Research Article| Volume 116, P100-107, October 2018

Sedentary behavior and perceived stress among adults aged ≥50 years in six low- and middle-income countries

  • Garcia Ashdown-Franks
    Corresponding author at: Institute of Psychiatry, Psychology and Neuroscience, Kings College London, De Crespigny Park, London, Box SE5 8AF, United Kingdom.
    Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom

    Department of Exercise Sciences, University of Toronto, 55 Harbord Street, Toronto, Ontario M5S 2W6, Canada
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  • Ai Koyanagi
    Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain

    Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujadas, Barcelona, Spain
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  • Davy Vancampfort
    KU Leuven, Department of Rehabilitation Sciences, Leuven, Belgium

    KU Leuven, University Psychiatric Center KU Leuven, Kortenberg, Belgium
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  • Lee Smith
    The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom
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  • Joseph Firth
    NICM Health Research Institute, Western Sydney University, Sydney, Australia

    Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, United Kingdom
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  • Felipe Schuch
    Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil

    Post Graduate Program in Health and Human Development, Universidade La Salle, Canoas, Brazil
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  • Nicola Veronese
    National Research Council, Neuroscience Institute, Aging Branch, Padua, Italy
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  • Brendon Stubbs
    Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom

    Physiotherapy Department, South London and Maudsley National Health Services Foundation Trust, United Kingdom
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      • Little is known about the relationship between sedentary behavior and perceived stress.
      • Our data across 6 low- and middle-income countries suggest sedentary behavior is associated with increased perceived stress.
      • A one-hour increase in sedentary behavior per day was associated with a perceived stress score of 0.92 points higher.
      • Research is warranted to examine the types and contexts of sedentary behavior and mechanisms underpinning this relationship.



      Sedentary behavior and perceived stress are both negatively associated with physical and mental health. Little is known about the association between sedentary behavior and perceived stress, and there is a particular paucity of data on people aged ≥50 years from low- and middle-income countries (LMICs).


      We analyzed cross-sectional, community-based data from 34,129 individuals aged ≥50 years [mean age 62.4 (SD = 16.0) years, 52% females] from six LMICs. Perceived stress was assessed using the Perceived Stress Scale and time spent sedentary per day was self-reported. Multivariable linear regression analyses were conducted, adjusting for important socio-economic and physical and mental health-related confounders.


      The mean perceived stress score increased with greater sedentary time (38.4 for 0–<4 h/day to 54.2 for ≥11 h/day). In the fully adjusted model, 4–8, 8–11, and ≥11 h/day of sedentary behavior (SB) were associated with 1.97 (95%CI = 0.57–3.36), 7.11 (95%CI = 4.96–9.27), and 9.02 (95%CI = 5.45–12.59) times higher mean perceived stress scores, compared with 0–<4 h/day. Greater time spent sedentary was associated with higher perceived stress scores in all six countries, although the association in Mexico fell short of statistical significance.


      This is the first multinational analysis to show that a greater amount of sedentary behavior is associated with higher levels of perceived stress among older adults in LMICs. Future research may examine the types and contexts of sedentary behavior, and explore the underlying mechanisms of the relationship.


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