Longitudinal associations between physical activity and depression scores in Swedish women followed 32 years
Open accessAbstract
OBJECTIVE: Physical activity is negatively associated with depressive symptoms. However, few studies consider dynamic associations of changes in physical activity and reciprocal relationships. This study aimed to perform comprehensive evaluations of relationships between physical activity and depression scores in women followed from mid- to late life. METHOD: The Prospective Population Study of Women in Gothenburg, Sweden, provided repeated measures of self-reported physical activity and depressive symptoms between 1974 and 2005 (baseline N = 676, 84.5% response rate). Depressive symptoms were assessed using the Montgomery-Åsberg Depression Rating Scale, and physical activity was evaluated by the Saltin-Grimby Physical Activity Level Scale. Latent growth curve analyses were used to evaluate associations of change, and cross-lagged models were used to study the reciprocal relationship between physical activity and depression scores. RESULTS: At baseline, lower levels of physical activity were related to higher depression scores. Individuals with decreasing physical activity over time evidenced higher depression scores at 32-year follow-up. Higher average baseline depression score was related to declining levels of physical activity at subsequent examinations. CONCLUSION: Reduced physical activity may be a long-term consequence of depression. It is important to address individual changes in physical activity and not merely absolute levels of physical activity in relationship to depression.
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Claims the paper makes
- Findingown data
Adding paths from depression scores to later physical activity significantly improved model fit.
“However, when adding predictions from depression scores to subsequent physical activity, the model fit did improve significantly, (Δ χ2=11.90/ 3 df, p<.01).”
Quote in the paperSubstantial claim - Findingown data
Women whose physical activity decreased over time had higher depression scores at the 32-year follow-up.
“Individuals with decreasing physical activity over time evidenced higher depression scores at 32 year follow-up.”
Quote in the paperSubstantial claim - Findingown data
Baseline physical activity was not associated with change in average depression scores during follow-up.
“No association was observed between baseline physical activity and change in average modified MADRS score during follow-up.”
Quote in the paperSubstantial claim - Findingown data
A higher average baseline depression score was associated with declining physical activity at later examinations.
“Higher average baseline depression score was related to declining levels of physical activity at subsequent examinations.”
Quote in the paperSubstantial claim - Interpretationown data
Depression may lead to reduced physical activity over the long term.
“Reduced physical activity may be a long-term consequence of depression.”
Quote in the paperSubstantial claim
- Borderline: one of the tests for a substantial claim is unclear. 1
- May combine two claims. 4
Borderline on S3 (load-bearing), S4 (based): unclear from the text.
Findingnone givenAt baseline, lower physical activity was associated with higher depression scores.
“At baseline, lower levels of physical activity were related to higher depression scores.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataHigher depression scores predicted lower physical activity in 1992 and 2000, but not in 2005.
“More specifically, higher depression scores reported in examinations preceding physical activity measures, predicted lower physical activity in 1992 (β = −.13, p < .01), and 2000 (β = −.11, p < .05), but not in 2005”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataAdding cross-lagged paths from physical activity to later depression did not significantly improve model fit, and none were significant.
“When adding cross-lagged predictions from physical activity to subsequent depression scores, model fit did not improve significantly (Δ χ2=1.92/ 3 df; p>.05). None of the cross-lagged predictions were significant.”
Quote in the paperSubstantial claimMay combine two claims.
Study design and conductown dataThe sample was small and consisted only of White women in Sweden, limiting generalizability by sex, ethnicity, and culture.
“The sample size is relatively small, and all members of the sample are female, White, and living in Sweden, thereby limiting sex, ethnic, and cultural generalizability.”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationown dataHigher depression scores predicted less subsequent physical activity, but the reverse was not found.
“Finally, cross-lagged analyses indicated that higher depression scores predicted less subsequent physical activity but not vice versa.”
Quote in the paperSubstantial claim
The paper relies on this without support.
The study is the first to examine dynamic within-person associations between physical activity and depression scores in this population.
“Our study is the first to examine dynamic associations of within-person change between physical activity and depression scores in a non-clinical sample of women assessed at repeated occasions over three decades using latent growth curve modelling and cross-lagged analyses.”
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?
In the general population, low physical activity, sleep disorders, and pain increase the risk of developing mental health disorders.
“In the general population, physical risk factors, such as low levels of physical activity,4 sleep disorders,5 and pain,6 increase the risk of developing mental health disorders.”
From Mental Health Disorders and Physical Risk Factors in Children with Cerebral Palsy: A Cross-Sectional Study (2019) · cites this paper as [4]
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.
Confounder-selection thresholds conflict
MinorOne methods section says covariates needed an association with both variables at p<0.1; a later section says the threshold was p<0.05. These are different criteria for inclusion in the final model.
