Physical Activity and Incident Depression: A Meta-Analysis of Prospective Cohort Studies
Abstract
Objective:
Method:
Results:
Conclusions:
Method
Search Procedure
Inclusion and Exclusion Criteria
Study Selection
Outcomes
Data Extraction
Study Quality
Meta-Analysis
Results
Search Results
Studies and Participant Characteristics
Study Authors, Year, Reference | Study Name | Country | N | Follow-Up (years) | Persons-Years | Male (%) | Age at Baseline | Depression Definition | Physical Activity Measure | Physical Activity Parameters |
---|---|---|---|---|---|---|---|---|---|---|
Almeida et al., 2006 (29)b,c,d | None | Australia | 601 | 4.8 | 2,884 | 100.0 | Older | GDS-15 >5 | Single question on physical activity intensity | Intensity |
Augestad et al., 2008 (30)e | Nord-Trøndelag Health Survey (HUNT) | Norway | 6,660 | 11 | 73,271 | 49.6 | Adults | HADS-D >8 | Physical activity questions used in HUNT study | Composite/metabolic equivalents |
Baumeister et al., 2017 (31)e,f,g | Study of Health in Pomerania (SHIP) | Germany | 1,952 | 4.5 | 8,784 | 49.7 | Adults | BDI-II ≥12 or M-CIDI | Baecke questionnaire | Frequency |
Beard et al., 2007 (32)c | Northern Rivers Mental Health Study (NoRMHS) | Australia | 968 | 2 | 1,936 | 43.3 | Adults | CIDI or DIS | Physical activity questionnaire (not specified) | Volume |
Brown et al., 1996 (33)b,c,h | National Health and Nutrition Examination Survey (NHANES I) | United States | 1,132 | 7–9 (8 used) | 9,056 | 45.0 | Adults | CES-D ≥16 | Two questions on level of activity | N/A |
Cabello et al., 2017 (34)d,e | WHO Study on Global Ageing and Adult Health (SAGE) | Ghana, India, Mexico, and Russian Federation | 4,888 | 3 (computed) | 14,664 | 34.5 | Adults | CIDI-based algorithm | IPAQ | Composite/metabolic equivalents |
Chang et al., 2016 (35)e | Age Gene/Environment Susceptibility–Reykjavik Study | Iceland | 4,140 | 25 | 103,500 | 55.4 | Older | GDS-15 >6 | Two questions on regularity and time spent in physical activity | Volume |
Chang et al., 2016 (36)b,c,d,f,h | Nurses’ Health Study (NHS) Waves 2000–2010 | United States | 21,728 | 10 | 217,280 | 0.0 | Older | Self-report of physician-diagnosed major depression or depressive symptoms, use of antidepressants, MHI-5 <52, CES-D10 ≥16 or GDS-15 >6 (2000–2010) | Questions on hours per week of moderate to vigorous exercise | Volume |
Chen and Millar, 1999 (37)b,c,d,h,i | National Population Health Survey (NPHS 1994/1995–1996/1997) | Canada | 7,593 | 2 | 15,186 | 46.2 | Adults | CIDI | Questions on frequency and duration of different physical activities | Composite/metabolic equivalents |
Choi et al., 2015 (38)c,d,e | Korean Longitudinal Study of Aging (KLoSA) | South Korea | 5,327 | 4 | 21,308 | 47.4 | Adults | CES-D10 ≥4 | Single question on exercise | Frequency |
