The DOI matches its Crossref record; 54 of the 59 references it cites were found in a registry or an index; none of the 42 sources its claims cite is checked for support yet.
The relationship between physical and mental health: A mediation analysis
Open accessAbstract
There is a strong link between mental health and physical health, but little is known about the pathways from one to the other. We analyse the direct and indirect effects of past mental health on present physical health and past physical health on present mental health using lifestyle choices and social capital in a mediation framework. We use data on 10,693 individuals aged 50 years and over from six waves (2002-2012) of the English Longitudinal Study of Ageing. Mental health is measured by the Centre for Epidemiological Studies Depression Scale (CES) and physical health by the Activities of Daily Living (ADL). We find significant direct and indirect effects for both forms of health, with indirect effects explaining 10% of the effect of past mental health on physical health and 8% of the effect of past physical health on mental health. Physical activity is the largest contributor to the indirect effects. There are stronger indirect effects for males in mental health (9.9%) and for older age groups in mental health (13.6%) and in physical health (12.6%). Health policies aiming at changing physical and mental health need to consider not only the direct cross-effects but also the indirect cross-effects between mental health and physical health.
Overview
AI snapshot
Written from the paper’s full text.
TL;DR
Using six waves of the English Longitudinal Study of Ageing, this paper finds significant direct and indirect cross-effects between past mental and physical health, with lifestyle choices and social capital mediating about 10% and 8% of the total effects. Physical activity is the largest mediator, and indirect effects vary by age and gender.
Key findings
- Past mental health has significant direct and indirect effects on present physical health, and past physical health has significant direct and indirect effects on present mental health. The total indirect effect accounts for 9.7% of the effect of past mental health on physical health and 8% of the effect of past physical health on mental health.
- Physical activity is the largest contributor to the indirect effects: it explains 77.27% of the total indirect effect of past mental health on physical health, all of the total indirect effect of past physical health on mental health, 7.55% of the total effect of past mental health on physical health, and 8% of the total effect of past physical health on mental health.
- Social interaction explains 13.63% of the total indirect effect of past mental health on physical health. In the full-sample mediation, the indirect cigarette effect is not statistically significant for either direction, though better baseline mental health is associated with smoking about 16% fewer cigarettes on average.
- Indirect effects are heterogeneous: stronger indirect effects are reported for males in mental health (9.9%) and for older age groups in mental health (13.6%) and physical health (12.6%). For 50–60 year olds, cigarette smoking explains 41.7% of the total indirect effect and 5.4% of the total effect of past mental health on physical health.
Methods
- Data: six waves (2002–2012) of the English Longitudinal Study of Ageing, covering 10,693 individuals aged 50 years and over, with 29,944 observations.
- Measures: physical health via the six-item Activities of Daily Living index (0–6, higher = better); mental health via the eight-item Center for Epidemiological Studies Depression scale (0–8, higher = better); mediators are lagged physical activity, cigarette consumption, and a social interaction index; controls include demographics, education, retirement, insurance, income, region, and year.
- Analysis: random effects regression models estimate direct effects; mediation is estimated by total differentiation/product-of-coefficients, with bootstrapped direct, indirect, and total effects; subgroup analyses are by gender and age quartiles (50–60, 60–70, 70–80, 80+), with robustness checks for smoking addiction stock, two-period lagged mediators, balanced panel, and attrition.
Limitations
- The paper states that only three mediators are considered, whereas other factors such as socio-economic status, dietary choices, or medical care may be important; therefore the estimates are lower bounds for mediator effects and upper bounds for direct effects.
- The paper states that further studies are needed to consider a broader set of mediators and to examine specific health interventions and long-term cross-effects.
- Evident from the text: the analysis relies on observational ELSA data and assumes conditional exogeneity of lifestyle choices and social interaction, random effects, and no reverse causality between physical and mental health, which may limit causal interpretation.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The indirect effect accounts for about 10% of the total effect in both models, mainly explained by past physical activity.”
§ The relationship between physical and mental health: A mediation analysis > 1. Introduction
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Physical activity is the largest contributor to the indirect effects.”
§ The relationship between physical and mental health: A mediation analysis > Abstract
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Estimation by subgroups shows heterogeneous effects by age and gender.”
