivity. This association was not modified by gender or the presence of a CVD. Future research should focus on lifestyle interventions aiming at the increase of physical activity levels, while emphasizing on improving symptoms of depression in men, women, and patients both with and without a history of CVD.
Literature
1.
go back to reference Scrutinio D, Temporelli PL, Passantino A, Giannuzzi P. Long-term secondary prevention programs after cardiac rehabilitation for the reduction of future cardiovascular events: focus on regular physical activity. Futur Cardiol. 2009;5:297–314.CrossRef Scrutinio D, Temporelli PL, Passantino A, Giannuzzi P. Long-term secondary prevention programs after cardiac rehabilitation for the reduction of future cardiovascular events: focus on regular physical activity. Futur Cardiol. 2009;5:297–314.CrossRef
2.
go back to reference Myers J, Prakash M, Froelicher V, Do D, Partingstion S, Atwoord JE. Exercise capacity and mortality among men referred for exercise testing. N Engl J Med. 2002;346:793–801.CrossRef Myers J, Prakash M, Froelicher V, Do D, Partingstion S, Atwoord JE. Exercise capacity and mortality among men referred for exercise testing. N Engl J Med. 2002;346:793–801.CrossRef
3.
go back to reference Sunamura M, Ter Hoeve N, van den Berg-Emons HJ, Haverkamp M, Redekop K, Geleijnse ML, et al. OPTImal CArdiac REhabilitation (OPTICARE) following acute coronary syndromes: rationale and design of a randomised, controlled trial to investigate the benefits of expanded educational and behavioural intervention programs. Neth Heart J. 2013;21:324–30.CrossRef Sunamura M, Ter Hoeve N, van den Berg-Emons HJ, Haverkamp M, Redekop K, Geleijnse ML, et al. OPTImal CArdiac REhabilitation (OPTICARE) following acute coronary syndromes: rationale and design of a randomised, controlled trial to investigate the benefits of expanded educational and behavioural intervention programs. Neth Heart J. 2013;21:324–30.CrossRef
4.
go back to reference ter Hoeve N, Huisstede BM, Stam HJ, van Domburg RT, Sunamura M, Van den berg-Emons RJ. Does cardiac rehabilitation after an acute cardiac syndrome lead to changes in physical activity habits? Systematic review. Phys Ther. 2015;95:167–79.CrossRef ter Hoeve N, Huisstede BM, Stam HJ, van Domburg RT, Sunamura M, Van den berg-Emons RJ. Does cardiac rehabilitation after an acute cardiac syndrome lead to changes in physical activity habits? Systematic review. Phys Ther. 2015;95:167–79.CrossRef
5.
go back to reference Kotseva K, Wood D, De Bacquer D, De Backer G, Rydén L, Jennings C, et al. EUROASPIRE IV: a European Society of Cardiology survey on the lifestyle, risk factor and therapeutic management of coronary patients from 24 European countries. Eur J Prev Cardiol. 2016;23:636–48.CrossRef Kotseva K, Wood D, De Bacquer D, De Backer G, Rydén L, Jennings C, et al. EUROASPIRE IV: a European Society of Cardiology survey on the lifestyle, risk factor and therapeutic management of coronary patients from 24 European countries. Eur J Prev Cardiol. 2016;23:636–48.CrossRef
6.
go back to reference Cooper AF, Jackson G, Weinman J, Horne R. Factors associated with cardiac rehabilitation attendance: a systematic review of the literature. Clin Rehabil. 2002;16:541–52.CrossRef Cooper AF, Jackson G, Weinman J, Horne R. Factors associated with cardiac rehabilitation attendance: a systematic review of the literature. Clin Rehabil. 2002;16:541–52.CrossRef
7.
go back to reference Glazer KM, Emery CF, Frid DJ, Banyasz RE. Psychological predictors of adherence and outcomes among patients in cardiac rehabilitation. J Cardpulm Rehabil. 2002;22:40–6.CrossRef Glazer KM, Emery CF, Frid DJ, Banyasz RE. Psychological predictors of adherence and outcomes among patients in cardiac rehabilitation. J Cardpulm Rehabil. 2002;22:40–6.CrossRef
8.