Clark et al., 2007 (39)d,e | East London Adolescents: Community Health Survey (RELACHS) | England | 1,170 | 2 | 2,340 | 49.5 | Children/adolescents | SMFQ ≥8 | Question on physical activity/exercise | Unclear |
Collard et al., 2015 (40)d,f | Invecchiare in Chianti (Aging in the Chianti Area) (InCHIANTI) | Italy | 699 | 9 | 6,291 | 50.0 | Older | CES-D ≥20 | Unclear | Unclear |
Cooper-Patrick et al., 1997 (41)b,d,f | Precursors Study | United States | 752 | 15 | 11,280 | 92.0 | Adults | Self-report on annual morbidity questionnaires and by review of medical records, using DSM-IV criteria | Harvard Alumni Physical Activity Questionnaire | Frequency |
Da Silva et al., 2012 (42)c,e | Whitehall II Study | United Kingdom | 9,309 | 8 | 74,472 | 68.5 | Adults | GHQ (four items for depression) ≥ 4 | Two questions on time and intensity of physical activity | Composite/metabolic equivalents |
España-Romero et al., 2013 (43)e | Aerobic Center Longitudinal Study (ACLS) | United States | 5,110 | 6.1 | 31,171 | 79.6 | Adults | CES-D ≥8 | Participation in recreational physical activity | Composite/metabolic equivalents |
Farmer et al., 1988 (44)d,e | National Health and Nutrition Examination Survey (NHANES I) augumentation group (1975) | United States | 1,163 | 7–9 (8 used) | 9,304 | 48.5 | Adults | CES-D ≥16 | Two questions on level of activity | N/A |
Gallegos-Carrillo et al., 2013 (45)e | Health Worker Cohort Study (HWCS) | Mexico | 1,047 | 6 | 6,282 | 22.5 | Adults | CES-D ≥16 | Questionnaire assessing time and intensity spent in different recreational physical activities | Composite/metabolic equivalents |
García-Peña et al., 2013 (46)e | Integrated Study of Depression Among the Elderly | Mexico | 7,449 | 2 | 14,898 | 48.85 | Older | GDS-30 >11 | Single question on regular exercise | Unclear |
Giltay et al., 2006 (47)b,c,h | Zutphen Elderly Study | Netherlands | 464 | 15 | 6,960 | 100.0 | Older | ZSDS ≥50 | Questionnaire on total minutes per week | Volume |
Groffen et al., 2013 (48)d,f | Health, Aging, and Body Composition (Health ABC) Study | United States | 2,694 | 9 | 24,246 | 49.7 | Older | CES-D10 >10 or use of antidepressant medication | Adapted Minnesota Leisure Time Physical Activity Questionnaire | Composite/metabolic equivalents |
Hiles et al., 2015 (49)e,g | Hunter Community Study | Australia | 1,410 | 4 | 5,640 | 49.6 | Older | CES-D ≥16 | Pedometer | Volume |
Jerstad et al., 2010 (50)e,g | None | United States | 496 | 6 | 2,976 | 0.0 | Children/adolescents | K-SADS | Past Year Activity Scale | Volume |
Jonsdottir et al., 2010 (51)b,f | None | Sweden | 2,818 | 2 | 5,636 | 13.0 | Adults | HADS-D > 10 | Adapted Saltin-Grimby scale | Intensity |
Joshi et al., 2016 (52)e,g | New York City Neighborhood and Mental Health in the Elderly Study II | United States | 2,355 | 3 | 7,065 | 40.1 | Older | PHQ-9 ≥10 | PASE | Composite/metabolic equivalents |