§ The relationship between physical and mental health: A mediation analysis > 1. Introduction
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We find that better baseline mental health increases the intensity of physical activity on average by about 10% in the full sample in Table 2 (3).”
§ The relationship between physical and mental health: A mediation analysis > 5.2. Models for the mediators
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- The authors state this as an assumption: Conditional on baseline health, lifestyle choices and social interaction are exogenous to mental and physical health.
- The authors state this as an assumption: The indirect effects of past mental health on current physical health and of past physical health on current mental health are mediated through lagged effects of physical activity, social interactions, and cigarette consumption.
- The authors state this as an assumption: The errors v_it and ρ_it in equations (1) and (2) are uncorrelated.
- The authors state this as an assumption: The composite error term v_it = μ_i + ε_it has a time-invariant individual component μ_i and a time-varying error ε_it.
- The authors state this as an assumption: Choices of health investments and consumption are maximised over health, requiring that errors are not serially correlated and choices are independent of previous choices.
- The authors state this as an assumption: RE rules out correlation between the regressors and the unmeasured variability across individuals.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The baseline value of mental health has a statistically significant and positive direct effect on present physical health.”
§ The relationship between physical and mental health: A mediation analysis > 5.1. Models for the direct effects
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- The authors state this as an assumption: Conditional on baseline health, lifestyle choices and social interaction are exogenous to mental and physical health.
- The authors state this as an assumption: The indirect effects of past mental health on current physical health and of past physical health on current mental health are mediated through lagged effects of physical activity, social interactions, and cigarette consumption.
- The authors state this as an assumption: The errors v_it and ρ_it in equations (1) and (2) are uncorrelated.
- The authors state this as an assumption: The composite error term v_it = μ_i + ε_it has a time-invariant individual component μ_i and a time-varying error ε_it.
- The authors state this as an assumption: Choices of health investments and consumption are maximised over health, requiring that errors are not serially correlated and choices are independent of previous choices.
- The authors state this as an assumption: RE rules out correlation between the regressors and the unmeasured variability across individuals.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“A one unit increase in baseline mental health implies a 4% increase in the intensity of physical activity on average.”
§ The relationship between physical and mental health: A mediation analysis > 5.2. Models for the mediators
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes- The authors state this as an assumption: Conditional on baseline health, lifestyle choices and social interaction are exogenous to mental and physical health.
- The authors state this as an assumption: The indirect effects of past mental health on current physical health and of past physical health on current mental health are mediated through lagged effects of physical activity, social interactions, and cigarette consumption.
- The authors state this as an assumption: The errors v_it and ρ_it in equations (1) and (2) are uncorrelated.
- The authors state this as an assumption: The composite error term v_it = μ_i + ε_it has a time-invariant individual component μ_i and a time-varying error ε_it.
- The authors state this as an assumption: Choices of health investments and consumption are maximised over health, requiring that errors are not serially correlated and choices are independent of previous choices.
- The authors state this as an assumption: RE rules out correlation between the regressors and the unmeasured variability across individuals.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Fourthly, the employment channel is less important in the older population as 59% of our sample is retired.”
- Also stated in: § 3.2. Summary statistics · hedged
“Approximately 59% of the sample are retired, 45% are males, 59% have higher education qualifications, and the majority is from a white ethnic group (Table 1).”
§ The relationship between physical and mental health: A mediation analysis > 2.2. Application to mediation analysis
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Also stated in: § 3.2. Summary statistics · hedged
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Associations of mental health with baseline physical and mental health, physical activity and social interaction are similar to those in the physical health models (Table 2 (2) and table A2 in the appendix).”
§ The relationship between physical and mental health: A mediation analysis > 5.1. Models for the direct effects
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes- The authors state this as an assumption: Conditional on baseline health, lifestyle choices and social interaction are exogenous to mental and physical health.
- The authors state this as an assumption: The indirect effects of past mental health on current physical health and of past physical health on current mental health are mediated through lagged effects of physical activity, social interactions, and cigarette consumption.
- The authors state this as an assumption: The errors v_it and ρ_it in equations (1) and (2) are uncorrelated.
- The authors state this as an assumption: The composite error term v_it = μ_i + ε_it has a time-invariant individual component μ_i and a time-varying error ε_it.
- The authors state this as an assumption: Choices of health investments and consumption are maximised over health, requiring that errors are not serially correlated and choices are independent of previous choices.