go back to reference Lichtman JH, Froelicher ES, Blumenthal JA, Carney RM, Doering LV, Frasure-Smith N, et al. Depression as a risk factor for poor prognosis among patients with acute coronary syndrome: systematic review and recommendations: a scientific statement from the American Heart Association. Circulation. 2014;129:1350–69.CrossRef Lichtman JH, Froelicher ES, Blumenthal JA, Carney RM, Doering LV, Frasure-Smith N, et al. Depression as a risk factor for poor prognosis among patients with acute coronary syndrome: systematic review and recommendations: a scientific statement from the American Heart Association. Circulation. 2014;129:1350–69.CrossRef
9.
go back to reference Appelman Y, van Rijn BB, Ten Haaf ME, Boersma E, Peters SA. Sex differences in cardiovascular risk factors and disease prevention. Atherosclerosis. 2015;241:211–8.CrossRef Appelman Y, van Rijn BB, Ten Haaf ME, Boersma E, Peters SA. Sex differences in cardiovascular risk factors and disease prevention. Atherosclerosis. 2015;241:211–8.CrossRef
10.
go back to reference Moller-Leimkuhler AM. Women with coronary artery disease and depression: a neglected risk group. World J Biol Psychiatry. 2008;9:92–101.CrossRef Moller-Leimkuhler AM. Women with coronary artery disease and depression: a neglected risk group. World J Biol Psychiatry. 2008;9:92–101.CrossRef
11.
go back to reference Armstrong NM, Meoni LA, Carlson MC, Xue QL, Bandeen-Roche K, Gallo JJ, et al. Cardiovascular risk factors and risk of incident depression throughout adulthood among men: the Johns Hopkins precursors study. J Affect Disord. 2017;214:60–6.CrossRef Armstrong NM, Meoni LA, Carlson MC, Xue QL, Bandeen-Roche K, Gallo JJ, et al. Cardiovascular risk factors and risk of incident depression throughout adulthood among men: the Johns Hopkins precursors study. J Affect Disord. 2017;214:60–6.CrossRef
12.
go back to reference Hearing CM, Chang WC, Szuhany KL, Deckersbach T, Nierenberg AA, Sylvia LG. Physical exercise for treatment of mood disorders: a critical review. Curr Behav Neurosci Rep. 2016;3:350–9.CrossRef Hearing CM, Chang WC, Szuhany KL, Deckersbach T, Nierenberg AA, Sylvia LG. Physical exercise for treatment of mood disorders: a critical review. Curr Behav Neurosci Rep. 2016;3:350–9.CrossRef
13.
go back to reference Teychenne M, Ball K, Salmon J. Physical activity and likelihood of depression in adults: a review. Prev Med. 2008;46:397–411.CrossRef Teychenne M, Ball K, Salmon J. Physical activity and likelihood of depression in adults: a review. Prev Med. 2008;46:397–411.CrossRef
14.
go back to reference Schuch FB, Vancampfort D, Firth J, Rosenbaum WFB, Silva ES, et al. Physical activity and Incedent depression: a meta-analysis of prospective cohort studies. Am J Psychiatry. 2018;7:631–48.CrossRef Schuch FB, Vancampfort D, Firth J, Rosenbaum WFB, Silva ES, et al. Physical activity and Incedent depression: a meta-analysis of prospective cohort studies. Am J Psychiatry. 2018;7:631–48.CrossRef
15.
go back to reference Pogosova GV. Depression-a novel risk factor of ischemic heart disease and predictor of coronary death. Kardiologiia. 2002;42:86–90.PubMed Pogosova GV. Depression-a novel risk factor of ischemic heart disease and predictor of coronary death. Kardiologiia. 2002;42:86–90.PubMed
16.
