肌少症与中国老年人抑郁症状轨迹的关系：身体活动的中介效应

The present study aimed to investigate the associations of depression with muscle mass and muscle strength, and whether these associations were modified or mediated by dietary energy intake and dietary quality. Our study included participants aged 40 and above from the 2011-2018 cycles of the National Health and Nutrition Examination Survey (NHANES). Depression was evaluated using the nine-item Patient Health Questionnaire. Skeletal muscle mass index (SMI) and handgrip strength (HGS) were used to evaluate muscle mass and muscle strength, respectively. Information on dietary intake were obtained via dietary recall. Dietary quality was assessed using healthy eating index-2015 (HEI-2015). We performed multivariable linear regression models to examine the associations of depression with SMI (N = 3,648) and HGS (N = 4,679). Interaction analyses and mediation analyses were conducted to test the effect of dietary energy intake and HEI-2015 on the associations of depression with SMI and HGS. Depression was associated with decreased SMI and HGS. Interactions between depression and HEI-2015 were observed for SMI, but not for HGS. The stratified analyses showed that depression was associated with decreased SMI in participants whose HEI-2015 were lower than the median. Mediation analyses revealed that dietary energy intake mediated the associations of depression with SMI and HGS. HEI-2015 modified the associations between depression and muscle mass. The inverse associations of depression with muscle mass and muscle strength were partially mediated by dietary energy intake. These findings emphasized the importance of dietary energy intake and dietary quality in preventing muscle loss in middle-aged and older participants with depression.

first, to record, in a representative sample of older men and women, longitudinal changes in (i) maximal voluntary strength of the handgrip muscles, (ii) maximal range of movement in the shoulder joint and (iii) body weight and skeletal size; second, to explore associations between the changes in muscle strength and both customary physical activity and health outcomes. longitudinal analyses of survivors measured at baseline, and 4-year and 8-year follow-ups. 350 survivors of a random sample originally aged 65 and over. over 8 years average loss of body weight was slight but significant at about 2 kg (less than 5%). Loss of shoulder range was negligible, while loss of muscle strength was significant at about 40 N (less than 2% per year). Demispan remained stable across all three points of measurement. These mean values concealed substantial variation in the rate of loss of strength, which was twice as fast in the older groups, especially in the women. These losses could not be attributed to worsening health, although this was observed. All the respondents had at least two chronic health problems at the 8-year stage. For the changes in handgrip strength, reduced reported habitual use of the handgrip muscles and increased symptoms of anxiety and depression were significant independent covariates in addition to age and time (all P < 0.0001). there are significant independent associations between the loss of muscle strength in old age and both decline in physical activity and increase in depression scores. This is strongly suggestive of causal links and confirms the need to encourage physical activity and control depression in order to maintain strength and function in old age.

Weight change in older adults affects physical function (PF). However, data suggest that, conversely, PF may be a determinant of weight change. Our objective was to assess the role of baseline PF as a predictor of 2-year weight loss (WL) and weight gain (WG) ≥ 5% among healthy well-functioning community-dwelling older adults. The NuAge cohort (67-84 years) was classified into three groups according to the percent weight change over a 2-year follow-up: weight stable (weight change ≤ 2%; n = 629), WL ≥ 5% (n = 189), and WG ≥ 5% (n = 111). A summary measure of baseline PF was computed (sum of biceps, quadriceps, and grip strength, timed up and go, chair stand, normal and maximal gait speed, and balance performance scores [individual test score range = 0-4]; PF score range = 0-32). Multivariable logistic regression models separately assessed the relationships between baseline PF and 2-year WL and WG ≥ 5%. Baseline PF was worse in both the WL (p < .001) and the WG (p = .001) groups compared with the weight stable group. In models adjusting for sex, age, body mass index, energy intake, depressive symptoms, and other significantly associated covariates, each 1-unit increase in standard deviation of PF was associated with decreased risk of either 2-year WL (odds ratio = 0.79, 95% CI = 0.63-0.99, p = .043) or WG (odds ratio = 0.74, 95% CI = 0.55-0.99, p = .041). Low baseline PF was an independent common predictor of 2-year WL and WG ≥ 5% in the healthy well-functioning community-dwelling elderly population. Whether PF is an early cause or marker of weight change in this population remains to be determined.

We conducted a systematic review of literature from the years 2000 through 2017 on the prevalence and burden of lower urinary tract symptoms (LUTS) in men aged 50 and older, and medical treatments of and alternative nonmedical approaches to LUTS. EBSCOhost (Medline with Full Text) was searched for observational, experimental, and review studies in peer-reviewed journals in the English language. Our review found that LUTS were highly prevalent in the world and estimated to affect 2.3 billion people in 2018, with 44.7% being men. Men with LUTS suffer from not only burdensome symptoms such as nocturia and urgency but also adverse psychological consequences (e.g., anxiety and depression) and financial burden. Current medical treatments are clinically effective, but their efficacy is compromised by side effects and low compliance rates. Alternative nonmedical treatments for LUTS were also sought worldwide. There is evidence that lifestyle modifications such as pelvic muscle exercises and bladder training, physical activity, dietary modification, and nutritional supplements can alleviate LUTS and improve patient quality of life; however, evidence based on rigorous methodology remains minimal and cannot be generalized across populations. Evidence of effectiveness of weight loss programs to reduce LUTS is inconclusive. We conclude that although behavioral treatment is a promising approach to alleviating LUTS, especially when combined with medical treatments, well-designed randomized controlled and longitudinal clinical trials on behavioral treatments of LUTS are still needed. Minimally invasive procedures and neuromodulation therapy also show positive results of alleviating LUTS but require further research as well.

The ongoing pandemic could affect the duration, variety and severity of the mental, physical, and cognitive impairments intensive care unit (ICU) survivors and their families frequently present. We aim to determine the impact of the COVID-19 pandemic on the mental, physical, and cognitive health of survivors, the experience of their families and their treating healthcare professionals. Prospective, multicentre, mixed-methods cohort study in seven Chilean ICUs. 450 adults, able to walk independently prior to admission, in ICU and mechanical ventilation >48 hours with and without COVID-19. Clinical Frailty Scale, Charlson comorbidity index, mobility (Functional Status Score for the Status Score for the Intensive Care Unit) and muscle strength (Medical Research Council Sum Score) will be assessed at ICU discharge. Cognitive functioning (Montreal Cognitive Assessment-blind), anxiety and depression (Hospital Anxiety and Depression Scale), post-traumatic stress (Impact of Event Scale-Revised) symptoms, disability (WHO Disability Assessment Schedule 2.0), quality of life (European Quality of Life Health Questionnaire), employment and survival will be assessed at ICU discharge, 3 months and 6 months. A sample will be assessed using actigraphy and the Global Physical Activity Questionnaire at 6 months after ICU discharge. Trajectories of mental, physical, and cognitive impairments will be estimated using multilevel longitudinal modelling. A sensitivity analysis using multiple imputations will be performed to account for missing data and loss-to-follow-up. Survival will be analysed using Kaplan-Meier curves. The perceptions of family members regarding the ICU stay and the later recovery will be explored 3 months after discharge. Healthcare professionals will be invited to discuss the challenges faced during the pandemic using semistructured interviews. Interviews will be thematically analysed by two independent coders to identify the main themes of the experience of family members and healthcare professionals. The study was approved by the Clinica Alemana Universidad del Desarrollo Ethics Committee (2020-78) and each participating site. Study findings will be published in peer-reviewed journals and disseminated through social media and conference meetings. NCT04979897.

