Highlights
- •Physical inactivity, smoking and a low intake of fruits and vegetables were all associated with elevated depressive symptoms.
- •The risk for developing elevated depressive symptoms increased with the increment of risk behaviors.
- •Interventions integrating multiple health behaviors are warranted among older adults.
Abstract
Objectives
To investigate the cross-sectional and prospective associations of lifestyle risk
behaviors clustering with elevated depressive symptoms and to explore synergic prospective
associations of different combinations of lifestyle risk behaviors with subsequent
depressive symptoms.
Study design
Prospective cohort study. Data on 31,190 middle-aged and older adults from waves 4
(2011) and 6 (2015) of the Survey of Health, Ageing and Retirement in Europe (SHARE)
were used.
Main outcome measures
Elevated depressive symptoms were estimated using the EURO-D 12-item scale. Lifestyle
risk behaviors composing the cluster included physical inactivity, inadequate consumption
of fruit and/or vegetables, binge drinking, and tobacco smoking. Gender, age group,
education, place of residence, country, number of chronic diseases and body mass index
were considered as confounders.
Results
With the exception of binge drinking, all lifestyle risk behaviors were associated
with higher odds of elevated depressive symptoms in cross-sectional and prospective
analyses. The clustering of unhealthy lifestyle behaviors was cross-sectionally associated
with elevated depressive symptoms and the clustering of two [odds ratio [OR]: 1.39;
95%CI: 1.28–1.51) and three or four (OR: 1.60; 95%CI: 1.38–1.85) were prospectively
associated with elevated depressive symptoms. There were no interactions between the
pairs of behaviors in the association with later elevated depressive symptoms.
Conclusions
Our findings support the need for interventions integrating multiple health behaviors
to prevent elevated depressive symptoms among middle-aged and older adults.
Keywords
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Article info
Publication history
Published online: September 27, 2021
Accepted:
September 22,
2021
Received in revised form:
August 6,
2021
Received:
March 19,
2021
Identification
Copyright
© 2021 Elsevier B.V. All rights reserved.