Koster et al., 2006 (53)d,f | Longitudinal Aging Study Amsterdam (LASA) | Netherlands | 2,153 | 9 | 19,377 | 50.8 | Older | CES-D ≥16 | Question on number of activities in past week | Frequency |
Ku et al., 2009 (54)e,g | Taiwan’s Health and Living Status of the Elderly Survey | Taiwan | 3,778 | 7 | 26,446 | 53.9 | Older | CES-D10 ≥10 | Single question on frequency of leisure-time physical activity | Frequency |
Kuwahara et al., 2015 (55)b,f | None | Japan | 29,802 | 6.4 | 190,732 | 84.8 | Adults | Adapted CES-D ≥16 | Questions on regularity, frequency, and time spent in 20 physical activities | Composite/metabolic equivalents |
Mckercher et al., 2014 (56)b,c,f,h | Childhood Determinants of Adult Health Study | Australia | 1,630 | 20 | 32,600 | 46.5 | Children/adolescents | CIDI-Auto | Questions on frequency and time spent on physical activity | Composite/metabolic equivalents |
Messier et al., 2013 (57)b,c,d,e,h | Montreal Diabetes Health and Well-Being Study | Canada | 1,868 | 1 | 1,868 | 46.4 | Adults | PHQ-9 (one of the first two symptoms and five of the others) | Question on the frequency of sports participation | Frequency |
Mihrshahi et al., 2015 (58)c,e | Australian Longitudinal Study on Women’s Health (ALSWH), waves 2004–2010 | Australia | 5,117 | 6 | 30,702 | 0.0 | Adults | CES-D10 ≥10 | Questionnaire based on Australian recommendations for physical activity | Composite/metabolic equivalents |
Mikkelsen et al., 2010 (59)b,f,g | Copenhagen City Heart Study | Denmark | 18,146 | 26 | 471,796 | 44.1 | Adults | Record of major depression in Danish hospital discharge register or Danish psychiatric hospital (ICD-8 codes 296, 298, or 300 or ICD-10 codes F32, F33) | Single question on intensity and frequency | Composite/metabolic equivalents |
Mobily et al., 1996 (60)e | Iowa 65+ Rural Health Study | United States | 1,926 | 10 | 19,260 | 38.6 | Older | CES-D11 ≥15 | Single question on walking frequency | Frequency |
Park et al., 2015 (61)b,c,e,h | Yeoncheon Elderly Depression and Dementia Study | South Korea | 340 | 5 | 1,700 | 61.2 | Older | SGDS-K ≥8 | IPAQ | Composite/metabolic equivalents |
Pasco et al., 2011 (62)e | Geelong Osteoporosis Study (GOS) | Australia | 547 | 4.1 | 2,242 | 56.0 | Older | SCID-I/NP | PASE | Composite/metabolic equivalents |
Rius-Ottenheim et al., 2013 (63)b,c,e,h | Alpha Omega Trial (AOT) | Netherlands | 445 | 4.3 | 1,913 | 81.3 | Older | GDS-15 ≥4 | PASE | Composite/metabolic equivalents |
Roh et al., 2015 (64)e | None | Korea | 15,146 | 3 | 45,438 | 44.5 | Older | SGDS-K ≥8 | Two questions on frequency and duration of moderate to vigorous physical activity “in a week” | Frequency |
Sanchez-Villegas et al., 2008 (65)e | SUN study | Spain | 10,381 | 6 | 62,286 | N/A | Adults | Self-report of physician diagnosis of depression | Questionnaire assessing time spent per week in 17 physical activities | Composite/metabolic equivalents |