Chronic obstructive pulmonary disease (COPD) is a multisystem disease. Established comorbidities include cardiovascular disease, osteoporosis, loss of muscle mass and function, depression, and impaired quality of life. The natural history is not well understood. The Assessment of Risk in Chronic Airways Disease Evaluation (ARCADE) is a longitudinal study of comorbidities in COPD. The primary aims are to delineate the progression and interrelationships of cardiovascular disease and associated comorbidities. Each year ARCADE aims to recruit 250 patients diagnosed with COPD and 50 comparators (free from respiratory disease). Assessments include spirometry, body composition, blood pressure, aortic stiffness (pulse wave velocity (PWV)), noninvasive measures of cardiac output, systemic inflammatory mediators, blood and urine biochemistry, and physical and health outcomes. These will be repeated at 2 and 5 years. In the first year of recruitment, 350 patients and 100 comparators were recruited. The reproducibility of aortic PWV, cardiac output, stroke volume, and cardiac index was evaluated and accepted in 30 patients free from overt cardiovascular disease. The preliminary data from ARCADE have demonstrated acceptable reproducibility of hemodynamic outcome measures. Further longitudinal data collection will increase knowledge of the progression and interactions between cardiovascular risk factors and other comorbidities in COPD.

Loss of motor function is a common consequence of aging, but little is known about the factors that predict idiopathic motor decline. Our objective was to test the hypothesis that late-life social activity is related to the rate of change in motor function in old age. Longitudinal cohort study with a mean follow-up of 4.9 years with 906 persons without stroke, Parkinson disease, or dementia participating in the Rush Memory and Aging Project. At baseline, participants rated the frequency of their current participation in common social activities from which a summary measure of social activity was derived. The main outcome measure was annual change in a composite measure of global motor function, based on 9 measures of muscle strength and 9 motor performances. Mean (SD) social activity score at baseline was 2.6 (0.58), with higher scores indicating more frequent participation in social activities. In a generalized estimating equation model, controlling for age, sex, and education, global motor function declined by approximately 0.05 U/y (estimate, 0.016; 95% confidence interval [CI], -0.057 to 0.041 [P = .02]). Each 1-point decrease in social activity was associated with approximately a 33% more rapid rate of decline in motor function (estimate, 0.016; 95% CI, 0.003 to 0.029 [P = .02]). The effect of each 1-point decrease in the social activity score at baseline on the rate of change in global motor function was the same as being approximately 5 years older at baseline (age estimate, -0.003; 95% CI, -0.004 to -0.002 [P<.001]). Furthermore, this amount of motor decline per year was associated with a more than 40% increased risk of death (hazard ratio, 1.44; 95% CI, 1.30 to 1.60) and a 65% increased risk of incident Katz disability (hazard ratio, 1.65; 95% CI, 1.48 to 1.83). The association of social activity with the rate of global motor decline did not vary along demographic lines and was unchanged (estimate, 0.025; 95% CI, 0.005 to 0.045 [P = .01]) after controlling for potential confounders including late-life physical and cognitive activity, disability, global cognition depressive symptoms, body composition, and chronic medical conditions. Less frequent participation in social activities is associated with a more rapid rate of motor function decline in old age.

Although body mass index (BMI) and grip strength (GS) are both predictors of disability, their joint effect on predicting incident disability remains uncertain. We examined whether the effect of BMI on incident disability can be modulated by GS in community-dwelling older people in Japan. A total of 1486 community-dwellers in Japan (731 men and 755 women, aged 65-82 years) who participated in the 2nd to 7th waves of the National Institute for Longevity Sciences-Longitudinal Study of Aging (NILS-LSA) project, were followed up to 20 years. Twelve subgroups were created according to the intersections of GS (sex-specific tertiles: low, intermediate, and high) and BMI (underweight 1, <18.5; underweight 2, 18.5-<21.5; normal, 21.5-<25.0; and overweight/obese, ≥25.0 kg/m Compared with that for participants in the 'high GS-normal BMI' group, the risk of incident disability was higher for participants in the 'low GS-normal BMI', 'low GS-overweight/obese', 'intermediate GS-underweight 1' and 'intermediate GS-overweight/obese' groups. The multivariable-adjusted HR (95% CI) were 1.72 (1.27-2.32, P value<0.001), 1.81 (1.27-2.58, P value = 0.001), 2.42 (1.35-4.32, P value = 0.003) and 1.53 (1.06-2.20, P value = 0.023), respectively. The results did not change substantially when participants with disability occurring within 1 and 2 years of follow-up were excluded, or when the competing events were death without incident disability or dementia. The joint effect of BMI and GS was more pronounced in those of normal weight or overweight/obese status and low GS, along with underweight or overweight/obese status and intermediate GS in predicting disability. The lack of observed joint effect for those underweight with low GS was likely due to insufficient sample size. GS consideration is necessary for weight management in older adults, and interventions for individuals who are underweight or overweight/obese with adequate GS need not be prioritized for disability prevention.

Mediterranean diet (MeDi) is considered as a key component for healthy aging, including prevention of age-related disability, while its association with frailty, independent of disability has never been assessed. Our objective was to investigate the relation between MeDi adherence and frailty incidence among persons aged ≥75 years participating at the prospective population-based French Three-City Study. The study sample consisted of 560 initially non-frail participants of the Three-City-Bordeaux center, seen at the 2009-2010 follow-up, and re-examined two years later. Adherence to MeDi was computed from a food frequency questionnaire (scored as 0-9). Frailty was defined as having at least three out of the following five slightly modified Fried frailty criteria: involuntary weight loss, exhaustion, slowness, weakness and low physical activity. Logistic regression models adjusted for sociodemographic and clinical covariates, including cognitive performance and depressive symptomatology, were used to assess the association between MeDi score and subsequent frailty risk. Over the 2-year follow-up, 79 participants (14%) became frail. Older adults with the highest MeDi adherence (score 6-9) had a significantly 68% frailty risk reduction (95% CI: 28-86%, p = 0.006) compared to those in the lowest MeDi category (score 0-3). Regarding the frailty criterion separately, the highest MeDi adherence was associated with a significantly reduced risk of incident slowness (OR = 0.45; 95% CI: 0.20-0.99, p = 0.04), poor muscle strength (OR = 0.44; 95% CI: 0.20-0.98, p = 0.04) and low physical activity (OR = 0.39; 95% CI: 0.18-0.82, p = 0.01), compared to the lowest MeDi adherence. In addition to its well-documented beneficial effects on health, adherence to MeDi might contribute to prevent the onset of frailty, even at late stages of life.

Even with healthy and active aging, many older adults will experience a decrease in physical capacities. This decrease might be associated with diminished functional autonomy. However, little is known about the physical capacities associated with functional autonomy in older women and men. This study aimed to examine gender-specific associations between functional autonomy and physical capacities in independent older women and men. Secondary analyses were carried out using cross-sectional data from 652 women and 613 men who participated in the NuAge longitudinal study. The "functional autonomy measurement system" (SMAF) was used to evaluate functional autonomy. The physical capacities measured (tests used) were: biceps and quadriceps strength (Microfet dynamometer), grip strength (Martin vigorimeter), unipodal balance, changing position & walking (timed up and go), normal & fast walking (four-meter walking speed) and changing position (chair stand). Correlation and multiple linear regression analyses adjusted for age, depressive symptoms and body composition were performed. On average, participants were aged 73 years and had mild to moderate functional autonomy loss. In women, after controlling for age, depressive symptoms and body composition, greater functional autonomy was best explained by faster changing position & walking skills and superior biceps strength (R(2)=0.46; p<0.001). After controlling for depressive symptoms, faster changing position & walking skills and better unipodal balance best explained greater functional autonomy in men (R(2)=0.21; p<0.001). According to these results, physical capacities are moderately associated with functional autonomy among independent older adults, especially women.