go back to reference Pelletier R, Bacon SL, Arsenault A, Dupuis J, Laurin C, Blais L, et al. Relative associations between depression and anxiety on adverse cardiovascular events: does a history of coronary artery disease matter? A prospective observational study. BMJ Open. 2015;5:e006582.CrossRef Pelletier R, Bacon SL, Arsenault A, Dupuis J, Laurin C, Blais L, et al. Relative associations between depression and anxiety on adverse cardiovascular events: does a history of coronary artery disease matter? A prospective observational study. BMJ Open. 2015;5:e006582.CrossRef
17.
go back to reference Rugulies R. Depression as a predictor for coronary heart disease. A review and meta-analysis. Am J Prev Med. 2002;23:51–61.CrossRef Rugulies R. Depression as a predictor for coronary heart disease. A review and meta-analysis. Am J Prev Med. 2002;23:51–61.CrossRef
18.
go back to reference Paganini-Hill A. Lifestyle practices and cardiovascular disease mortality in the elderly: the leisure world cohort study. Cardiol Res Pract. 2011:983764. Paganini-Hill A. Lifestyle practices and cardiovascular disease mortality in the elderly: the leisure world cohort study. Cardiol Res Pract. 2011:983764.
19.
go back to reference Carroll AJ, Carnethon MR, Liu K, Jacobs DR, Colangelo LA, Stewart JC, et al. Interaction between smoking and depressive symptoms with subclinical heart disease in the coronary artery risk development in young adults (CARDIA) study. Health Psychol. 2017;36:101–11.CrossRef Carroll AJ, Carnethon MR, Liu K, Jacobs DR, Colangelo LA, Stewart JC, et al. Interaction between smoking and depressive symptoms with subclinical heart disease in the coronary artery risk development in young adults (CARDIA) study. Health Psychol. 2017;36:101–11.CrossRef
20.
go back to reference Petter M, Blanchard C, Kemp KA, Mazoff AS, Ferrier SN. Correlates of exercise among coronary heart disease patients: review, implications and future directions. Eur J Cardiovasc Prev Rehabil. 2009;16:515–26.CrossRef Petter M, Blanchard C, Kemp KA, Mazoff AS, Ferrier SN. Correlates of exercise among coronary heart disease patients: review, implications and future directions. Eur J Cardiovasc Prev Rehabil. 2009;16:515–26.CrossRef
21.
go back to reference Moller-Leimkuhler AM. Gender differences in cardiovascular disease and comorbid depression. Dialogues Clin Neurosci. 2007;9:71–83.PubMedPubMedCentral Moller-Leimkuhler AM. Gender differences in cardiovascular disease and comorbid depression. Dialogues Clin Neurosci. 2007;9:71–83.PubMedPubMedCentral
22.
go back to reference Blanchard C, Arthur HM, Gunn E. Self-efficacy and outcome expectations in cardiac rehabilitation: associations with women's physical activity. Rehabil Psychol. 2015;60:59–66.CrossRef Blanchard C, Arthur HM, Gunn E. Self-efficacy and outcome expectations in cardiac rehabilitation: associations with women's physical activity. Rehabil Psychol. 2015;60:59–66.CrossRef
23.
go back to reference Mosca L, Banka CL, Benjamin EJ, Berra K, Bushnell C, Dolor RJ, et al. Evidence-based guidelines for cardiovascular disease prevention in women: 2007 update. J Am Coll Cardiol. 2007;49:1230–50.CrossRef Mosca L, Banka CL, Benjamin EJ, Berra K, Bushnell C, Dolor RJ, et al. Evidence-based guidelines for cardiovascular disease prevention in women: 2007 update. J Am Coll Cardiol. 2007;49:1230–50.CrossRef
24.
go back to reference Trost SG, Owen N, Bauman AE, Sallis JF, Brown W. Correlates of adults' participation in physical activity: review and update. Med Sci Sports Exerc. 2002;34:1996–2001.CrossRef Trost SG, Owen N, Bauman AE, Sallis JF, Brown W. Correlates of adults' participation in physical activity: review and update. Med Sci Sports Exerc. 2002;34:1996–2001.CrossRef
25.