Sanchez-Villegas et al., 2016 (66)d,f | SUN study | Spain | 11,800 | 14 | 165,200 | N/A | Adults | Self-report of physician diagnosis of depression | Questionnaire assessing time spent per week in 17 physical activities | Composite/metabolic equivalents |
Smith et al., 2010 (67)c,e | Honolulu-Asia Aging Study | United States | 1,417 | 8 | 11,336 | 100.0 | Older | CES-D11 ≥9 | Single question on distance walked per day | Volume |
Strawbridge et al., 2002 (68)d,e | Alameda County Study (waves 1994–1999) | United States | 1,651 | 5 | 8,255 | N/A | Older | DSM-12D | Four questions evaluating the usual frequency of physical exercise, taking part in active sports, taking long walks, and swimming | Frequency |
Strohle et al., 2007 (69)e | Early Developmental Stages of Psychopathology Study (EDSP) | Germany | 2,458 | 4 | 9,832 | 50.9 | Children/adolescents | CIDI | Four questions on physical activity frequency | Frequency |
Ten Have et al., 2011 (70)e | Netherlands Mental Health Survey and Incidence Study (NEMESIS) | Netherlands | 4,796 | 3 | 14,388 | 50.6 | Adults | DSM-III-R | Single question on hours per week of exercise | Volume |
Tsai et al., 2013 (71)e | Taiwan Longitudinal Survey on Aging (TLSA) | Taiwan | 2,145 | 8 | 17,160 | 53.2 | Older | CES-D ≥10 | Three questions on frequency, time, and intensity of exercise | Composite/metabolic equivalents |
Tsutsumimoto et al., 2017 (72)b,c,d,e,h | Obu Study of Health Promotion for the Elderly (OSHPE) | Japan | 3,053 | 15 | 45,795 | 49.7 | Older | GDS-15 >6 | IPAQ | Volume |
Veronese et al., 2017 (73)c,d,e | English Longitudinal Study of Ageing (ELSA) | United Kingdom | 4,077 | 2 | 8,154 | 47.0 | Older | CES-D8 ≥4 | Three questions on frequency of participation in light, moderate, or vigorous physical activity | Intensity |
Wang et al., 2011 (74)d,f | National Population Health Survey (NPHS waves 1994–1995 to 2004–2005) | Canada | 15,201 | 6 | 91,206 | 54.4 | Adults | CIDI | Questions on frequency and duration of engagement in different physical activities | Composite/metabolic equivalents |
Weyerer, 1992 (75)d,e | Upper Bavarian Field Study | Germany | 1,233 | 5 | 6,165 | 46.8 | Adults | CIS | Single question on exercise frequency | Frequency |
Wise et al., 2006 (76)b,c,e | Black Women’s Health Study | United States | 35,224 | 2 | 70,448 | 0.0 | Adults | CES-D ≥16 | Questionnaire on number of hours spent in walking for exercise and vigorous exercise | Volume |
Yoshida et al., 2015 (77)c,d,e | None | Japan | 680 | 1 | 680 | 42.5 | Older | GDS-15 >6 | Questions about participants’ engagement in physical activity and weekly frequency | Frequency |
Study Quality
Physical Activity and Incident Depression
Highest versus lowest physical activity.