To examine the association between 2-year weight change and onset of lower body disability over time in older Mexican Americans. Data were from the Hispanic Established Population for the Epidemiological Study of the Elderly (1993-2001). Weight change was examined by comparing baseline weight to weight at 2-year follow-up. Incidence of lower body disability was studied from the end of this period through an additional 5 years. Five southwestern states: Texas, New Mexico, Colorado, Arizona, and California. One thousand seven hundred thirty-seven noninstitutionalized Mexican-American men and women aged 65 and older who reported no limitation in activities of daily living (ADLs) and were able to perform the walk test at 2-year follow-up. In-home interviews assessed sociodemographic factors, self-reported physician diagnoses of medical conditions (arthritis, diabetes mellitus, heart attack, stroke, hip fracture, and cancer), self-reported ADLs, depressive symptoms, and number of hospitalizations. Cognitive function, handgrip muscle strength, and body mass index (BMI) were obtained. The outcomes were any limitation of lower body ADL (walking across a small room, bathing, transferring from a bed to a chair, and using the toilet) and limitation on the walk test over subsequent 5-year follow-up period. General Estimation Equation (GEE) was used to estimate lower body disability over time. Weight change of 5% or more occurred in 42.3% of the participants; 21.7% lost weight, 20.6% gained weight, and 57.7% had stable weight. Using GEE analysis, with stable weight as the reference, weight loss of 5% or more was associated with greater risk of any lower body ADL limitation (odds ratio (OR)=1.43, 95% confidence interval (CI)=1.06-1.95) and walking limitation (OR=1.35, 95% CI=1.03-1.76) after controlling for sociodemographic variables and BMI at baseline. Weight gain of 5% or more was associated with greater risk of any lower body ADL limitation (OR=1.39, 95% CI=1.02-1.89), after controlling for sociodemographic variables and BMI at baseline. When medical conditions, handgrip muscle strength, high depressive symptomatology, cognitive function, and hospitalization were added to the equation, the relationship between 2-year weight change (>5% loss or >5% gain) and lower body disability decreased. Health conditions and muscle strength partially mediate the association between weight loss or gain and future loss of ability to walk and independently perform ADLs.

To assess, first, the prevalence and severity of symptoms associated with the climacteric period and their treatment and, second, the prevalence of exercise, smoking and body weight in a population-based sample of Swedish women. Prospective, longitudinal cohort study, initiated in 1992, in women aged 46, 50, 54, 58 and 62 years with a follow-up 6 years later. Information was obtained from the same women (n=3816) on both occasions using a postal questionnaire regarding sociodemographic variables, general and reproductive health, the occurrence of climacteric symptoms and their severity, and the use of hormone replacement therapy (HRT). The prevalences of climacteric symptoms were as follows (1992/1998): vasomotor symptoms, 52%/62%; depression/irritability, 57%/65%; sleeping disturbances, 51%/69%; muscle/joint pain, 55%/70%; and loss of libido, 38%/57%. HRT with medium-potency estrogens was currently being used by 34% (1992: 14%), and 12% (1992: 8%) were using low-potency estrogens. The maximum prevalence of HRT (medium-potency estrogens) use was found in the 56-year-old group, at 46% (1992: 25% in the 54-year-old group). Body mass for the whole group had increased from 66.3 to 68.9 kg. Exercise was more frequent in all age groups in 1998 compared to 1992. There was a decrease in current smokers from 32 to 26% between the two periods. Compared with 1992, the women in all five birth cohorts considered themselves to be less healthy and quality of life had decreased for the whole group. The prevalence of symptoms associated with the climacteric period and the use of HRT had increased markedly in this longitudinal study of the same women followed between 1992 and 1998. During the same period, smoking decreased, while body weight and exercise frequency increased.

Anecdotal and research evidence is that vertical jump performance declines over the competitive volleyball season. The purpose of this study was to evaluate whether a short period of ballistic resistance training would attenuate this loss. Fourteen collegiate women volleyball players were trained for 11 weeks with periodized traditional and ballistic resistance training. There was a 5.4% decrease (p < 0.05) in approach jump and reach height during the traditional training period (start of season to midseason), and a 5.3% increase (p < 0.05) during the ballistic training period (midseason to end of season), but values were not different from start to end of season. These changes in overall jump performance were reflective of changes in underlying neuromuscular performance variables: in particular, power output and peak velocity during loaded jump squats, countermovement jumps, and drop jumps. During the first 7 weeks of traditional heavy resistance training, it appears that the neuromuscular system is depressed, perhaps by the combination of training, game play, and skills practice precluding adequate recovery. Introduction of a novel training stimulus in the form of ballistic jump squats and reduction of heavy resistance training of the leg extensors stimulated a rebound in performance, in some cases to exceed the athlete's ability at the start of the season. Periodization of in-season training programs similar to that used in this study may provide volleyball players with good vertical jump performance for the crucial end-of-season games.

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Background: The accelerating global population aging underscores the urgency of addressing public health challenges. Sarcopenia and depression are prevalent, interrelated conditions in older adults, yet prevailing research often treats depression as a static state, neglecting its longitudinal progression and limiting predictive capability for sarcopenia. Methods: Using data from four waves (2011–2018) of the China Health and Retirement Longitudinal Study (CHARLS), we identified distinct depressive symptom trajectories via Group-Based Trajectory Modeling. Seven machine learning algorithms were employed to develop predictive models for sarcopenia risk, incorporating these trajectory patterns and baseline characteristics. Results: Three depressive symptom trajectories were identified: ‘Persistently Low’, ‘Persistently Moderate’, and ‘Persistently High’. Tree-based ensemble methods, particularly Random Forest and XGBoost, demonstrated superior and robust performance (mean accuracy: 0.8265 and 0.8178; mean weighted F1-score: 0.8075 and 0.8084, respectively). Feature importance analysis confirmed depressive symptoms as a core, independent predictor, ranking third (5.7% importance) in the optimal Random Forest model, only after BMI and cognitive function, and surpassing traditional risk factors like age and waist circumference. Conclusions: This study validates that longitudinal depressive symptom trajectories provide superior predictive power for sarcopenia risk compared to single-time-point assessments, effectively mapping mental health trajectories to physical risk. The robust ML framework not only enables early identification of high-risk individuals but also reveals a multidimensional risk profile, highlighting the intricate mind–body connection in aging. These findings advocate for integrating dynamic mental health monitoring into routine geriatric assessments, demonstrating the potential of AI to facilitate a paradigm shift towards proactive, personalized, and scalable prevention strategies in public health and clinical practice.

Objectives: Sarcopenia is influenced by multiple factors, including psychological aspects. This study aimed to explore the relationships among depressive symptoms, dyspnea-related fear, and sarcopenia, with a focus on the mediating role of physical activity. Methods: A cross-sectional study was conducted among 348 COPD patients at a tertiary hospital in Western China from July 2023 to July 2024. Sarcopenia was assessed according to the 2019 AWGS criteria, including hand bioelectrical impedance analysis (BIA), and grip strength testing. Depressive symptoms, dyspnea-related fear, and physical activity were evaluated through self-reported measures using the depression subscale of the Hospital Anxiety and Depression Scale (HADS), the Breathlessness Beliefs Questionnaire (BBQ), and the International Physical Activity Questionnaire Short Form (IPAQ-SF), respectively. Logistic regressions analyses explored associations among depressive symptoms, dyspnea-related fear, and sarcopenia. Maximum Likelihood (ML) estimation was employed using Mplus software to evaluate the mediating effect of physical activity on the relationships. Results: The prevalence of sarcopenia among COPD patients was 60.3%. In the logistic regression analysis with sarcopenia as the dependent variable, physical activity levels (OR = 0.508, p = 0.019) and depressive symptoms (OR = 1.079, p = 0.029) were statistically significant, while BBQ scores were not (OR = 1.031, p = 0.070). Mediating analyses revealed that depressive symptoms directly increased the risk of sarcopenia (β = 0.076, p = 0.042) but did not do so indirectly via physical activity (β = 0.056, p = 0.146). Conversely, dyspnea-related fear had an indirect effect on sarcopenia through physical activity, with a borderline statistical significance (β = 0.053, p = 0.049). Conclusions: This study highlights the critical role of psychological factors in sarcopenia development among COPD patients, with physical activity serving as a significant mediator. These findings underscore the need for integrated rehabilitation strategies addressing both psychological and physical activity barriers to improve outcomes for COPD patients.

