Mental health – adults

Background: While randomized controlled trials have demonstrated the short-term benefits of physical activity, particularly during leisure-time, on depressive symptoms, uncertainties persist regarding long-term interventions and the necessary dose in different domains. Purpose: Applying the principles of target trial emulation, our objective was to estimate the effect of sustained physical activity interventions on the 2-year risk of depressive symptoms among adults. Methods: We used the NutriNet-Brasil cohort, including 15,558 adults (12,036 women, 46.0±12.9) without depressive symptoms, as well as with complete data on baseline and pre-baseline potential confounders. Physical activity was assessed using the global physical activity questionnaire. Depressive symptoms were assessed using the Patient Health Questionnaire. We estimated the 2-year risk of developing depressive symptoms from baseline to the end of follow-up, incomplete follow-up or incident depressive symptoms, whichever comes first. We adjusted for pre-baseline, baseline and time-varying potential confounders, using parametric g-formula, to estimate the 2-year risk of depressive symptoms under different physical activity intervention strategies (i.e., domains and durations), comparing them to the natural course. Results: Compared to the estimated 30.7%(95%CI:27.1; 34.3) risk of depressive symptoms under the natural course, the 2-year risk of depressive symptoms was reduced by 0.4 percentage points (pp) (-0.7;-0.1) for ≥75min/wk, 1.2pp(-1.9;-0.4) for ≥ 150min/wk, and 2.2pp(-3.5;-0.8) for ≥300min/wk. Considering leisure-time physical activity, the risk was reduced in 1.5pp(-2.1;-1.1) for practicing any leisure-time physical activity, 3.2pp(-4.2;-2.3) for ≥75min/week, and 4.6pp(-6.1;-3.2) for ≥150min/week. However, emulated interventions on transport physical activity showed no association with a reduced risk of developing depressive symptoms. Conclusions: Adults experience a lower incidence of depressive symptoms with long-term sustained physical activity interventions, even with lower doses. Practical implications: Long-term strategies aimed at preventing incident depressive symptoms should prioritize leisure-time physical activity, particularly targeting individuals who do not engage in any leisure-time physical activity. Funding: São Paulo Research Foundation (process: 2019/24124-7).

Background: Low physical activity and high sedentary behavior are independently associated with poorer mental health, however, studies examining their combined associations are scarce. Purpose: To examine the joint association of sedentary behavior and leisure-time physical activity (LTPA) on psychological distress in Finnish adult population from two cross-sectional studies before (2017) and after (2023) COVID-19 pandemic. Methods: Random sample of Finnish adults were asked to fill in questionnaire of the FinHealth 2017 (n=10 300) and Healthy Finland 2023 (n= 10 000) surveys. Analytical samples in 2017 (n=4400) and in 2023 (n=2900) were restricted to working age population. LTPA was classified into: inactive, moderately active, and active and non-work sedentary time into: low sedentary and high sedentary (>5 hours/day) yielding a six-category variable for the joint analyses. Psychological distress was measured with Mental Health Inventory-5 (MHI-5) dichotomized using clinically significant symptoms (≤ 52 points) as a cut-point. Logistic regression analysis was used adjusting for key covariates with SPSS 29. Results: The prevalence of psychological distress increased from 8% to 14% between 2017 and 2023. Compared with the active low sedentary group, the inactive high sedentary group in 2017 (OR 3.46 CI 95% 2.08-5.77) and in 2023 (OR 3.42 CI 95% 2.27-5.16) as well as, the moderate active high sedentary groups and the inactive low sedentary groups had increased likelihood of psychological distress. In 2017, the active high sedentary group also showed a similar association (OR 2.36, 95% CI 1.32-4.23), and in 2023 moderate active low sedentary group (OR 1.69, 95% CI 1.15-2.48) . Conclusions: The study emphasize that both lack of LTPA and high sedentary time associate with psychological distress in adults. Practical implications: Promoting LTPA and reduce sedentariness among the working-age population may prove useful to reduce psychological distress. Funding: Juho Vainio Foundation

Background: Mental health disorders such as depression, anxiety, and stress have been identified as one of the main current societal problems, and are also associated with a lower perception of quality of life. The physical activity (PA) practice in free time is recognized for health benefits, including physical and mental aspects, assuming great importance for Public Health. Purpose: To analyze the association among free-time PA, mental health, and perception of quality of life in Primary Health Care users in the Auriflama municipality, SP, Brazil. Methods: A cross-sectional study, performed from August to October 2022, with 230 adults who answered questionnaires regarding mental health (DASS-21), perception of quality of life (SF-12v.2), and PA practice (IPAQ-long version). Simple and multiple binomial logistic regression models were used for the outcome free-time PA ≥ 150 minutes/week – results are expressed in odds ratio (OR) [95%CI]. Multiple linear regression models were used to compare free-time PA groups for the quality of life domains. Results: Participants classified as inactive during their free time presented a greater indication of risk for depression (3.49[1.54;7.89]) and anxiety (2.11;[1.04;4.27]). In the comparison of groups, inactive participants presented lower scores in all the quality of life domains (functional capacity, physical aspects, body pain, general health status, vitality, social aspects, emotional aspects, and mental health). Conclusion: People who practice at least 150 minutes of PA in free time per week had better outcomes related to mental health and perception of quality of life. Practical implications: It is useful to expand the possibilities of free-time PA access, understanding that these habits may not be choices for the majority and depend on people having basic and dignified living conditions. Funding: Andrella JL received a master’s scholarship from the Coordination for the Improvement of Higher Education Personnel (CAPES) of Brazil.