![](/cms/10.1176/appi.ajp.2018.17111194/asset/images/large/appi.ajp.2018.17111194f1.jpeg)
Subgroup and sensitivity analysis.
Analysis | Number of Cohorts (Arms) | Meta-Analysis | Heterogeneity | Trim and Fill Method | Adjusted Studies | Classic Fail Safe N | ||||
---|---|---|---|---|---|---|---|---|---|---|
Studies with adjusted odds ratio | Adjusted odds ratio | 95% CI | p | I2 | Q | Effect size | 95% CI | N | N | |
Overall | 36 | 0.837 | 0.794, 0.883 | <0.0001 | 0.00 | 25.93 | 0.85 | 0.81, 0.89 | 10 | 380 |
Continent | ||||||||||
Asia | 7 | 0.765 | 0.682, 0.859 | <0.0001 | 0.00 | 3.97 | 0.77 | 0.69, 0.87 | 2 | 26 |
Europe | 12 | 0.836 | 0.732, 0.954 | 0.008 | 0.00 | 2.53 | 0.72 | 0.72, 0.94 | 1 | 6 |
North America | 13 | 0.864 | 0.796, 0.937 | <0.0001 | 4.28 | 12.53 | 0.88 | 0.79, 0.97 | 6 | 54 |
Oceania | 3 | 0.658 | 0.484, 0.895 | 0.008 | 0.00 | 0.54 | 0.64 | 0.47, 0.86 | 1 | 1 |
Physical activity assessment unit | ||||||||||
Composite/metabolic equivalents | 14 | 0.746 | 0.648, 0.858 | <0.0001 | 0.00 | 5.83 | 0.75 | 0.66, 0.87 | 2 | 50 |
Frequency | 10 | 0.789 | 0.718, 0.866 | <0.0001 | 0.00 | 4.85 | Unchanged | 39 | ||
Intensity | 1 | 0.780 | 0.453, 1.344 | 0.371 | 0.00 | 0.00 | N/A | N/A | ||
Volume | 7 | 0.888 | 0.822, 0.960 | 0.003 | 0.00 | 4.71 | 0.89 | 0.83, 0.97 | 2 | 9 |
150 minutes of moderate to vigorous physical activity per week | 4 | 0.780 | 0.617, 0.986 | 0.038 | 0.00 | 1.33 | 0.77 | 0.61, 0.97 | 2 | 1 |
Depression assessment | ||||||||||
Depressive symptoms | 28 | 0.844 | 0.798, 0.892 | <0.0001 | 0.00 | 23.22 | 0.85 | 0.81, 0.90 | 7 | 245 |
Major depression | 10 | 0.862 | 0.757, 0.981 | 0.024 | 0.00 | 5.29 | 0.89 | 0.79, 1.00 | 3 | 7 |
Age at baseline | ||||||||||
Adults | 16 | 0.787 | 0.707, 0.877 | <0.0001 | 0.00 | 5.85 | 0.79 | 0.71, 0.88 | 1 | 57 |
Older | 16 | 0.794 | 0.726, 0.868 | <0.0001 | 0.00 | 13.13 | 0.80 | 0.74, 0.88 | 4 | 85 |
Children/adolescents | 3 | 0.907 | 0.836, 0.985 | 0.021 | 0.00 | 0.68 | Unchanged | 0 | ||
Adjustments | ||||||||||
Age and sex | 32 | 0.836 | 0.791, 0.883 | <0.0001 | 0.00 | 20.92 | 0.85 | 0.80, 0.90 | 10 | 310 |
a. Baseline depressive symptoms | 3 | 0.897 | 0.829, 0.970 | 0.007 | 0.00 | 0.99 | Unchanged | 3 | ||
b. Body mass index | 12 | 0.871 | 0.810, 0.937 | <0.0001 | 0.00 | 8.18 | 0.90 | 0.81, 1.00 | 5 | 34 |
c. smoking | 12 | 0.748 | 0.647, 0.865 | <0.0001 | 0.00 | 6.37 | 0.75 | 0.65, 0.87 | 1 | 32 |
Age and sex and one other (a, b, or c) | 17 | 0.865 | 0.800, 0.928 | <0.0001 | 0.00 | 12.38 | 0.88 | 0.80, 0.97 | 6 | 66 |
Age and sex and two others (a+b, a+c, or b+c) | 8 | 0.836 | 0.749, 0.934 | 0.001 | 9.23 | 7.71 | 0.90 | 0.79, 1.03 | 5 | 26 |
Studies with crude odds ratio | Odds ratio | 95% CI | p | I2 | Q | Effect size | 95% CI | N | N | |
Overall | 19 | 0.591 | 0.510, 0.685 | <0.0001 | 52.38 | 37.80 | 0.63 | 0.54, 0.74 | 4 | 519 |