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Background Depression and sarcopenia pose significant health challenges for older adults with diabetes. While previous studies have established a positive association between depression and the risk of sarcopenia, the underlying mechanisms driving this relationship remain poorly understood. Objectives The aim of this study was to investigate the relationship between depression and sarcopenia risk in older adults with diabetes, with a particular focus on the potential mediating roles of nutrition and physical activity. The findings would provide empirical evidence to inform future prevention and intervention strategies. Design A multi-center cross-sectional study. Methods A total of 312 older adult patients with diabetes were selected from two hospitals using a convenience sampling method. The study evaluated demographic and clinical characteristics, along with factors such as nutrition, physical activity, depression, and sarcopenia risk. A multivariate logistic regression model was used to assess the association between depression and sarcopenia risk. Furthermore, the bootstrap resampling method, involving 5,000 samples and a 95% confidence interval (CI), was employed to examine the parallel mediating effects and determine whether nutrition and physical activity mediated the relationship between depression and sarcopenia risk. Data analysis was conducted using SPSS 26.0 and Mplus 7.0 software. Results A total of 58.0% of participants were found to be at high risk for sarcopenia. Depression was shown to influence sarcopenia risk significantly, with nutrition and physical activity acting as parallel mediators. The total indirect effect was estimated at 0.087 (95% CI: 0.056, 0.126), accounting for 34.9% of the total effect (total effect = 0.249, 95% CI: 0.175, 0.311). Notably, nutrition played a crucial role in this mediation, contributing 61% of the total indirect effect. Conclusion A significant proportion of older adults with diabetes were found to be at high risk of sarcopenia, which underscores the importance of routine screening for sarcopenia risk in older adults with diabetes. Depression was strongly associated with sarcopenia risk, with nutrition and physical activity acting as parallel mediators in this relationship. Given the pivotal role of nutrition in this parallel mediation model, the implementation of individualized nutrition plans is crucial for preventing muscle loss and reducing the risk of sarcopenia.

Physical activity (PA) plays an important role in the process of several chronic diseases. It may be also associated with the incidence of sarcopenia. This study aimed to determine the association of PA from different components including frequency, duration, intensity, and volume with the incidence of sarcopenia in middle-aged and older adults. This study used data from the China Health and Retirement Longitudinal Study in 2011 and 2015. A total of 3,760 individuals aged ≥ 40 years were involved in this study. Sarcopenia was diagnosed using muscle mass, strength and physical performance according to the Asian Working Group for Sarcopenia. PA information including frequency, duration, intensity, and volume was obtained by a self-reported questionnaire. Logistic regression analysis was employed to examine the association between PA and the incidence of sarcopenia at 4-year follow-up. The incidence of sarcopenia was 5.9% during the 4-year follow-up. Compared to sedentary individuals, those taking 1–2 days or more per week, or a minimum of 10 min each time on vigorous-intensity PA (VPA) had a lower incidence of sarcopenia. Adults spending 3 days or more each week, a minimum of 30 min each time, or 150 min or more per week on moderate-intensity PA (MPA) had a lower presence of sarcopenia than sedentary adults. Adults taking 3 days or more per week, at least 30 min each time, or 150 min or more each week on light-intensity PA (LPA) tended to have a lower incidence of sarcopenia than sedentary individuals. Sensitivity analyses confirmed the robustness of the findings after removing persons with hypertension, dyslipidemia, or diabetes. These findings suggest that the frequency, duration, and volume of VPA or MPA are negatively associated with the presence of sarcopenia. Participation in LPA tends to have a lower incidence of sarcopenia in middle-aged and older adults.

Background: Older adults have a high risk for musculoskeletal, cardiorespiratory, and mental health problems. We compared respiratory muscle strength, cardiovascular endurance, physical activity (PA), and depression between older adults with and without sarcopenia. Methods: This matched case–control study included 200 Thai older adults (100 participants with and without sarcopenia). According to the Asian Working Group for Sarcopenia 2019, participants completed a handgrip dynamometer, a 6 m walk test, and bioimpedance analysis for sarcopenia screening. Individuals were required to evaluate their cardiovascular endurance and respiratory muscle strength and complete a set of questionnaires (i.e., depression and PA). Participants with and without sarcopenia were compared using a t-test, and ANOVA was used for subgroup analysis. Results: Participants with sarcopenia had significantly lower inspiratory muscle strength (p < 0.001), functional capacity (p = 0.032), PA (p < 0.001), and higher depression scores (p < 0.001) than those without sarcopenia. Respiratory muscle strength and PA were significantly reduced in those with severe sarcopenia, followed by those with sarcopenia, possible sarcopenia, and no sarcopenia. Older adults with severe sarcopenia had higher depression scores than those with sarcopenia, possible sarcopenia, or no sarcopenia. Conclusions: Older adults with sarcopenia may exhibit lower cardiorespiratory performance, less PA, and higher depression than those without sarcopenia.

Objectives This study aimed to determine the longitudinal relationship between the changes in physical activity in middle-aged and older persons and sarcopenia risk utilizing data from a nationally representative population in China. Methods This study included 2831 participants (44.5 % men, 55.5 % women, mean age 61.86 ± 9.33 years). Participants were divided into active to active (A-A, n = 1367), inactive to active (I-A, n = 455), active to inactive (A-I, n = 553), and inactive to inactive (I-I, n = 456) groups based on changes in physical activity between 2011 and 2015. Sarcopenia and sarcopenia risk indicators were determined using the Asian Working Group for Sarcopenia 2019 consensus. One-way analysis of variance, analysis of covariance, and logistic regression analyses were used to determine the association between the changes in physical activity and sarcopenia risk. Results Handgrip strength tended to have a significant difference, and walking speed and 5-time chair stand test had significant differences among the A-A, I-A, A-I, and I-I groups (all p < 0.05). Compared to the I-I group, the likelihood of sarcopenia was lower in the A-A (OR: 0.65, 95 % CI: 0.52–0.81) and I-A (OR: 0.67, 95 % CI: 0.51–0.87) groups, the likelihood of poor muscle strength was lower in the A-A (OR: 0.61, 95 % CI: 0.50–0.76) and I-A (OR: 0.65, 95 % CI: 0.50–0.83) groups, and the rate of low physical performance was lower in the A-A (OR: 0.33, 95 % CI: 0.26–0.41), I-A (OR: 0.38, 95 % CI: 0.29–0.50) and A-I (OR: 0.55, 95 % CI: 0.43–0.71) groups after controlling for covariates. Conclusions Middle-aged and older people who remain or become physically active have a lower risk of sarcopenia, poor muscle strength, and low physical performance. Conversely, those who stop being physically active have a higher risk of sarcopenia, poor muscle strength, and low physical performance.

Objectives: This study aimed to explore the independent and joint associations of daily sitting time and leisure-time physical activity (LTPA) with sarcopenia among older adults. Methods: The participants were 847 community-dwelling adults aged 60 or older from Beijing and Shanghai, China. Sarcopenia was diagnosed based on the criteria established by the Asian Working Group for Sarcopenia (2019). Daily sitting time and LTPA were self-reported using the Physical Activity Scale for the Elderly (PASE). Logistics regression models were used to explore the associations between daily sitting time, LTPA, and sarcopenia. To examine joint associations, participants were classified based on daily sitting time and LTPA levels. Final models were adjusted for sociodemographic variables, lifestyle factors, and chronic conditions. Results: Prolonged sitting time and insufficient LTPA were independently associated with higher odds of sarcopenia. Among insufficiently active participants, sitting for 1–2 h, 2–4 h, and more than 4 h per day was associated with 5.52-fold (95% CI: 1.13–26.83), 6.69-fold (95% CI: 1.33–33.59), and 12.82-fold (95% CI: 2.75–59.85) increased odds of sarcopenia, respectively, compared to sitting for less than 1 h. For those meeting the physical activity guideline (≥150 min of LTPA per week), only sitting for more than 4 h per day was significantly associated with higher odds of sarcopenia (OR: 7.25, 95% CI: 1.99–26.36). Conclusions: Prolonged sedentary behavior was associated with increased odds of sarcopenia. The higher odds of sarcopenia associated with more than 4 h daily sitting may not be offset by achieving the recommended levels of physical activity.