go back to reference Bauman AE, Reis RS, Sallis JF, Wells JC, Loos RJ, Martin BW. Correlates of physical activity: why are some people physically active and others not? Lancet. 2012;380:258–71.CrossRef Bauman AE, Reis RS, Sallis JF, Wells JC, Loos RJ, Martin BW. Correlates of physical activity: why are some people physically active and others not? Lancet. 2012;380:258–71.CrossRef
26.
go back to reference Thombs BD, Bass EB, Ford DE, Stewart KJ, Tsilidis KK, Patel U, et al. Prevalence of depression in survivors of acute myocardial infarction. J Gen Intern Med. 2006;21:30–8.CrossRef Thombs BD, Bass EB, Ford DE, Stewart KJ, Tsilidis KK, Patel U, et al. Prevalence of depression in survivors of acute myocardial infarction. J Gen Intern Med. 2006;21:30–8.CrossRef
27.
go back to reference Meijer A, Conradi HJ, Bos EH, Thombs BD, van Melle JP, de Jonge P. Prognostic association of depression following myocardial infarction with mortality and cardiovascular events: a meta-analysis of 25 years of research. Gen Hosp Psychiatry. 2011;33:203–16.CrossRef Meijer A, Conradi HJ, Bos EH, Thombs BD, van Melle JP, de Jonge P. Prognostic association of depression following myocardial infarction with mortality and cardiovascular events: a meta-analysis of 25 years of research. Gen Hosp Psychiatry. 2011;33:203–16.CrossRef
28.
go back to reference van Lieshout J, Huntink E, Koetsenruijter J, Wensing M. Tailored implementation of cardiovascular risk management in general practice: a cluster randomized trial. Implement Sci. 2016;11:115.CrossRef van Lieshout J, Huntink E, Koetsenruijter J, Wensing M. Tailored implementation of cardiovascular risk management in general practice: a cluster randomized trial. Implement Sci. 2016;11:115.CrossRef
29.
go back to reference Wensing M. The tailored implementation in chronic diseases (TICD) project: introduction and main findings. Implement Sci. 2017;12:5.CrossRef Wensing M. The tailored implementation in chronic diseases (TICD) project: introduction and main findings. Implement Sci. 2017;12:5.CrossRef
30.
go back to reference Huntink E, Heijmans N, Wensing M, van Lieshout J. Effectiveness of a tailored intervention to improve cardiovascular risk management in primary care: study protocol for a randomised controlled trial. Trials. 2013;14:433.CrossRef Huntink E, Heijmans N, Wensing M, van Lieshout J. Effectiveness of a tailored intervention to improve cardiovascular risk management in primary care: study protocol for a randomised controlled trial. Trials. 2013;14:433.CrossRef
32.
go back to reference Topolski TD, LoGerfo J, Patrick DL, Williams B, Walwick J, Patrick MB. The rapid assessment of physical activity (RAPA) among older adults. Prev Chronic Dis. 2006;3:A118.PubMedPubMedCentral Topolski TD, LoGerfo J, Patrick DL, Williams B, Walwick J, Patrick MB. The rapid assessment of physical activity (RAPA) among older adults. Prev Chronic Dis. 2006;3:A118.PubMedPubMedCentral
33.
go back to reference Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16:606–13.CrossRef Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16:606–13.CrossRef
34.
go back to reference Hibbard JH, Stockard J, Mahoney ER, Tusler M. Development of the patient activation measure (PAM): conceptualizing and measuring activation in patients and consumers. Health Serv Res. 2004;35:1005–26.36.CrossRef Hibbard JH, Stockard J, Mahoney ER, Tusler M. Development of the patient activation measure (PAM): conceptualizing and measuring activation in patients and consumers. Health Serv Res. 2004;35:1005–26.36.CrossRef
35.
