Accelerometer Derived Physical Activity and Depression and Anxiety Symptoms in Children and Adolescents: A Meta-Analysis

Background: The association between accelerometer measured PA and depression/anxiety symptoms in children and adolescents remains unclear. Furthermore, the impact of accelerometry methodologies on this relationship has yet to be explored.
Purpose: This meta-analysis examined the association between accelerometer measured PA and symptoms of depression and anxiety in children and adolescents and determined whether the strength of this relationship differed by accelerometer data collection and processing methods.
Method: Terms relating to children, PA, depression/anxiety and observational design were used to search electronic databases for potentially eligible studies up to September 2023. Meta-analysis was used to synthesize results and assess the moderating effects of accelerometer data collection and processing methods with subgroup analysis.
Results: Seventeen studies were meta-analysed, showing a small negative association of moderate to vigorous physical activity (MVPA) with depression (partial r = -0.19, 95%CI [-0.31, -0.06], p = 0.002) and anxiety (partial r = -0.24, 95%CI [-0.38, -0.10], p = 0.01) in the 10 studies that analysed the outcomes as a continuous scale. The effect varied by epoch length (≤ 15 second: partial r = -0.38, > 15 second: partial r = -0.09, difference p = 0.01) and wear location (wrist: partial r = -0.32, hip: partial r = -0.10, difference p = 0.03). In the 7 studies that analysed the outcomes as a binary-scale, total physical activity (OR = 0.98, 95%CI [0.96,1.00], p = 0.05) and light physical activity (OR = 0.95, 95%CI [0.92,0.98], p < 0.001), but not MVPA, showed a small negative relationship with depression.
Conclusion: The results demonstrate that increased PA is associated with lower depression and anxiety symptoms in youth; accelerometry methodologies may influence this relationship.
Practical implications: This study highlights the importance of considering measurement methodologies when examining objective PA in relation to mental health outcomes.
Funding: China Scholarship Council