Continent | ||||||||||
Asia | 4 | 0.657 | 0.577, 0.749 | <0.0001 | 0.00 | 2.01 | 0.66 | 0.58, 0.75 | 1 | 24 |
Europe | 4 | 0.546 | 0.286, 1.040 | 0.065 | 75.01 | 12.00 | 0.37 | 0.19, 0.73 | 2 | 13 |
North America | 6 | 0.644 | 0.496, 0.835 | 0.001 | 63.94 | 13.86 | Unchanged | 52 | ||
Oceania | 5 | 0.480 | 0.405, 0.568 | <0.0001 | 0.00 | 0.07 | 0.48 | 0.40, 0.56 | 1 | 35 |
Studies with crude odds ratio | Odds ratio | 95% CI | p | I2 | Q | Effect size | 95% CI | N | N | |
Physical activity assessment unit | ||||||||||
Composite/metabolic equivalents | 4 | 0.574 | 0.402, 0.819 | 0.002 | 52.52 | 6.31 | Unchanged | 33 | ||
Frequency | 3 | 0.662 | 0.580, 0.755 | <0.0001 | 0.00 | 0.36 | 0.66 | 0.58, 0.75 | 1 | 17 |
Intensity | 2 | 0.303 | 0.198, 0.462 | <0.0001 | 0.00 | 0.53 | N/A | N/A | ||
Volume | 8 | 0.628 | 0.487, 0.810 | <0.0001 | 48.49 | 13.59 | 0.64 | 0.51, 0.80 | 2 | 56 |
150 minutes of moderate to vigorous physical activity per week | 3 | 0.704 | 0.477, 1.038 | 0.077 | 8.38 | 2.18 | Unchanged | 1 | ||
Depression assessment | ||||||||||
Depressive symptoms | 14 | 0.618 | 0.568, 0.674 | <0.0001 | 58.44 | 31.28 | 0.66 | 0.54, 0.80 | 3 | 281 |
Major depression | 5 | 0.511 | 0.429, 0.608 | <0.0001 | 0.00 | 2.79 | 0.48 | 0.40, 0.58 | 2 | 32 |
Age at baseline | ||||||||||
Adults | 8 | 0.662 | 0.550, 0.979 | <0.0001 | 62.10 | 18.47 | 0.63 | 0.54, 0.74 | 1 | 190 |
Older | 9 | 0.496 | 0.399, 0.616 | <0.0001 | 21.79 | 10.22 | 0.45 | 0.36, 0.57 | 2 | 112 |
Children/adolescents | 2 | 0.496 | 0.208, 1.186 | <0.0001 | 0.00 | 0.05 | N/A | N/A | ||
Studies with adjusted relative risk/hazard ratio (ARR/AHR) | ARR/AHR | 95% CI | p | I2 | Q | Effect size | 95% CI | N | N | |
Overall | 18 | 0.832 | 0.762, 0.909 | <0.0001 | 0.00 | 14.86 | 0.86 | 0.78, 0.96 | 8 | 102 |
Continent | ||||||||||
Asia | 1 | 0.950 | 0.777, 1.162 | 0.611 | 0.00 | 0.00 | N/A | N/A | ||
Europe | 8 | 0.773 | 0.660, 0.906 | 0.001 | 21.92 | 8.99 | 0.84 | 0.70, 1.01 | 4 | 31 |
North America | 7 | 0.811 | 0.673, 0.978 | 0.028 | 0.00 | 2.19 | 0.86 | 0.73, 1.02 | 3 | 4 |
Oceania | 2 | 0.502 | 0.241, 1.045 | 0.0001 | 0.00 | 0.01 | N/A | N/A | ||
Physical activity assessment unit | ||||||||||
Composite/metabolic equivalents | 12 | 0.832 | 0.741, 0.935 | 0.002 | 0.00 | 8.72 | 0.88 | 0.79, 0.98 | 6 | 35 |
Frequency | 3 | 0.873 | 0.755, 1.010 | 0.062 | 0.00 | 0.61 | 0.89 | 0.77, 1.02 | 2 | 0 |
Intensity | 1 | 0.290 | 0.104, 0.805 | 0.017 | 0.00 | 0.00 | N/A | N/A | ||
Volume | 1 | 0.815 | 0.815, 1.331 | 0.413 | 0.00 | 0.00 | N/A | N/A | ||
150 minutes of moderate to vigorous physical activity per week | 4 | 0.689 | 0.498, 0.951 | 0.024 | 0.00 | 0.53 | Unchanged | 2 | ||
Depression assessment | ||||||||||
Depressive symptoms | 11 | 0.845 | 0.766, 0.932 | 0.001 | 0.12 | 10.03 | 0.88 | 0.78, 1.00 | 6 | 57 |