- The authors state this as an assumption: RE rules out correlation between the regressors and the unmeasured variability across individuals.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Physical health is further explained by a set of covariates varying across the subgroups.”
§ The relationship between physical and mental health: A mediation analysis > 5.1. Models for the direct effects
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes- The authors state this as an assumption: Conditional on baseline health, lifestyle choices and social interaction are exogenous to mental and physical health.
- The authors state this as an assumption: The indirect effects of past mental health on current physical health and of past physical health on current mental health are mediated through lagged effects of physical activity, social interactions, and cigarette consumption.
- The authors state this as an assumption: The errors v_it and ρ_it in equations (1) and (2) are uncorrelated.
- The authors state this as an assumption: The composite error term v_it = μ_i + ε_it has a time-invariant individual component μ_i and a time-varying error ε_it.
- The authors state this as an assumption: Choices of health investments and consumption are maximised over health, requiring that errors are not serially correlated and choices are independent of previous choices.
- The authors state this as an assumption: RE rules out correlation between the regressors and the unmeasured variability across individuals.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This effect is stronger for the sample of 50-60 year-olds.”
§ The relationship between physical and mental health: A mediation analysis > 5.1. Models for the direct effects
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes- The authors state this as an assumption: Conditional on baseline health, lifestyle choices and social interaction are exogenous to mental and physical health.
- The authors state this as an assumption: The indirect effects of past mental health on current physical health and of past physical health on current mental health are mediated through lagged effects of physical activity, social interactions, and cigarette consumption.
- The authors state this as an assumption: The errors v_it and ρ_it in equations (1) and (2) are uncorrelated.
- The authors state this as an assumption: The composite error term v_it = μ_i + ε_it has a time-invariant individual component μ_i and a time-varying error ε_it.
- The authors state this as an assumption: Choices of health investments and consumption are maximised over health, requiring that errors are not serially correlated and choices are independent of previous choices.
- The authors state this as an assumption: RE rules out correlation between the regressors and the unmeasured variability across individuals.
- It may state two separate claims as one. 20
- Probably not a substantial claim. 19
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“To preface our results, we find that both present physical and mental health are explained by direct and indirect effects of past mental and physical health, respectively.”
- Also stated in: § Abstract · plain
“We find significant direct and indirect effects for both forms of health, with indirect effects explaining 10% of the effect of past mental health on physical health and 8% of the effect of past physical health on mental health.”
§ The relationship between physical and mental health: A mediation analysis > 1. Introduction
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Also stated in: § Abstract · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Past physical activity and social interactions improve physical health.”
§ The relationship between physical and mental health: A mediation analysis > 5.1. Models for the direct effects
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- The authors state this as an assumption: Conditional on baseline health, lifestyle choices and social interaction are exogenous to mental and physical health.
- The authors state this as an assumption: The indirect effects of past mental health on current physical health and of past physical health on current mental health are mediated through lagged effects of physical activity, social interactions, and cigarette consumption.
- The authors state this as an assumption: The errors v_it and ρ_it in equations (1) and (2) are uncorrelated.
- The authors state this as an assumption: The composite error term v_it = μ_i + ε_it has a time-invariant individual component μ_i and a time-varying error ε_it.
- The authors state this as an assumption: Choices of health investments and consumption are maximised over health, requiring that errors are not serially correlated and choices are independent of previous choices.
- The authors state this as an assumption: RE rules out correlation between the regressors and the unmeasured variability across individuals.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“For the physical health models, the coefficient of baseline physical health is positive and statistically significant in all specifications.”
§ The relationship between physical and mental health: A mediation analysis > 5.1. Models for the direct effects
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
- The authors state this as an assumption: Conditional on baseline health, lifestyle choices and social interaction are exogenous to mental and physical health.
- The authors state this as an assumption: The indirect effects of past mental health on current physical health and of past physical health on current mental health are mediated through lagged effects of physical activity, social interactions, and cigarette consumption.
- The authors state this as an assumption: The errors v_it and ρ_it in equations (1) and (2) are uncorrelated.
- The authors state this as an assumption: The composite error term v_it = μ_i + ε_it has a time-invariant individual component μ_i and a time-varying error ε_it.
