Independent associations and isotemporal substitution analysis of 24-hour movement behaviors and depression among Chinese older adults
Bibliographic Data
| ID | 15699202 |
|---|---|
| Authors | Shulei Chen (0009-0006-0673-7742, Wenzhou Medical University), Xiaodan Kuang (Wenzhou Medical University), Liuhong Tian (0000-0002-5619-0590, Wenzhou Medical University), Pan Ding (0000-0002-5237-2194, Wenzhou Medical University), Jiaming Fang (0000-0002-1806-8017, Wenzhou Medical University), Jinghai Li (0000-0002-6655-3228, Wenzhou Medical University), Lingfang Wang (0000-0002-9002-3657, Wenzhou Medical University), Hongying Shi (0000-0002-3087-0192, Wenzhou Medical University, corresponding author) |
| Year | 2026 |
| Volume | 14 |
| Issue | 1 |
| Publication date | 2026-04-01 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | BMC Psychology (JOURNAL) |
| Journal identifiers | ISSN: 2050-7283 • E-ISSN: 2050-7283 |
| Publisher | BioMed Central (PUBLISHER • GB) |
| DOI | 10.1186/s40359-026-04480-y |
| PMID | 41918038 |
| OpenAlex | W7147591270 |
| Language | EN |
| References cited | 69 |
Previous studies on the association between 24-hour movement behaviors and depression have often both overlooked the interrelationships among daily movement behaviors and the potential confounding effect of the timing of 24-hour movement behaviors. This study examined the independent associations between 24-hour movement behaviors and depression among older adults and explored the substitution effects of reallocating time among these behaviors using an isotemporal substitution model. A cross-sectional study was conducted from September 2021 to July 2024 among adults aged ≥ 60 years, recruited through multistage sampling across regions with diverse socioeconomic levels. Physical activity (PA) and sedentary behavior (SB) were assessed using the International Physical Activity Questionnaire, sleep duration was obtained from the Pittsburgh Sleep Quality Index, and depressive symptoms were evaluated with the Geriatric Depression Scale-15. Logistic regression and isotemporal substitution models were used for analysis. Among 992 participants (mean [SD] age, 69.7 [6.9] years), 159 (16.0%) had depression. Compared with not engaging in any intensity of PA, engaging in any intensity of PA was associated with lower odds of depression. Threshold effect analysis suggested a possible L-shaped pattern between SB and depression. Compared with participants sleeping 7–8 h/night, both short ( 8 h/night) sleep durations were significantly associated with higher odds of depression. Isotemporal substitution analysis indicated that, among participants with sleep duration ≤ 7 h/night, replacing 0.5 h/day of SB with light physical activity (LPA) (OR = 0.63, 95% CI: 0.42–0.93) or replacing 0.5 h/day of vigorous physical activity (VPA) with LPA (OR = 0.61, 95% CI: 0.40–0.94) was associated with lower odds of depression. Additionally, replacing 0.5 h/day of SB (OR = 0.80, 95% CI: 0.69–0.92), moderate physical activity (MPA) (OR = 0.83, 95% CI: 0.70–1.00), or VPA (OR = 0.78, 95% CI: 0.65–0.94) with sleep duration was also protective. Among participants with sleep duration > 7 h/night, replacing 0.5 h/day of sleep duration with VPA was associated with lower odds of depression (OR = 0.75, 95% CI: 0.58–0.95), whereas replacing VPA with sleep duration increased depression odds (OR = 1.33, 95% CI: 1.05–1.73). These findings highlight the importance of promoting PA of any intensity and maintaining optimal sleep duration, while limiting excessive SB, for mental health among Chinese older adults. The isotemporal substitution model further indicated that among participants with ≤ 7 h/night of sleep, replacing SB or VPA with LPA, or replacing SB, MPA, or VPA with sleep duration, was associated with reduced odds of depression. In contrast, among those with > 7 h/night of sleep, replacing sleep with VPA was associated with lower odds of depression. These findings emphasize the importance of optimizing 24-hour movement behaviors to promote mental health in later life
Confounding · Depression (economics · Depressive symptoms · Logistic regression · Odds · Odds ratio · Physical activity · Sleep (system call · Dietary Effects on Health · Physical Activity and Health · Sleep and related disorders
Walking on sunshine
National Sleep Foundation’s updated sleep duration recommendations
Time for united action on depression
Association Between Physical Activity and Risk of Depression
Global, regional, and national disability-adjusted life-years (Dalys) for 315 diseases and injuries and healthy life expectancy (Hale), 1990–2015
Compendium of Physical Activities
Prevalence of depression in older adults
Objectively Measured Sedentary Time, Physical Activity, and Metabolic Risk
Canadian 24-Hour Movement Guidelines for Adults aged 18–64 years and Adults aged 65 years or older
Long sleep duration and health outcomes
The Physical Activity Guidelines for Americans
Canadian 24-Hour Movement Guidelines for Children and Youth
Sedentary behaviour and the risk of depression
Management of Depression in Older Adults
The Pittsburgh sleep quality index as a screening tool for sleep dysfunction in clinical and non-clinical samples
The Pittsburgh sleep quality index
Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019
Association between 24-hour movement behaviors and depressive symptoms among urban older adults in china
Association between obesity status and successful aging among older people in China
| Highly cited | No |
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