Objective Sarcopenia significantly impacts quality of life and increases morbidity in older adults with type 2 diabetes mellitus (T2DM). This study aimed to investigate the association between Living habits, physical activity levels, and sarcopenia in this population. Methods A cross-sectional study included 65 older adults with T2DM from a tertiary hospital in Shanxi Province, China. Dietary habits were assessed using a 3-day dietary recall method. Physical activity levels were quantified using the International Physical Activity Questionnaire (IPAQ) and categorized (high/moderate/low) based on metabolic equivalent (MET)-minutes/week. Sleep patterns were evaluated using the Pittsburgh Sleep Quality Index (PSQI), with regular sleep defined as 7–9 h nightly and a PSQI score ≤ 5. Sarcopenia was diagnosed according to the 2019 Asian Working Group for Sarcopenia (AWGS) criteria. Participants were categorized into sarcopenia and non-sarcopenia groups. Clinical data were compared, and multivariate logistic regression analyzed associations between lifestyle factors, physical activity, and sarcopenia. Results The proportions of regular exercise, regular sleep, balanced diet, and high physical activity were significantly lower in the sarcopenia group (P < 0.05). Multivariate analysis identified regular exercise (OR = 0.42, 95% CI: 0.25–0.71), regular sleep (OR = 0.56, 95% CI: 0.33–0.94), balanced diet (OR = 0.61, 95% CI: 0.37–0.99), and high physical activity (OR = 0.48, 95% CI: 0.29–0.80) as protective factors against sarcopenia (all P < 0.05). Conclusion Living habits and physical activity levels are significantly associated with sarcopenia risk in older adults with T2DM, suggesting potential targets for prevention strategies.

Objectives Physical activity (PA) intensity is a critical factor in managing chronic diseases. However, a significant gap remains regarding how the relative proportion of moderate-to-vigorous PA (MVPA) within total PA volume specifically influences sarcopenia risk, particularly as evidenced by longitudinal data. This study therefore specifically aimed to investigate the longitudinal association between the MVPA fraction and the incidence of possible sarcopenia (PS). Methods We conducted a prospective cohort study of 4,215 middle-aged and older individuals from the first wave in 2011 and the third wave in 2015 of the China Health and Retirement Longitudinal Study. We used a Chinese version of the International Physical Activity Questionnaire to assess PA. Muscle strength and physical performance were used to determine PS in accordance with the Asian Working Group for Sarcopenia 2019. The association between the proportion of MVPA to total PA volume and the risk of PS was tested using robust Poisson regression analysis. Results In comparison to no activity, the 0%, 1%–33%, 34%–66%, and 67%–100% of MVPA were linked to 11% (aRR = 0.89, 95 % CI = 0.74, 1.08), 26% (aRR = 0.74, 95 % CI = 0.57, 0.96), 20% (aRR = 0.80, 95 % CI = 0.66, 0.98), and 33% (aRR = 0.67, 95 % CI = 0.56, 0.83) decreases in the risk of PS, respectively. Subgroup analyses by sex and age revealed that the inverse association between MVPA proportion and PS risk remained significant specifically among women and older adults. A sensitivity analysis confirmed the inverse association between MVPA proportion and PS risk. Conclusions The study findings suggest that middle-aged and older adults with a greater proportion of MVPA to total volume of PA may have a decreased risk of PS, and the correlation is affected by age and sex.

To investigate sarcopenia state transitions (non-sarcopenia, possible sarcopenia, and sarcopenia) and their determinants among older Chinese adults, emphasizing the roles of physical activity, cognitive status, and other risk factors. A longitudinal study utilizing data from the China Health and Retirement Longitudinal Study (CHARLS) spanning 2011–2015, integrating Multi-State Markov (MSM) models and Transformer-based deep learning approaches. We examined 5,756 participants (including 3,373 for deep learning) across three waves, with a mean age of 67.9 years (SD = 6.5). MSM models estimated transition intensities and probabilities between sarcopenia states. Deep learning with SHAP analysis identified key determinants of transitions and mortality. Covariates included age, sex, BMI, smoking, physical activity, mild cognitive impairment (MCI), and functional disability. MSM models indicated a high transition rate from non-sarcopenia to possible sarcopenia (intensity: 0.383, 95% CI: 0.355–0.411) and a 38.6% five-year recovery probability from possible sarcopenia to non-sarcopenia. Physical activity reduced deterioration risk (HR: 0.916, 95% CI: 0.842–0.997) and mortality in possible sarcopenia (HR: 0.565, 95% CI: 0.339–0.944). MCI increased deterioration risk (HR: 1.724, 95% CI: 1.268–2.346). Age > 80 significantly elevated deterioration (HR: 3.007, 95% CI: 1.992–4.538) and mortality risks (HR: 7.400, 95% CI: 2.542–21.544). Sex, BMI, smoking, and functional disability also influenced transitions. Sarcopenia exhibits bidirectional progression, with physical activity serving as a key protective factor. MCI attenuates this benefit, highlighting the need for tailored interventions that address cognitive status and other risk factors in older adults.

Introduction The present study aimed to explore the effect of different levels of physical activity on depression, instrumental activities of daily living (IADLs), and activities of daily living (ADLs) among older adults over the age of 60. Methods Data on older adults’ health were obtained from the China Longitudinal Aging Social Survey (CLASS) conducted in 2021. A questionnaire was used to survey older adults aged 60 years and older in 28 regions of China. The International Physical Activity Questionnaire (IPAQ) was used to evaluate physical activity, and participants were categorized into groups based on their physical activity levels: vigorous (5.38%), moderate (16.33%), light (74.58%), and no physical activity (control group). The CES-D9 scale was used to assess the level of depression, and both the activities of daily living (ADLs) scale and the instrumental activities of daily living (IADLs) scale were used to evaluate self-care ability. Propensity score matching was used to determine the intensity of physical activity that affected depression, instrumental daily activity ability (IADLs), and activities of daily living (ADLs) among the participants. Results The participation rates of vigorous, moderate, and light physical activities among the older adult Chinese participants were 5.38%, 16.33%, and 74.58%, respectively. Propensity score matching (PSM) showed moderate and light physical activity decreased depression by -0.367 and − 0.409 units, respectively. Moderate and light physical activity increased instrumental activities of daily living (IADLs) by 0.165 and 0.607 units, respectively. Light physical activity increased the level of activities of daily living (ADLs) by 0.265 units. Conclusion Moderate and light physical activity in older adults alleviates depression and improves instrumental activities of daily living (IADLs), and light physical activity improves the level of activities of daily living (ADLs).

BACKGROUND Previous research on the interaction of physical activity and sleep on depressive symptoms was mostly cross-sectional or conducted with children or young adults. This study examines the main and interactive associations of physical activity and sleep duration with depressive symptoms over a 3-year period among middle-aged and older Chinese adults. METHODS Data from 4269 Chinese adults aged 45 or older from the China Health and Retirement Longitudinal Study (CHARLS) were used. Physical activity was categorized as inadequate (<600 MET), adequate (600-8000 MET), and extremely high (>8000 MET). Sleep was classified as inadequate (<6 hours), adequate (6-9 hours), and excessive (>9 hours). The Center for Epidemiologic Studies Depression Scale (CES-D) was used to measure depressive symptoms. RESULTS Inadequate sleep was linked to greater increases in depressive symptoms over 3years. A significant interaction between baseline physical activity and sleep duration in predicting depressive symptoms at the 3-year follow-up showed that inadequate sleep, when combined with either inadequate or extremely high physical activity, was associated with higher depressive symptoms at the 3-year follow-up. In middle-aged subgroups, for people with either inadequate physical activity or an extremely high level of physical activity, inadequate sleep was associated with higher CES-D score compared to adequate sleep; for older adults, only inadequate sleep was associated with a higher follow-up CES-D score. CONCLUSION Physical activity and sleep interactively impacted depressive symptoms, suggesting future personalized interventions that simultaneously target physical activity and sleep. Adequate sleep was associated with lower levels of future depressive symptoms in people with inadequate or extremely high physical activity.