Major depression | 8 | 0.873 | 0.748, 1.108 | 0.082 | 10.78 | 7.84 | 0.93 | 0.77, 1.13 | 4 | 6 |
Studies with adjusted relative risk/hazard ratio (ARR/AHR) | ARR/AHR | 95% CI | p | I2 | Q | Effect size | 95% CI | N | N | |
Age at baseline | ||||||||||
Adults | 9 | 0.863 | 0.776, 0.960 | 0.007 | 7.53 | 8.65 | 0.89 | 0.78, 1.02 | 4 | 20 |
Older | 7 | 0.703 | 0.567, 0.879 | 0.001 | 0.00 | 1.27 | Unchanged | 12 | ||
Children/adolescents | 0 | N/A | N/A | N/A | N/A | N/A | N/A | 0 | ||
Adjustments | ||||||||||
Age and sex | 18 | 0.832 | 0.762, 0.909 | <0.0001 | 0.00 | 14.86 | 0.86 | 0.78, 0.96 | 8 | 102 |
a. Baseline depressive symptoms | 1 | 0.950 | 0.777, 1.162 | 0.618 | 0.00 | 0.00 | N/A | N/A | ||
b. Body mass index | 10 | 0.821 | 0.714, 0.945 | 0.006 | 14.28 | 10.50 | 0.88 | 0.74, 1.04 | 5 | 28 |
c. smoking | 4 | 0.694 | 0.505, 0.953 | 0.024 | 0.00 | 1.24 | Unchanged | 1 | ||
Age and sex and (a, b, or c) | 11 | 0.833 | 0.734, 0.946 | 0.005 | 0.39 | 10.50 | 0.88 | 0.75, 1.04 | 5 | 29 |
Age and sex and two others (a+b, a+c, or b+c) | 4 | 0.823 | 0.648, 1.045 | 0.109 | 13.25 | 11.23 | Unchanged | 1 | ||
Studies with crude relative risk/hazard ratio (RR/HR) | RR/HR | 95% CI | p | I2 | Q | Effect size | 95% CI | N | N | |
Overall | 17 | 0.687 | 0.601, 0.786 | <0.0001 | 33.40 | 24.02 | 0.80 | 0.69, 0.94 | 9 | 210 |
Continent | ||||||||||
Asia | 3 | 0.821 | 0.688, 0.980 | 0.029 | 0.00 | 1.00 | 0.84 | 0.72, 0.99 | 2 | 2 |
Europe | 5 | 0.593 | 0.439, 0.801 | 0.001 | 0.00 | 3.10 | 0.55 | 0.42, 0.72 | 1 | 11 |
North America | 6 | 0.681 | 0.537, 0.865 | 0.002 | 66.23 | 14.80 | Unchanged | 49 | ||
Oceania | 3 | 0.513 | 0.270, 0.974 | 0.041 | 0.00 | 0.07 | 0.49 | 0.27, 0.91 | 1 | 0 |
Physical activity assessment unit | ||||||||||
Composite/metabolic equivalents | 5 | 0.774 | 0.653, 0.916 | 0.003 | 0.00 | 3.11 | 0.84 | 0.69, 1.01 | 3 | 9 |
Frequency | 2 | 0.705 | 0.440, 1.129 | 0.146 | 0.00 | 0.00 | N/A | N/A | ||
Intensity | 2 | 0.336 | 0.157, 0.718 | 0.005 | 0.00 | 0.48 | N/A | N/A | ||
Volume | 6 | 0.695 | 0.538, 0.898 | 0.005 | 66.50 | 14.92 | 0.71 | 0.55, 0.90 | 1 | 40 |
150 minutes of moderate to vigorous physical activity per week | 2 | 0.635 | 0.368, 1.096 | 0.103 | 0.00 | 0.10 | N/A | N/A | ||
Depression assessment | ||||||||||
Depressive symptoms | 9 | 0.811 | 0.729, 0.920 | <0.0001 | 0.00 | 7.38 | 0.83 | 0.72, 0.95 | 5 | 36 |
Major depression | 8 | 0.575 | 0.502, 0.660 | <0.0001 | 0.00 | 1.63 | 0.55 | 0.48, 0.63 | 3 | 63 |
Age at baseline | ||||||||||
Adults | 9 | 0.764 | 0.667, 0.876 | <0.0001 | 16.01 | 9.52 | 0.82 | 0.69, 0.96 | 5 | 51 |
Older | 6 | 0.588 | 0.509, 0.678 | <0.0001 | 0.00 | 2.99 | 0.56 | 0.48, 0.64 | 2 | 34 |
Children/adolescents | 2 | 0.537 | 0.250, 1.149 | 0.109 | 0.00 | 0.03 | N/A | N/A |
Meta-Regressions
Moderator | Number of Cohorts | β | 95% CI | p | R2 |
---|---|---|---|---|---|