- The authors state this as an assumption: Choices of health investments and consumption are maximised over health, requiring that errors are not serially correlated and choices are independent of previous choices.
- The authors state this as an assumption: RE rules out correlation between the regressors and the unmeasured variability across individuals.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The share of the total indirect effect in the total effect is lowest for 60-70 year olds (7.9%) and highest for 50-60 year olds (12.9%).”
§ The relationship between physical and mental health: A mediation analysis > 5.3. Estimates of the mediating effects
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
- Rests on an assumption: The mediation models are not confounded by unmeasured variables.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Only physical activity mediates the effect of baseline physical health on current mental health, with a positive association.”
- Also stated in: § 5.3. Estimates of the mediating effects · plain
“The sub-sample analysis by age groups and gender on mental health, presented in table A7, is consistent with the full sample analysis in finding that only physical activity mediates the effect of baseline physical health with current mental health.”
- Also stated in: § 6. Discussion & conclusion · plain
“The relationship of past physical health with present mental health is only mediated by past physical activity.”
§ The relationship between physical and mental health: A mediation analysis > 5.3. Estimates of the mediating effects
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Rests on an assumption: The mediation models are not confounded by unmeasured variables.
- Also stated in: § 5.3. Estimates of the mediating effects · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The coefficient is slightly stronger for females with -0.237 than it is for males with -0.205.”
§ The relationship between physical and mental health: A mediation analysis > 5.2. Models for the mediators
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
- The authors state this as an assumption: Conditional on baseline health, lifestyle choices and social interaction are exogenous to mental and physical health.
- The authors state this as an assumption: The indirect effects of past mental health on current physical health and of past physical health on current mental health are mediated through lagged effects of physical activity, social interactions, and cigarette consumption.
- The authors state this as an assumption: The errors v_it and ρ_it in equations (1) and (2) are uncorrelated.
- The authors state this as an assumption: The composite error term v_it = μ_i + ε_it has a time-invariant individual component μ_i and a time-varying error ε_it.
- The authors state this as an assumption: Choices of health investments and consumption are maximised over health, requiring that errors are not serially correlated and choices are independent of previous choices.
- The authors state this as an assumption: RE rules out correlation between the regressors and the unmeasured variability across individuals.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The total effect is positive and increases present mental health by about 3.5%.”
§ The relationship between physical and mental health: A mediation analysis > 5.3. Estimates of the mediating effects
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Rests on an assumption: The mediation models are not confounded by unmeasured variables.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Physical health activity is important throughout the life-cycle from 50+, but is stronger for higher age groups.”
§ The relationship between physical and mental health: A mediation analysis > 6. Discussion & conclusion
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Rests on an assumption: The mediation models are not confounded by unmeasured variables.
In the paper
“A report by the Ageing Research Group (Melzer et al., 2012) finds that approximately 55% of the burden of disease amongst the population aged 60 years and over is avoidable by changes in lifestyles in high income countries.”
§ The relationship between physical and mental health: A mediation analysis > 1. Introduction
What the sources say
- Not checked yetcites Melzer et al., 2012
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“These are strong risk factors for ill health and impose a high risk on the health of older populations that could be easily avoided with low-cost interventions (Steptoe et al., 2012).”
§ The relationship between physical and mental health: A mediation analysis > 1. Introduction
What the sources say
- Not checked yetcites Steptoe et al., 2012 source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“On the full population, lifestyle factors explain up to 70% of the burden of disease (WHO, 2009).”
§ The relationship between physical and mental health: A mediation analysis > 1. Introduction
What the sources say
- Not checked yetcites WHO, 2009
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Several studies have found that physical activity is negatively associated with depression/anxiety disorders and poor physical health outcomes (Gerber and Puehse 2009;De Mello et al., 2013;Durstine et al., 2013;Wang et al., 2014;Hegberg and Tone, 2015).”
§ The relationship between physical and mental health: A mediation analysis > 2.1. Conceptual framework
What the sources say
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Systematic reviews find strong evidence for positive effects of exercising on both mental and physical health outcomes for older people (Forbes et al., 2008;Clegg et al., 2012).”
§ The relationship between physical and mental health: A mediation analysis > 2.1. Conceptual framework
What the sources say
Strength:boosted· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The findings are robust to the timing of the mediators and how the stock of addiction is modelled.”
