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Aging increased the risks of cognitive impairment and depression. Then, these conditions can lead to poor quality of life by reducing one’s ability to perform activities of daily living. Recently, it is established that physical activity can decrease the cognitive decline and the risk of depression in older adults. Moreover, regular physical activity can improve physical and mental functions in populations of all ages. However, level and speed of cognitive decline occurs varies greatly among individual especially the difference between middle-aged and older adults.
This study aimed to focus on the comparison of physical activity, cognitive function and depression between older and middle-aged adults, which has never been done before. Moreover, the associations of physical activity with cognitive impairment and depression were also investigated in older and middle-aged adults. The information in this study will provide an understanding regarding the design of physical activity program for different age groups.
All participants were divided into two groups of 50 middle-aged adults and 50 older adults. The assessments of physical activity, cognitive function, and level of depression were conducted for all participants.
The total level of physical activity and cognitive function in older adults was decreased when compared with middle-aged ones. Moreover, each work and transportation domain of physical activity in older adults also was decreased when compared with that in middle-aged ones. However, the leisure domain of physical activity in older adults was increased
We suggested that total level of physical activity in older adults can increase
The number of older people has increased worldwide [
We conducted the study on older and middle-aged adults living in the community. A cross-sectional study design was employed to explore the differences between physical activity, cognitive function, and depression in older and middle-aged adults. In addition, the associations of physical activity with cognitive impairment and depression between older and middle-aged adults were explored.
The older and middle-aged people living in the Nongpakhrang community in Chiang Mai province, Thailand, were invited to participate in the study
All the methods were performed as per the relevant guidelines and regulations. All data were collected through face-to-face interviews between the participant and the researcher.
The population of this study comprised Nongpakhrang community members in Chiang Mai province, Thailand. Moreover, we also studied the participant who had regular physical activity. It is established that the person's lifestyle is one of the essential factors in determining the level of physical activity and a predictor of long-term response to physical activity [
Thus, the inclusion criteria of this study were active adults who had participated in regular activities at least three times a week for at least six consecutive months. In this study, active adults who had participated in regular activities in the past six months from the center of activities and health services in the Nongpakhrang community in Chiang Mai province, Thailand, were randomly selected. After that, all participants were divided equally into two groups of 50 middle-aged (ages 36–59 years) and 50 older adults (aged 60 years or above). The assessments of physical activity, cognitive function, and level of depression were conducted for all participants on the same day. The eligibility criteria used in this study included lack of physical disability and ability to sit for 60 minutes for each study protocol.
In this study, the Global Physical Activity Questionnaire (GPAQ), initially designed by the World Health Organization (WHO), was used to assess physical activity [
In this study, the Montreal Cognitive Assessment (MoCA) was used to assess mild cognitive impairments (MCI) [
In this study, depression was assessed using the Thai version of the Patient Health Questionnaire (PHQ-9) [
All data were presented as mean values ± SEM. The t-test was used to compare the difference in physical activity, depression, and MoCA scores between middle-aged and older adults. The Pearson χ2 test was used to analyze categorical variables. This study also studied categorical variables regarding health status, including the history of head injury and underlying disease. It is established that a history of head injury was associated with cognitive impairment [
General characteristics of middle-aged and older adults are shown in Table
The ability of middle-aged and older adults to perform physical activity is shown in Fig. (
The level of depression in middle-aged and older adults is shown in Fig. (
|
|
|
- |
Male | 28% |
Female | 72% |
|
- |
Average (SE) | 48.64 ± 0.76 |
|
- |
(Average) | 62.26 ± 1.80 |
|
- |
(Average) | 24.58 ± 0.64 |
|
- |
Uneducated | 0% |
Educated | 100% |
|
- |
Yes | 0% |
No | 100% |
|
- |
Yes | 16% |
No | 84% |
Cognitive function levels are shown in Fig. (
Factors associated with physical activity in middle-aged and older adults are shown in Fig. (
In the results, older adults showed that the PHQ-9 score was associated negatively with physical activity (r = -0.36, p = 0.01) (Fig.
The significant findings of this study are as follows:
(1) The total level of physical activity decreased in older adults compared with that in middle-aged ones.
(2) The level of physical activity in work and transportation domains decreased in older adults compared with that in middle-aged ones, while the leisure domain of physical activity in older adults was significantly higher than that of middle-aged ones.
(3) The level of depression in older adults significantly reduced compared with that of middle-aged ones.
(4) The cognitive function of older adults was significantly lower than that of middle-aged ones.
(5) The level of physical activity was associated with cognitive function and depression and only depression in middle-aged and older adults, respectively.
It was established that regular physical activity could improve physical and mental functions in populations of all ages [
In this study, factors associated with physical activity in middle-aged adults were measured, and the results demonstrated that cognitive function was associated positively with physical activity. This finding is consistent with a study that showed that physical activity is associated with cognitive function in middle-aged adults [
Moreover, the results of this study first show that depression level was associated negatively with physical activity in middle-aged adults. In addition, factors associated with physical activity in older adults were measured, and the results showed that depression level was associated negatively with physical activity. This finding is consistent with studies that showed that adequate exercise was associated with depression in older adults [
Thus, we suggested that the level of physical activity is associated with both cognitive function and depression and depression alone in middle-aged and older adults respectively. In the future, the mechanisms of factors associated with physical activity in middle-aged and older adults need to be investigated.
However, the level of physical activity may be associated with cognitive function and depression
Interestingly, the studies demonstrated that activation of Sirtuin 1 could attenuate cognitive impairment and depression [
For clinical application of this study, we suggested that the total level of physical activity in older adults can be increased
Second, we suggested that it is possible that the increase in active leisure activity in older adults was induced by decreasing the risk of mental health problem. However, this hypothesis has not been evaluated in this study. In the future, this hypothesis needs to be investigated. Thus, the covariables and confounders, which influence the level of physical activity, need to be studied in the future.
The significant findings of this study were that the total level of physical activity and cognitive function in older adults decreased when compared with middle-aged ones. Moreover, each work and transportation domain of physical activity in older adults also decreased compared with that in middle-aged ones. However, the leisure domain of physical activity in older adults increased. It is possible that the increase in active leisure activity in older adults was induced by decreasing the risk of mental health problem. In addition, physical activity is associated with cognitive function and depression and depression alone in middle-aged and older adults, respectively.
= Quality of Life
= Mild Cognitive Impairment
= Montreal Cognitive Assessment
The study protocol was reviewed and approved by the Institutional Ethics Committee of the Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand (Ethic number: AMSEC-62EX-065).
The study on humans was conducted following the ethical standards of the Helsinki Declaration and Good Clinical Practice. No animals were used in this study. All methods were performed following the relevant guidelines and regulations.
All participants gave written informed consent for participation in this study.
STROBE guidelines and methodologies were followed in this study.
The data supporting the findings of the article are available within the article.
This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
The authors declare no conflict of interest, financial or otherwise.
This study was supported by the Faculty of Associated Medical Sciences, Chiang Mai University, Thailand. Moreover, we would like to thank all staff and members of the Nongpakhrang Subdistrict Municipality in Chiang Mai province, Thailand, for their assistance throughout this study.