BACKGROUND Sarcopenia, a common debilitating geriatric syndrome, is frequently accompanied by depression and physical inactivity, forming a detrimental cycle that accelerates functional decline. However, hospital-based data on these interrelationships among Chinese older adults remain limited. This study aimed to determine the prevalence of sarcopenia in geriatric in- and out-patients and to test the hypothesis that sarcopenia is independently associated with higher depression scores and lower objectively measured physical activity. AIM To determine sarcopenia prevalence and its associations with depression and physical activity in older adults. METHODS In this cross-sectional study, 346 adults aged ≥ 60 years were recruited via convenience sampling from geriatric departments of hospitals. Data were analyzed using SPSS 26.0. Descriptive statistics, t-tests, χ2 tests, Spearman correlation, and binary logistic regression were employed to examine group differences, variable associations, and independent predictors of sarcopenia. RESULTS Sarcopenia was identified in 62/346 participants (17.92%). Significant inter-group differences emerged for age, body mass index (BMI), coronary artery disease, hypertension, appendicular skeletal muscle mass index (ASMI), grip strength, and 6-m gait speed (P < 0.05). Individuals with sarcopenia reported markedly lower physical activity: A higher prevalence of low activity and lower Physical Activity Scale for the Elderly (PASE) scores (P < 0.001). Spearman correlations revealed ASMI, grip strength, and gait speed were inversely related to depressive symptoms, while positively linked to physical activity (P < 0.01). Logistic regression confirmed 30-item Geriatric Depression Scale and PASE scores independently predicted sarcopenia after adjustment for age, BMI, coronary artery disease, and hypertension (P < 0.05). CONCLUSION Sarcopenia is linked to depression and physical inactivity in elderly inpatients, supporting the need for integrated screening and comprehensive management in clinical practice.

Objectives: The purpose of this multicenter cross-sectional study was to investigate the association between SARC-F, fear of COVID 19, anxiety, depression and physical activity in patients undergoing hemodialysis. Methods: This study was conducted in 3 hemodialysis centers in Greece during the period of the COVID-19 pandemic. Sarcopenia risk was assessed using the Greek version of SARC-F (≥4). Demographic and medical history were collected from the patient’s medical charts. The participants were also asked to fill the Fear of COVID-19 Scale (FCV-19S), the Hospital Anxiety and Depression Scale (HADS), and the International Physical Activity Questionnaire (IPAQ) questionnaire. Results: A hundred and thirty-two (132) patients on hemodialysis (92 men, 70.75±13.14 years) were enrolled. Sarcopenia risk (utilizing the SARC-F) was found in 41.7% of patients on hemodialysis. The average duration of hemodialysis was 3.94±4.58 years. The mean score values for SARC-F, FCV-19S and HADS were 3.9±2.57, 21.08±5.32, and 15.02±6.69, respectively. The majority of patients were physically inactive. The SARC-F scores were strongly associated with age (r=56; p<0.001), HADS (r=0.55; p<0.001), levels of physical activity (r=0.5; p<0.001), but not with FCV-19S (r=0.27; p<0.001). Conclusion: A statistically significant relationship was recorded between sarcopenia risk and age, anxiety/depression and levels of physical inactivity in patients on hemodialysis. Future studies are necessary in order to evaluate the association of specific characteristics of patients.

No abstract available

Background While the association between physical activity (PA) and depression has been established, there is limited research on the effect of PA on the risk of depression among Chinese individuals. Thus, this study aimed to investigate the relationship between PA and depression among Chinese individuals. Methods We used a stratified random sampling approach to recruit participants from five urban districts in Wuhan, China. A total of 5,583 permanent residents aged 18 years or older completed questionnaires, which included the International Physical Activity Questionnaire Short Form (IPAQ-SF) to measure PA, and the 9-item Patient Health Questionnaire (PHQ-9) to evaluate depressive symptoms. To control for potential confounders, multiple logistic regression was employed to assess the association of PA with depression. Results The depression group had significantly lower weekly PA levels, measured in metabolic equivalent of task-minutes per week (MET-min/w), compared to the non-depression group [1,770 (693–4,200) MET-min/w vs. 2,772 (1,324–4,893) MET-min/w, p < 0.001]. In the fully adjusted model, the moderate and high PA level groups had lower odds ratios (ORs) for depressive symptoms compared to the low PA level group [OR (95% confidence interval (CI)) = 0.670 (0.523–0.858), 0.618 (0.484–0.790), respectively]. Among males, moderate and high levels of PA were associated with lower risk of depression compared to low PA levels [OR (95% CI) = 0.417 (0.268–0.649), 0.381 (0.244–0.593), respectively]. However, this association was not observed in females [OR (95% CI) = 0.827 (0.610–1.121), 0.782 (0.579–1.056), respectively]. The study found a significant interaction between PA levels and gender in relation to depression (P for interaction = 0.019). Conclusion The findings suggest a negative association between PA and risk of depressive symptoms, indicating that moderate to high levels of PA may serve as a protective factor against depressive symptoms.

Depressive symptoms and sarcopenia, often observed among middle-aged and elderly individuals, are significant health concerns in China, particularly given the country’s rapidly aging population. Depressive symptoms, characterized by persistent feelings of sadness and loss of interest, can significantly impact quality of life. Little is known about the underlying pathway connecting these two conditions. The data for this study were derived from the China Health and Retirement Longitudinal Study (CHARLS). Depressive symptoms were evaluated using the Centre for Epidemiological Studies Depression (CSED) scale. Logistic regression analyses were employed to investigate the association between depressive symptoms, activities of daily living (ADL) disability, and sarcopenia, while adjusting for potential confounding factors. The selection of predictor variables, including social activity, chronic diseases, demographic factors, and lifestyle habits, was based on their known associations with mental health, physical functioning and sarcopenia. These variables were included to ensure a comprehensive adjustment for potential confounding factors and to provide a more accurate estimation of the relationship between depressive symptoms and sarcopenia. Additionally, mediation analysis was conducted to assess the mediating role of ADL disability in the relationship between depressive symptoms and sarcopenia. A comprehensive study was conducted on a total of 8,238 participants aged 45 years and older, comprising 3,358 men and 4,880 women. Logistic regression analyses were conducted to identify significant associations between depressive symptoms (OR = 1.30, P = 0.0269,95%CI = 1.03–1.63), ADL disability (OR = 1.94, P < 0.001,95%CI = 1.37–2.75) and sarcopenia. The results revealed significant relationships among these variables. Furthermore, mediation effect analyses demonstrated that ADL disability partially mediated the association between depressive symptoms and sarcopenia (estimated indirect effect: 0.006, 95% CI: 0.003, 0.008, proportion of mediation effect: 20.00%). The study underscores a significant association between depressive symptoms and sarcopenia among middle-aged and elderly individuals in China, with ADL disability acting as a mediator. These findings offer novel insights for targeted health interventions. Future interventions should effectively combat sarcopenia by integrating psychological support with muscle-strengthening exercise programs. By addressing both depressive symptoms and ADL disability, clinicians and public health professionals can enhance outcomes for this demographic. Collaborative efforts across disciplines are essential for providing comprehensive health management tailored to the needs of middle-aged and elderly individuals. Future research should longitudinally assess the impact of such integrated interventions on sarcopenia prevention and depressive symptom alleviation. Additionally, investigating the role of social and environmental factors in mediating this relationship is crucial for developing more effective health strategies for this vulnerable population.