go back to reference Mayer CJ, Steinman L, Williams B, Topolski TD, LoGerfo J. Developing a telephone assessment of physical activity (TAPA) questionnaire for older adults. Prev Chronic Dis. 2008;5:A24.PubMed Mayer CJ, Steinman L, Williams B, Topolski TD, LoGerfo J. Developing a telephone assessment of physical activity (TAPA) questionnaire for older adults. Prev Chronic Dis. 2008;5:A24.PubMed
36.
go back to reference Yaroch AL, Nebeling L, Thompson FE, Hurley TG, Hebert JR, Toobert DJ, et al. Baseline design elements and sample characteristics for seven sites participating in the nutrition working Group of the Behavior Change Consortium. J Nutr. 2008;138:185S–92S.CrossRef Yaroch AL, Nebeling L, Thompson FE, Hurley TG, Hebert JR, Toobert DJ, et al. Baseline design elements and sample characteristics for seven sites participating in the nutrition working Group of the Behavior Change Consortium. J Nutr. 2008;138:185S–92S.CrossRef
38.
go back to reference Vancampfort D, Stubbs B, Veronese N, Mugisha N, Koyanagi A. Correlates of physical activity among depressed older people in six low-income and middle income countries: Acommunity-bases cross-sectional study. Int J Geriatr Psychiatry. 2018;2:314–22.CrossRef Vancampfort D, Stubbs B, Veronese N, Mugisha N, Koyanagi A. Correlates of physical activity among depressed older people in six low-income and middle income countries: Acommunity-bases cross-sectional study. Int J Geriatr Psychiatry. 2018;2:314–22.CrossRef
39.
go back to reference Vancampfort D, Stubbs B, Sienaert P, Wyckaert S, Hert D, Rosenbaum S, Probst M. What are the factors that influence physical activity participation in individuals with depression? A review of physical activity correlater from 59 studies. Psychiatr Danub. 2015;3:210–24. Vancampfort D, Stubbs B, Sienaert P, Wyckaert S, Hert D, Rosenbaum S, Probst M. What are the factors that influence physical activity participation in individuals with depression? A review of physical activity correlater from 59 studies. Psychiatr Danub. 2015;3:210–24.
40.
go back to reference Blanchard CM, Reid RD, Morrin LI, McDonnell L, McGannon K, Rhodes RE, et al. Demographic and clinical determinants of moderate to vigorous physical activity during home-based cardiac rehabilitation: the home-based determinants of exercise (HOME) study. J Cardiopulm Rehabil Prev. 2010;30:240–5.CrossRef Blanchard CM, Reid RD, Morrin LI, McDonnell L, McGannon K, Rhodes RE, et al. Demographic and clinical determinants of moderate to vigorous physical activity during home-based cardiac rehabilitation: the home-based determinants of exercise (HOME) study. J Cardiopulm Rehabil Prev. 2010;30:240–5.CrossRef
41.
go back to reference Sallis JF, Prochaska JJ, Taylor WC. A review of correlates of physical activity of children and adolescents. Med Sci Sports Exerc. 2000;32:963–75.CrossRef Sallis JF, Prochaska JJ, Taylor WC. A review of correlates of physical activity of children and adolescents. Med Sci Sports Exerc. 2000;32:963–75.CrossRef
42.
go back to reference Gaalema DE, Savage PD, Rengo JL, Cutler AY, Elliott RJ, Priest JS, et al. Patient characteristics predictive of cardiac rehabilitation adherence. J Cardiopulm Rehabil Prev. 2017;37:103–10.CrossRef Gaalema DE, Savage PD, Rengo JL, Cutler AY, Elliott RJ, Priest JS, et al. Patient characteristics predictive of cardiac rehabilitation adherence. J Cardiopulm Rehabil Prev. 2017;37:103–10.CrossRef
Metadata
Title
Symptoms of depression are associated with physical inactivity but not modified by gender or the presence of a cardiovascular disease; a cross-sectional study
Authors
Retze Achttien
Jan van Lieshout
Michel Wensing
Maria Nijhuis van der Sanden
J. Bart Staal
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2019
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/s12872-019-1065-8

Other articles of this Issue 1/2019

BMC Cardiovascular Disorders 1/2019 Go to the issue