§ The relationship between physical and mental health: A mediation analysis > 1. Introduction
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“Tobacco use explains 17.9% of all deaths and physical inactivity explains 7.7% of all deaths (WHO, 2009).”
§ The relationship between physical and mental health: A mediation analysis > 2.2. Application to mediation analysis
What the sources say
- Not checked yetcites WHO, 2009
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Using a baseline value that pre-dates the mediators mitigates concerns over reverse-causality and captures earlier life investments in health and health endowments.”
§ The relationship between physical and mental health: A mediation analysis > 4. Methodology and empirical strategy
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Bootstrapping takes both the longitudinal structure and the random effect error assumption into account.”
§ The relationship between physical and mental health: A mediation analysis > 4. Methodology and empirical strategy
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✗ Based: failsProbably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
- The authors state this as an assumption: The composite error term v_it = μ_i + ε_it has a time-invariant individual component μ_i and a time-varying error ε_it.
- The authors state this as an assumption: RE rules out correlation between the regressors and the unmeasured variability across individuals.
In the paper
“Tobacco use explains 17.9% of all deaths and physical inactivity explains 7.7% of all deaths (WHO, 2009).”
§ The relationship between physical and mental health: A mediation analysis > 2.2. Application to mediation analysis
What the sources say
- Not checked yetcites WHO, 2009
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Social capital is similarly important in increasing the risks of social isolation, loneliness and exclusion of older populations, which lead to higher risks of mortality (Holt-Lunstad et al., 2012;Melzer et al., 2012;Steptoe et al., 2012).”
§ The relationship between physical and mental health: A mediation analysis > 2.2. Application to mediation analysis
What the sources say
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“Reverse-causality is likely to occur as smoking rates are twice as high among adults with depression or anxiety disorders (RCP, 2013).”
§ The relationship between physical and mental health: A mediation analysis > 2.1. Conceptual framework
What the sources say
- Not checked yetcites RCP, 2013
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“For these reasons, we consider our estimates to be lower bounds of the indirect effects between physical and mental health and upper bounds of their direct effects.”
§ The relationship between physical and mental health: A mediation analysis > 2.2. Application to mediation analysis
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Rests on an assumption: Other potential mediators such as stress and sleep are captured directly by the measure of mental health.
- Rests on an assumption: Social interactions are critical production factors in health.
In the paper
“We measure mental health using the validated eight-item version of the Center for Epidemiological Studies-Depression (CES-D) developed by Radloff (1977).”
§ The relationship between physical and mental health: A mediation analysis > 3.1.1. Explanatory and outcome variables
What the sources say
- Not checked yetcites Radloff (1977) source
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
In the paper
“Thirdly, other factors such as obesity, high blood pressure and alcohol consumption are widely used in the literature as health outcome measures (Banks et al., 2006).”
§ The relationship between physical and mental health: A mediation analysis > 2.2. Application to mediation analysis
What the sources say
- Not checked yetcites Banks et al., 2006 source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Smoking is the leading cause of preventable death in the UK (Office for National Statistics UK, 2016).”
§ The relationship between physical and mental health: A mediation analysis > 2.2. Application to mediation analysis
What the sources say
- Not checked yetcites Office for National Statistics UK, 2016
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“For example, alcohol consumption and dietary choices together explain only 4.1% of deaths (WHO, 2009).”
§ The relationship between physical and mental health: A mediation analysis > 2.2. Application to mediation analysis
What the sources say
- Not checked yetcites WHO, 2009
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“For example, the ELSA started including questions about dietary choices only in the third wave and the phrasing of these questions changed from wave 5 onwards.”
§ The relationship between physical and mental health: A mediation analysis > 2.2. Application to mediation analysis
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Potential interrelations of mental and physical health are accounted for by the inclusion of baseline health values.”
§ The relationship between physical and mental health: A mediation analysis > 4. Methodology and empirical strategy
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
- The authors state this as an assumption: Conditional on baseline health, lifestyle choices and social interaction are exogenous to mental and physical health.
In the paper
“The measure is similar to Steptoe et al. (2012) and also reflects changes in social isolation and loneliness.”