Background: This meta-analysis aimed to investigate the links between the level of physical activity and the risk of anxiety or depression among college students in China during the Coronavirus Disease 2019 pandemic. Methods: Eligible studies were searched from the PubMed, Embase, and Web of Science databases. The associations between them were assessed with odd ratio (OR) and 95% confidence interval (CI). The heterogeneity of the included studies was evaluated and subgroup analysis was performed. Sensitivity analysis was executed using leave-one-out method. Publication bias of included studies was evaluated. Ten studies with moderate quality were included. Results: Physical activity levels of college students were associated with reduced risk of depression (OR [95%CI] = 0.69 [0.58, 0.82], P < .001) and anxiety (OR [95%CI] = 0.71 [0.62, 0.80], P < .001). The measurement scale of depression or anxiety and whether multi-factor correction was performed or not did not influence the pooled results. The pooled results of depression and anxiety were stable and were not significantly influenced by a single study. No publication bias was observed in the included studies reporting depression and anxiety. Conclusion: The physical activity level of college students is negatively correlated with anxiety and depression in China during the pandemic. During the Coronavirus Disease 2019 pandemic, it is necessary to strengthen the construction of university physical education courses. As an organized form of physical activity, physical education classes are a necessary and effective way to increase physical activity among college students.

We investigated the longitudinal association between physical activity (PA) and symptoms of depression and anxiety in people with depression during the COVID-19 pandemic. We used data from baseline (June 2020) to wave 3 (June 2021) of the PAMPA Cohort, an ambispective cohort with adults in south Brazil. The Hospital Anxiety and Depression Scale assessed depressive and anxiety symptoms in all waves. Participants reported frequency (minutes), type (aerobic, strength, combined), and place (out of home, at home) of physical activity at baseline. Generalized linear models were used to investigate the interaction between time and PA, adjusting for possible confounding variables. Subjective memory decline was assessed using multivariate Cox proportional hazard regression models to obtain adjusted hazard ratio (HR) and respective 95% confidence interval (CI). Participants (n = 424) with self-reported clinically diagnosed depression were included. We observed a non-linear increase trajectory of depression during the first year of the COVID-19 pandemic. PA was associated with a slower trajectory of depressive (slope: -1.89; 95%CI: -3.34, -0.43 points) but not anxiety (slope: -1.33; 95%CI: -2.93, 0.25 points) symptoms during the COVID-19 pandemic. Participants who continued physically active from pre-pandemic in wave 1 showed a lower risk of subjective memory decline during follow-up than those who persisted inactive in the same period (HR: 0.52; 95%CI: 0.30, 0.89). PA attenuated the impact of the COVID-19 pandemic on depressive symptoms in adults living with depression in south Brazil. Regularity of physical activity was associated with fewer depression and anxiety symptoms and a lower risk of subjective memory decline.

This investigation sought to understand how physical activity, sleep quality, and depression interrelate among university students in a particular region of China. It involved a diverse group of 2363 students from three institutions, using a cross-sectional approach with well-established measurement tools. These tools demonstrated strong reliability and validity, with Cronbach's alpha values indicating robust internal consistency. The data revealed that higher levels of physical activity were inversely related to depression and directly related to better sleep quality, highlighting the potential of exercise and sleep improvement to reduce depressive symptoms among this demographic.

Fitness to maintain an ideal body shape is becoming increasingly popular among college students. However, it also leads to many mental health issues. This study explores the pathways through which negative body image affects depression in college students. It also examines possible means of implementing depression interventions in college populations through the mediating roles of self-efficacy and physical activity, and the moderating role of social support. The present study employed a convenience sampling method to collect data from 600 university students using the Body Image Scale, Self-Efficacy Scale, Physical Activity Scale, General Social Support Scale and Depression Self-Rating Scale. Data analysis and structural equation modeling were conducted using SPSS, M-plus and R software. The result indicate that negative body image is positively correlated with depression. Self-efficacy and physical exercise play a chain mediating role between body image and depression. Additionally, social support moderates the effects of self-efficacy by predicting the pathway through which physical activity effects depression. The study suggest that individuals with a negative body image are more prone to depression and that physical exercise can help alleviate their depressive symptoms. Self-efficacy is an important mediator, and social support moderates adherence to physical exercise. Therefore, attention should be paid to the mental health issues of college students with negative body images.

Background Currently, due to the progress of the aging population in China and the government’s attention to healthy aging, there is an increasing emphasis on the cognitive function and psychological function of older adult people. Therefore, the aim of our study was to investigate the relationships between physical activity and cognitive and psychological function in order to provide recommendations for exercise guidance. Methods The Center for Epidemiologic Studies Depression Scale (CESD-10) was used to assess mental capacity, and cognitive function was evaluated across three domains: orientation, memory and calculation. Total physical activity data were obtained via interviews. Ability of Daily Living (ADL) and Instrumental Ability of Daily Living (IADL) scores were used to determine the presence or absence of daily physical function impairment. Finally, we conducted correlation analysis and logistic regression on participants’ physical activity volume (PAV) and their cognitive and psychological functions, respectively. Results A total of 5,871 participants who met the inclusion criteria were selected from the China Health and Retirement Longitudinal Study (CHARLS). The prevalence of depression was 8.1, and 31.6% of the older adult participants reported experienced depressive symptoms. Additionally, 15.6% of the older adult individuals had insufficient weekly physical activity, while 3.9% had daily physical function (DPF) impairment. Physical activity volume (PAV) was negatively correlated with the CESD-10 score, as well as with orientation, calculation, and memory. Conclusion Our study confirmed that inactive weekly physical activity was associated with an increased risk of depression, cognitive impairment, and DPF impairment among older adult individuals in China.

Background Sarcopenia not only leads to impaired physical function but also may be associated with changes in sleep and mental health as individuals age. Research on the relationships between sleep disorders, anxiety, and depression and adult-onset sarcopenia is limited, however, with no reports of the associations between them and different severity of sarcopenia. The objective of this research endeavor is to investigate the associations between sarcopenia and sleep disturbances, anxiety, as well as depression, within a multi-ethnic population in western China. Method We conducted a cross-sectional study consisting of 4,500 participants from the WCHAT study. The diagnostic method recommended by the Asian Working Group for Sarcopenia in 2019 was used to screen for sarcopenia. The Pittsburgh Sleep Quality Index (PSQI), the 7-item Generalized Anxiety Disorder Questionnaire (GAD-7), and the 15-item Geriatric Depression Scale (GDS-15) were used to assess sleep quality, anxiety, and depression, respectively. The relationships among sleep, anxiety, depression, and the different sarcopenia subgroups were evaluated by using multivariate regression models. In addition, subgroup of gender analysis were performed. Results Among the 4,500 participants surveyed in the western region of China, 408 (9.06%) were diagnosed with sarcopenia and 618 (13.73%) with severe sarcopenia. A total of 2,515 individuals (55.88%) had poor sleep quality, while 842 (18.71%) suffered from anxiety, and 1,045 (23.22%) had depression. Good sleeping quality were negatively associated with severe sarcopenia (OR: 0.80, 95%CI 0.66–0.97) in model 1, whereas depression was positively associated with severe sarcopenia in three models (model 1: OR: 1.39, 95%CI 1.13–1.71; model 2: OR: 1.46, 95%CI 1.16–1.85; model 3: OR: 1.43, 95%CI 1.13–1.81). However, anxiety status was not associated with sarcopenia in our study. Conclusion It was found that good sleep quality were negatively associated with severe sarcopenia, and depression was positively associated with severe sarcopenia. These findings suggested that early intervention in sleep quality and depression may be one of the effective strategies to delay or reduce the severity of sarcopenia. Clinical trial registration https://www.chictr.org.cn/, identifier ChiCTR1800018895.