Studies presenting adjusted odds ratio | |||||
Sample size | 36 | <–0.0001 | <–0.001, <0.001 | 0.44 | 0.00 |
Year of publication | 36 | –0.0035 | <–0.015, <0.008 | 0.55 | 0.00 |
Length of follow-up | 36 | 0.0001 | –0.018, 0.018 | 0.99 | 0.00 |
Person-years | 36 | <–0.0001 | <–0.001, <0.001 | 0.13 | 0.00 |
Number of covariates | 34 | –0.0183 | –0.035, <0.001 | 0.05 | 0.00 |
Percent dropout | 29 | –0.0027 | –0.007, 0.001 | 0.23 | 0.00 |
Study quality | 36 | 0.0105 | –0.067, 0.088 | 0.78 | 0.00 |
Study quality (selection of participants) | 36 | 0.0657 | –0.161, 0.293 | 0.57 | 0.00 |
Study quality (comparability) | 36 | 0.0080 | –0.185, 0.201 | 0.93 | 0.00 |
Study quality (outcome) | 36 | 0.0777 | –0.039, 0.194 | 0.19 | 0.00 |
Studies presenting crude odds ratio | |||||
Sample size | 19 | <–0.0001 | <–0.001, <0.001 | 0.31 | 0.00 |
Year of publication | 19 | –0.0251 | –0.049, <0.001 | 0.05 | 0.00 |
Length of follow-up | 19 | –0.0025 | –0.035, 0.030 | 0.87 | 0.02 |
Person-years | 19 | <–0.0001 | <–0.001, <0.001 | 0.48 | 0.00 |
Percent males | 19 | 0.0002 | –0.003, 0.003 | 0.88 | 0.00 |
Percent dropout | 16 | –0.0034 | –0.014, 0.007 | 0.52 | 0.00 |
Study quality | 19 | –0.1168 | –0.409, 0.175 | 0.43 | 0.02 |
Study quality (selection of participants) | 19 | –0.0705 | –0.450, 0.309 | 0.71 | 0.00 |
Study quality (outcome) | 19 | –0.1364 | –0.601, 0.328 | 0.56 | 0.00 |
Studies presenting adjusted relative risk/adjusted hazard ratio | |||||
Sample size | 18 | <0.0001 | <–0.001, <0.001 | 0.13 | 0.00 |
Year of publication | 18 | 0.0207 | –0.008, 0.049 | 0.16 | 0.00 |
Length of follow-up | 18 | –0.0132 | –0.028, 0.001 | 0.08 | 0.00 |
Person-years | 18 | <0.0001 | <–0.001, <0.001 | 0.59 | 0.00 |
Number of covariates | 18 | 0.0195 | –0.009, 0.048 | 0.19 | 0.00 |
Percent dropout | 15 | –0.0036 | –0.020, 0.013 | 0.67 | 0.00 |
Study quality | 18 | –0.0139 | –0.132, 0.104 | 0.81 | 0.00 |
Study quality (selection of participants) | 18 | 0.0010 | –0.268, 0.270 | 0.99 | 0.00 |
Study quality (comparability)a | — | — | — | — | — |
Study quality (outcome) | 18 | –0.0214 | –0.141, 0.098 | 0.72 | 0.00 |
Studies presenting crude relative risk/hazard ratio | |||||
Sample size | 17 | <0.0001 | <–0.001, <0.001 | 0.06 | 0.82 |
Year of publication | 17 | –0.0036 | –0.026, 0.018 | 0.75 | 0.04 |
Length of follow-up | 17 | –0.0124 | –0.029, 0.004 | 0.14 | 0.58 |
Person-years | 17 | <–0.0001 | <–0.001, <0.001 | 0.70 | 0.07 |
Percent males | 17 | 0.0010 | –0.002, 0.004 | 0.57 | 0.00 |
Percent dropout | 13 | –0.0083 | –0.019, 0.003 | 0.15 | 0.00 |
Study quality | 17 | –0.0580 | –0.134, 0.018 | 0.13 | 0.30 |
Study quality (selection of participants) | 17 | 0.1204 | –0.059, 0.300 | 0.19 | 0.43 |
Study quality (outcome) | 17 | –0.1033 | –0.362, 0.155 | 0.43 | 0.00 |
Discussion
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