Background: Research focused on the provision of on-campus tailored exercise programs for post-secondary student mental health is increasing. Yet, there is limited focus on process evaluation considerations (e.g., reach, engagement motives), which are important for optimizing program delivery and for the dissemination of research findings into practice. Purpose: To explore the reach (e.g., referral pathways, student characteristics, mental health challenges) and motives for engagement in a tailored 6-week exercise program for student mental health. Methods: Students were screened for eligibility (178 screened, 118 eligible) and the analytical sample included students who provided baseline descriptive data (N= 59; Mage = 26.09 years; 82% women; 30% international student). Motives for engagement were open-ended responses and coded using inductive content analysis. Results: Students primarily heard about the program through campus media marketing (29%) or were referred through campus mental health (29%) or student support (15%) services. Respondents reported a history of diagnosed mental illness (56%). Mental health challenges included anxiety (86%), trouble concentrating (74%), difficulty coping with stress in a healthy way (70%), depression (58%), and loneliness (44%). Motives for engagement were offered by 85% of students and included motivation and social support (30%), healthy routine building (22%), and learning strategies for improving overall mental, physical, and academic well-being through exercise (48%). Conclusions: The reach and motives for student engagement in a tailored exercise program for mental health were demonstrated. Practical implications: To optimize program delivery, it is critical to ensure support structures (e.g., training, guidelines, standards of practice) are available to equip program developers, researchers, and practitioners with practical tools and knowledge for delivering exercise programs for student mental health. Funding: Doctoral fellowship from the Social Sciences and Humanities Research Council held by MLD and an Inlight Student Mental Health Grant awarded to MLD and CMS. CMS holds a Canada Research Chair.

Background: Perimenopause is the phase where a women’s body naturally transits to menopause. It occurs around the late 40’s or early 50’s which is characterized by hormonal imbalance that leads to experiencing climacteric symptoms. Women’s perception of their quality of life is not only bound to symptom profile but also includes variety of circumstances like progressive aging, increasing family responsibilities, possible mid-life crises, socio-cultural factors. This has an impact on working women, and can cause an imbalance in the thick of work place and household demands. Literature suggests, physical activity as a second which reduces perimenopausal symptoms and improves the quality of life. Hence, this study aims at assessing the levels of physical activity, evaluating the quality of life, and correlate physical activity with quality of life in perimenopausal women. Objectives of the study: To assess the levels of physical activity in perimenopausal women, to evaluate quality of life and to correlate physical activity with quality of life in perimenopausal women. Methods: In this study, 126 working women in the perimenopause stage, aged between 45-55years were included. STRAW criteria were used to screen the participants. The levels of physical activity were assessed by IPAQ-SF and quality of life was evaluated using Utain QOL. Results: Majority of population engaged in high levels of physical activity (median-2079), experienced high quality of life (median-77). The correlation coefficient of 0.227 suggests a positive relationship between IPAQ scores and UQOL scores however the p-value of 0.11 suggests it is not statistically significant. Interpretation & Conclusion: The observation in this study suggests that perimenopausal women were highly active and experienced good quality of life. Further research may be necessary to investigate the relationship or identify potential factors that could impact the outcomes. Keywords: Physical activity, Perimenopause, Menopause Transition, Quality of Life, Menopausal Symptoms Funding: None

Background: The physical health benefits of physical activity are widely acknowledged. Recently, its mental and cognitive health benefits have been increasingly recognised. Purpose: To synthesise experimental evidence from systematic reviews and meta-analyses examining the impact of physical activity interventions on cognition, memory, and executive function in all age and health population groups, thus offering a robust foundation for recommendations on physical activity for cognitive health. Methods: Adhering to PRISMA and AMSTAR2 recommendations, we conducted a comprehensive search across 11 databases, selecting systematic reviews and meta-analyses of RCTs that investigated the effects of physical activity on cognitive outcomes (PROSPERO ID: CRD42023468991). Data synthesis involved pooled effect sizes using random effects models, with subgroup analyses based on participant characteristics (age and health population) and intervention details (e.g. modality, duration, intensity). Results: The review included 133 systematic reviews, encompassing 2,724 unique RCTs with 258,279 participants. Physical activity significantly improved cognition (SMD 0.42), memory (SMD 0.23), and executive function (SMD 0.28). Subgroup analyses found no differences based on age group or population, but greater benefits for specific physical activity types like exergaming for cognition and mind-body exercises for memory, particularly with interventions of 1-3 months duration. Conclusions: This extensive umbrella review substantiates physical activity’s beneficial impact on cognitive health, underscoring its importance as a universally accessible and effective intervention for enhancing cognitive functions, including memory and executive function, across diverse populations and age groups. Practical implications: The results highlighted that all forms of physical activity are beneficial for enhancing cognitive function in both the general and clinical populations. Thus, people should be encouraged to engage in physical activity that meets their individual needs and preferences and maximises their enjoyment and adherence. Funding: No specific funding was received for this project.