Background The number of patients who suffer from chronic renal failure (CRF) has widely increased worldwide. Patients with advanced stages of CRF experience a gradual and progressive loss of muscle and fat mass leading to decreased physical activity and mental health problems. The loss of muscle mass in CRF might contribute to the development of sarcopenia. Therefore, this study aimed to explore the prevalence of sarcopenia and to determine the relationship of physical activity and mental state of depression with sarcopenia in hemodialysis patients. Methods A cross-sectional study was designed with a total of 104 male and female with a minimum age of 35 years. Based on the guidelines of the Asian Working Group for Sarcopenia in 2019, gait speed, muscle mass, and handgrip were used to define sarcopenia. In addition, participants were requested to perform a set of questionnaires to evaluate their physical activity and state of depression. Logistic regression analyses were used to explore the risk factors of sarcopenia. Results Thirty-four (32.69%) of 104 participants had sarcopenia. Compared to the 70 individuals without sarcopenia, they had a low physical activity and a high depression score (ps < .05). Furthermore, low physical activity and high depression scores in combination with sarcopenia were associated with an increased mortality risk. Low physical activity and high depression scores were also independently associated with sarcopenia in hemodialysis patients after controlling for age (odds ratio = 3.23, and 4.92, respectively).

No abstract available

Physical activity (PA) varies among middle-aged and older individuals, and insufficient or excessive in activity are associated with an individual’s health status. However, the associations between the trajectory of physical activity and the health status of middle-aged and older adults have been little studied. The study aims to explore the association between PA trajectories and successful aging in middle-aged and older adults. This study used data from the CHARLS in 2013 to 2020. Physical activity was measured with the IPAQ Short Form and total weekly energy expenditure was calculated for different intensities of exercise. The assessment of successful aging includes the following five aspects: the absence of major diseases, no physical impairment, high cognitive function, no depression, and active participation in social activities. Group-based trajectory modeling (GBTM) was used to identify PA trajectories and logistic regression was performed to explore the association between the trajectories of PA and the incidence of successful aging. A total of 1,413 individuals participated in the follow-up study. Three PA trajectories were identified based on GBTM model: stable low, decreasing and increasing. The increasing trajectory (17.1%) had a higher prevalence of successful aging than the stable low trajectory (14.0%) and the decreasing trajectory (15.7%). The sensitivity analyses were generally consistent with the main results. Our study identified three PA trajectories and found that increasing PA trajectory has a higher prevalence of successful aging compared with stable low and decreasing trajectories among Chinese middle-aged and older adults. The findings underscore the importance of monitoring changes in physical activity in middle-aged and older individuals, which provides new ideas for achieving successful aging.

Sarcopenia, defined as progressive loss of skeletal muscle mass and function, is a major health issue with economic consequences in aging societies. Physical activity is recognized as preventive, but its long-term impact across different life stages is not well established. This study examined the association between lifetime physical activity and sarcopenia prevalence using nationally representative data from the China Health and Retirement Longitudinal Study (CHARLS). Data from the 2014 CHARLS Life History Survey were matched with 2015 cross-sectional health assessments. After excluding participants younger than 60 years or with missing data, a final sample of 6,696 individuals was analyzed. Physical activity at different life stages was assessed using a self-reported questionnaire in the 2014 Life History Survey. Sarcopenia was classified according to the AWGS 2019 criteria. Multivariate logistic regression was conducted to evaluate the association between physical activity at different life stages and sarcopenia prevalence. A significance level of 0.05 was adopted for hypothesis testing. Among the study participants, 51.7% were without sarcopenia, 36.0% had possible sarcopenia, and 12.3% had sarcopenia. Across all life stages, individuals with sarcopenia were less likely to have engaged in regular physical activity. After adjusting for all covariates, engaging in physical activity for at least one year at any life stage was associated with a 47% lower odds of sarcopenia (OR = 0.53, 95% CI: 0.40–0.69). The strongest protective effect was observed for physical activity during middle adulthood (41–65 years) (OR = 0.36, 95% CI: 0.19–0.69), whereas physical activity in young adulthood (≤ 40 years) and older adulthood (> 65 years) showed no significant associations. Our findings highlight that maintaining physical activity, particularly during middle adulthood, is associated with reduced risk of sarcopenia. Because physical activity was self-reported, future research should employ objective measures and longitudinal designs to confirm these associations.

Background Age-related sarcopenia is associated with physical decline, including poor functional capacity, lack of physical activity, problems with activities of daily living, and disability. However, little is known about the association between mental health problems and cognitive function in older adults with sarcopenia. Therefore, this study explored community-dwelling older adults' sarcopenia prevalence and related associations with depression, cognitive performance, and physical activity. Methods This cross-sectional study included 330 community-dwelling older adults (66.85 ± 5.54 years, 76.06% female). Based on the Asian Working Group for Sarcopenia guidelines, gait speed, muscle mass, and handgrip were assessed. All participants responded to a set of questionnaires (e.g., Global Physical Activity Questionnaire, cognitive assessment, and depression scale). Logistic regression analysis and multivariate logistic regression were used to determine independent predictors for sarcopenia. Results Overall, 16.1% of the participants were identified as having sarcopenia. Further, advanced age (i.e., mean age ≥ 70 years; odds ratio: 4.67), high depression scores (odds ratio: 2.09), mild cognitive impairment (odds ratio: 0.22), and low physical activity levels (odds ratio: 1.96) were significant associated risk factors for sarcopenia after adjusting for age, sex, and educational level. Conclusions Sarcopenia can lead to adverse health outcomes (i.e., depressive symptoms, cognitive decline, and low physical activity) in older adults.

Background Happiness is one variable of subjective well-being, which has been increasingly shown to have protective effects on health. Although the association between happiness and cognition has been established, the mechanism by which happiness leads to cognition remains unclear. Since happiness, depression, and physical activity may all be related to cognition, and happiness is related to depression and physical activity, this study explored the effect of depression and physical activity on the relationship between happiness and cognition among middle and old-aged individuals in China. Methods Data on 14,344 participants above 45 years of age were obtained from the 2018 China Family Panel Studies survey. A multiple linear regression analysis was performed to identify the correlation factors of cognition. The conditional process analysis was used to assess the mediatory effect of depression and physical activity on the relationship between happiness and cognition. Results Residence, age, sex, income level, social status, smoking, napping, reading, education, exercise times, satisfaction, happiness, and depression had associations with cognition. When other variables were held constant, cognition score increased by 0.029 standard deviation(SD) for every 1 SD increased in happiness. Mediation analysis showed that happiness had a significant positive total effect on cognition. The direct effect of happiness was significant and accounted for 57.86% of the total effect. The mediatory effect of depression (path of happiness→depression→cognition) accounted for 38.31% of the total effect, whereas that of physical activity (path of happiness→exercise times→cognition) accounted for 3.02% of the total effect. Conclusion Happiness has a positive correlation with cognitive function, and depression and physical activity play mediatory roles in this association. Effective interventions to improve happiness levels of middle and old-aged population will not only improve their subjective well-being but also improve their cognitive function, which carries great potential for reducing public health burdens related to cognitive aging.

Physical activity (PA) has an established role in the promotion of health and fitness and the prevention of disease. Expected overall benefits include reduction of all-cause morbidity and death, weight control, improved quality of life, improved bone health and decreased falls of elderly subjects, , deeper cognition, and reduced risk of depression, anxiety, and sleeplessness. Currently, PA is a mainstay in the management of cardiovascular diseases, metabolic syndrome, diabetes, and bone health. Recently, the perception of its role in primary and secondary prevention, interception, and treatment of cancer, however, is also gaining importance. Regular walking, the simplest type of PA, is associated with reduced all-cause and cardiovascular disease mortality, and a role in cancer prevention is of increasing interest. Furthermore, PA improves the quality of life of cancer patients, attenuating side effects of chemotherapy, decreasing sarcopenia, increasing fitness, and inhibiting the recurrence and progression of some cancer types. It promotes emotional and psychological benefits in patients, inducing positive changes. While mechanisms, effective levels and useful amount of PA practice are well established in cardiology, they are yet to be fully determined in oncology. Nevertheless, PA is recommended to reduce cancer risk in the general population, and it has been introduced in programs for the prevention of second cancers. In perspective, it will help as integrative therapy in cancer patients and for cancer survivors. The number of beneficial effects in the cancer continuum is highlighted in this review.