§ The relationship between physical and mental health: A mediation analysis > 3.1.2. Mediators
What the sources say
- Not checked yetcites Steptoe et al. (2012) source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Previous studies have found a strong positive relationship between social interaction and mental health (Dour et al., 2014;Bekele et al., 2015).”
§ The relationship between physical and mental health: A mediation analysis > 2.1. Conceptual framework
What the sources say
Strength:boosted· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“We control in all models for year and regional effects.”
§ The relationship between physical and mental health: A mediation analysis > 5.4. Robustness test of stock of addiction and time-lags in mediators
Strength:plain· not yet calibratedn = 10,693Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Better physical and mental health status therefore leads to more physical activity which in return has a positive association with better mental health and physical health.”
§ The relationship between physical and mental health: A mediation analysis > 6. Discussion & conclusion
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Rests on an assumption: The mediation models are not confounded by unmeasured variables.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“A limitation of this paper is that only a set of three mediators is considered whereas other factors such as socio-economic status, dietary choices or medical care may be important.”
§ The relationship between physical and mental health: A mediation analysis > 6. Discussion & conclusion
Load-bearingStrength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
In the paper
“Gerber and Puehse (2009) have found a similar positive association between mental health and physical activity.”
§ The relationship between physical and mental health: A mediation analysis > 6. Discussion & conclusion
What the sources say
- Not checked yetcites Gerber and Puehse (2009)
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Whilst we justify the choice of mediators with a conceptual framework, existing literature, key policy relevance and data availability, we note that we can only capture a lower bound estimate for the mediator effects and an upper bound for the direct effects.”
§ The relationship between physical and mental health: A mediation analysis > 6. Discussion & conclusion
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“An explanation for this effect is that social interactions favour good health behaviours and vice versa (Umberson et al., 2010).”
§ The relationship between physical and mental health: A mediation analysis > 6. Discussion & conclusion
What the sources say
- Not checked yetcites Umberson et al., 2010
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“The positive association of social ties with mental health has previously been found (Umberson and Montez 2010).”
§ The relationship between physical and mental health: A mediation analysis > 6. Discussion & conclusion
What the sources say
- Not checked yetcites Umberson and Montez 2010
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
The paper relies on this without support.
Little is known about the potential pathways through which mental health affects physical health and vice versa.
“However, little is known about the potential pathways through which mental health affects physical health and vice versa (i.e.so-called “indirect effects”).”
The paper relies on this without support.
No existing mediation study has examined the relationship between physical and mental health and the pathways considered in this paper.
“Many psychological, epidemiologic, and economic studies have used mediation analysis, but none in the context of the relationship between physical and mental health and the pathways that we consider.”
The authors state this as an assumption.
Conditional on baseline health, lifestyle choices and social interaction are exogenous to mental and physical health.
“We assume that, conditional on baseline health, lifestyle choices and social interaction are exogenous to mental and physical health.”
The authors state this as an assumption.
The indirect effects of past mental health on current physical health and of past physical health on current mental health are mediated through lagged effects of physical activity, social interactions, and cigarette consumption.
“We assume that the indirect effects of past mental health on current physical health and of past physical health on current mental health are mediated through lagged effects of the individual health investments, including past physical activity ( -PhysAct it 1 ), past social interactions ( -SC Index it 1 ), and past cigarette consumption ( -CIG it 1 ).”
The authors state this as an assumption.
The errors v_it and ρ_it in equations (1) and (2) are uncorrelated.
“We assume that the errors v it and ρ it in equations ( 1) and ( 2) are uncorrelated.”
The authors state this as an assumption.
The composite error term v_it = μ_i + ε_it has a time-invariant individual component μ_i and a time-varying error ε_it.
“We account for unobserved heterogeneity by including random effects (RE) in all equations, assuming a composite error term = + v μ ε it i it with timeinvariant individual component μ i and time-varying error ε it .”
The authors state this as an assumption.
Choices of health investments and consumption are maximised over health, requiring that errors are not serially correlated and choices are independent of previous choices.
“This is an important assumption for our model where choices of health investments and consumption are maximised over health requiring that errors are not serially correlated and choices are independent of previous choices.”
The paper relies on this without support.
Other potential mediators such as stress and sleep are captured directly by the measure of mental health.
“Secondly, other potential mediators such as stress and sleep are captured directly by our measure of mental health.”
The paper relies on this without support.
Social interactions are critical production factors in health.