“Only variables showing association (p<0.1) with both physical inactivity and depressive symptoms were included in the final models”
“only variables related to both physical activity and depression score at a level of p<0.05 were included in the conditional model.”
Education definition names a birth cohort absent from the sample
MinorThe study population is described as born in five specified years, none of them 1940. The education definition nevertheless specifies a rule for women born in 1940.
“born in 1908, 1914, 1918, 1922, and 1930”
“6 years in those born 1914–22 and 7 years in those born 1940”
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BackgroundResultDang, K., Ritvo, P., Katz, J. D., Gratzer, D., Knyahnytska, Y., Ortiz, A., Walters, C., Attia, M., Gonzalez‐Torres, C., Lustig, A., et al. (2023) · Interactive Journal of Medical Research · doi:10.2196/46419 · Cited by 11 · see citing works
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“Furthermore, a higher level of depression and anxiety symptoms was found to be associated with a subsequent decline in health-related behavior over time (Gudmundsson et al., 2015; Hiles et al., 2017; Huang et al., 2023).”
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Exercise and physical activity for depression
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“Although some research suggests that the relationship may be bidirectional (e.g., Gudmundsson et al., 2015), the study by Choi and colleagues (2019) indicates that there may be more robust evidence supporting the preventive role of physical activity on depression.”
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“, the extent to which one feels capable of performing PA, motivation, and the levels of perceived stress and depression [12, 15, 16].”
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“Despite the substantial impact of CP on physical, functional, and mental well-being [10], research on the prevalence and factors associated with musculoskeletal problems, including hip displacement, remains limited in LMICs, particularly in Ethiopia.”
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“emerged as an important predictor of declining levels of physical activity over time [9] and of poor exercise adherence across prospective and intervention studies [10].”
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Protective Role of Regular Physical Activity on Mental Health During the COVID-19 Pandemic
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“…napping, and good mental health for increased physical activity; female sex, older age, rural residence, and depressive symptoms for decreased physical activity) (Nemoto et al. 2024 ; Buvarp et al. 2023 ; Gudmundsson et al. 2015 ; Finkel et al. 2018 ; Henderson et al. 2023 ; Kong et al. 2022 ).”
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“Longitudinal data further confirm that chronically low physical activity constitutes an independent risk factor for depressive symptoms (Roshanaei-Moghaddam et al., 2009), whereas individuals who exercise more frequently exhibit markedly milder depressive symptoms (Gudmundsson et al., 2015).”
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“…that light (β = 0.11) or moderate-vigorous PA (β = 0.19) played a protective role against psychological problem during follow-up [16], while another 32-year cohort study among 676 women in Gothen-burg, Sweden, showed that lower baseline PA levels were associated with higher depression scores [18].”
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- Authors
- Gudmundsson, P., Lindwall, M., Gustafson, D. R., Östling, S., Hällström, T., Waern, M., & Skoog, I.
- Affiliations
- University of Gothenburg (SE)
- State University of New York (US)
- Department for Psychiatry and Neurochemistry; Institute of Neuroscience and Physiology; Sahlgrenska Academy at University of Gothenburg; Mölndal Sweden
- Corresponding author
- Gudmundsson, P.
- Venue
- Acta Psychiatrica Scandinavica
- Publisher
- Wiley
- Published
- 2015-04-11
- Volume
- 132
- Issue
- 6
- Pages
- 451-458
- ISSN
- 0001-690X (ISSN-L)
- PMC
- PMC4600636
- OpenAlex
- W2064122286
- Cited by
- 60
- References
- 44
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 6 · 2023: 3 · 2022: 4 · 2021: 14 · 2020: 1 · 2019: 4 · 2018: 9 · 2017: 2 · 2016: 6 · 2015: 1
- FWCI
- 4.42
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Acta Psychiatrica Scandinavica (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Vetenskapsrådet (11267, 2005-8460, 825-2007-7462, 825-2012-5041, 2013-8717)
- Forskningsrådet om Hälsa, Arbetsliv och Välfärd (AgeCap 2013-2300, 2013-2496, 2835, 2646, 2004-0105, 2012-1138)
- Sahlgrenska Universitetssjukhuset
- Alzheimer's Association Stephanie B
- National Institutes of Health
- National Institute of Allergy and Infectious Diseases (UO1-AI-31834)
- Research Foundation for the State University of New York
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Health › Health disparities and outcomes
- Keywords
- physical activity, depression, depressive symptoms, women, bidirectional relationship, longitudinal change, declining physical activity, latent growth curve models, cross-lagged panel model
- MeSH terms
- Aged, Aged, 80 and over, Depression, Female, Humans, Longitudinal Studies, Middle Aged, Motor Activity, Sweden
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