“Finally, social interactions are critical production factors in health.”
The paper relies on this without support.
The ELSA is a representative sample of the English population aged 50 years and older.
“The study is a representative sample of English population aged 50 years and older, collecting objective and subjective data on physical and mental health, and on socio-economic status.”
The paper relies on this without support.
The effect of health lags is captured by the mediators.
“It differs from dynamic models with lagged health because the effect of health lags is captured by the mediators.”
The authors state this as an assumption.
RE rules out correlation between the regressors and the unmeasured variability across individuals.
“RE rules out correlation between the regressors and the unmeasured variability across individuals.”
The paper relies on this without support.
The mediation models are not confounded by unmeasured variables.
“The mediation analysis on physical health shows that the effect of baseline mental health on present physical health is significantly mediated by past physical activity and by past social interaction.”
The paper relies on this without support.
The temporal ordering of baseline health, mediators, and outcomes is correctly specified.
“For models (3)-(5) the time-variant covariates take on (t-1)-lagged values (e.g.Age (t-1), Age Squared (t-1), Higher Education (t-1), Household Size (t-1), Private Insurance (t-1), Retired (t-1), Log-equivalised household income (t-1)).”
The paper relies on this without support.
The ELSA sample is representative of the older English population.
“We use six waves of the ELSA (2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012), and investigate potential mediating effects on the full sample size and heterogeneous effects by age-quartiles and gender.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Ohrnberger and colleagues used a mediation model and reported that the relations between psychological and physical health are mediated by lifestyle factors, including increased physical activity and social connections.”
From Cancer, now what? A cross-sectional study examining physical symptoms, subjective well-being, and psychological flexibility (2023) · cites this paper as Ohrnberger et al., 2017
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“These findings support large-scale studies that highlight direct and indirect links between physical and psychological wellness (see Ohrnberger et al., 2017).”
From Cancer, now what? A cross-sectional study examining physical symptoms, subjective well-being, and psychological flexibility (2023) · cites this paper as Ohrnberger et al., 2017
In the citing paper
“SNS addiction (e.g., preoccupation with social media, excessive use) is associated with lower well-being and depression,14,58 which can predict worse physical health.59”
From Social Media Use and Its Link to Physical Health Indicators (2022) · cites this paper as [59]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Social-interaction shares imply more than the stated maximum indirect share
MinorFor ages 70-80, a pathway accounting for 1.3% of the indirect effect and 0.19% of the total effect implies that the indirect effect is about 14.6% of the total. That exceeds the stated maximum of 12.9% across age groups, even allowing for the printed rounding.
“Social interaction explains 1.3% of the total indirect effect and 0.19% of the total effect amongst 70-80 year olds.”
“The share of the total indirect effect in the total effect is lowest for 60-70 year olds (7.9%) and highest for 50-60 year olds (12.9%).”
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Metadata
- Authors
- Ohrnberger, J., Fichera, E., & Sutton, M.
- Affiliations
- University of Manchester (GB)
- University of Bath (GB)
- Corresponding author
- Ohrnberger, Julius
- Venue
- Social Science & Medicine
- Publisher
- Elsevier BV
- Published
- 2017-12
- Volume
- 195
- Pages
- 42-49
- ISSN
- 0277-9536 (ISSN-L)
- OpenAlex
- W2766487143
- Semantic Scholar
- ffc0fc37cb36639a67f3600d87f92e6ae76fbf8f
- Cited by
- 967
- References
- 59
- Citations by year
- 2026: 70 · 2025: 130 · 2024: 173 · 2023: 150 · 2022: 142 · 2021: 128 · 2020: 123 · 2019: 38 · 2018: 13
- FWCI
- 52.79
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Social Science & Medicine (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion, cc-by)
- RePEc: Research Papers in Economics (submittedVersion)
- Funders
- National Institute for Health and Care Research (NF-SI-0515-10080)
- Topics
- Social Sciences › Health › Health disparities and outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Keywords
- mental health, physical health, mediation analysis, physical activity, lifestyle choices, social capital, activities of daily living, depression, older adults, gender differences, age differences, health policy
- MeSH terms
- Aged, Female, United Kingdom, Health Status, Humans, Longitudinal Studies, Male, Mental Health, Middle Aged
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-08, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-08 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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