Association between Physical Activity Level with Depression, Anxiety, and Stress in Dyslipidaemia Patients
DOI:
https://doi.org/10.31674/mjn.2023.v15i02.003Abstract
Background: Dyslipidemia is a significant risk factor for cardiovascular and cerebrovascular events globally. Current findings have linked dyslipidemia with mental health. Since physical activity level (PAL) is a modifiable risk factor associated with CVD and depression risk, it is worth knowing if the level of PA among dyslipidaemia patients does affect their mental health. Objective: Hence, the main objective of this study was to determine the association between depression, anxiety, and stress and physical activity among lipid-lowering drug (LLD)-treated dyslipidaemia patients. Methods: This was a cross-sectional study that was conducted among dyslipidaemia patients receiving LLD treatment from the Lipid Clinic in Hospital Al-Sultan Abdullah UiTM (HASA) and the Clinical Training Centre (CTC) in Sungai Buloh. Mental health was assessed using the Depression Anxiety Stress Scale (DASS-21), physical activity was assessed using the International Physical Activity Questionnaire (IPAQ-SF), and sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Results: Most participants fell into the low physical activity level (60.5%), 34.8% fell into the moderate category, and only 4.8% fell into the high physical activity group. A multiple regression model to identify the association between sociodemographic factors, PAL, and sleep quality with depression, anxiety, and stress revealed that low PAL is negatively associated with stress (B = -0.794; OR (95% CI) = 0.45 (0.21 - 0.99); (p = 0.046) but was not significantly associated with depression and anxiety. Conclusions: Although PAL was only associated with stress in this study, interventions should target increasing physical activity, which is an important modifiable risk factor that can reduce the risk of developing depression, anxiety, and stress.
Keywords:
Depression, Dyslipidaemia, Mental Health, Physical ActivityDownloads
References
Ahmad, S. N. F. F., Salehuddin, N. S., Sharoni, S. K. A., Fauzi, R., Buhari, S. S., & Nor, N. M. (2023). Weight Management Behaviors among Students in a Public University. The Malaysian Journal of Nursing (MJN), 14(3), 67-75. https://doi.org/10.31674/mjn.2023.v14i03.008
Arija, V., Villalobos, F., Pedret, R., Vinuesa, A., Timón, M., Basora, T., Aguas, D., Basora, J., Domínguez, E., Jovani, D., Pascual, G., Peralta, L., Reche, A., & Pas-a-Pas research group. (2017). Effectiveness of a physical activity program on cardiovascular disease risk in adult primary health-care users: The “Pas-a-Pas” community intervention trial. BMC Public Health, 17(1), 576. https://doi.org/10.1186/s12889-017-4485-3
Barone Gibbs, B., Hivert, M. F., Jerome, G. J., Kraus, W. E., Rosenkranz, S. K., Schorr, E. N., ... & American Heart Association Council on Lifestyle and Cardiometabolic Health; Council on Cardiovascular and Stroke Nursing; and Council on Clinical Cardiology. (2021). Physical activity as a critical component of first-line treatment for elevated blood pressure or cholesterol: who, what, and how?: a scientific statement from the American Heart Association. Hypertension, 78(2), e26-e37.https://doi.org/10.1161/HYP.0000000000000196
Cao, B., Zhao, Y., Ren, Z., McIntyre, R. S., Teopiz, K. M., Gao, X., & Ding, L. (2021). Are Physical Activities Associated with Perceived Stress? The Evidence From the China Health and Nutrition Survey. Frontiers in Public Health, 9, 697484. https://doi.org/10.3389/fpubh.2021.697484
Chuang, C.-S., Yang, T.-Y., Muo, C.-H., Su, H.-L., Sung, F.-C., & Kao, C.-H. (2014). Hyperlipidemia, statin use and the risk of developing depression: A nationwide retrospective cohort study. General Hospital Psychiatry, 36(5), 497–501. https://doi.org/10.1016/j.genhosppsych.2014.05.008
Cleven, L., Krell-Roesch, J., Nigg, C. R., & Woll, A. (2020). The association between physical activity with incident obesity, coronary heart disease, diabetes and hypertension in adults: A systematic review of longitudinal studies published after 2012. BMC Public Health, 20, 726. https://doi.org/10.1186/s12889-020-08715-4
De Giorgi, R., Pesci, N. R., Rosso, G., Maina, G., Cowen, P. J., & Harmer, C. J. (2023). The pharmacological bases for repurposing statins in depression: A review of mechanistic studies. Translational Psychiatry, 13(1), 253. https://doi.org/10.1038/s41398-023-02533-z
Fioranelli, M., Bottaccioli, A. G., Bottaccioli, F., Bianchi, M., Rovesti, M., & Roccia, M. G. (2018). Stress and inflammation in coronary artery disease: A review psychoneuroendocrineimmunology-based. Frontiers in Immunology, 9(SEP). Scopus. https://doi.org/10.3389/fimmu.2018.02031
Gerber, M., Claussen, M., Cody, R., Imboden, C., Ludyga, S., Scherr, J., Seifritz, E., & Von Känel, R. (2021). Cardiovascular disease and excess mortality in depression: Physical activity as a game changer. Deutsche Zeitschrift Für Sportmedizin/German Journal of Sports Medicine, 72(6), 261–270. https://doi.org/10.5960/dzsm.2021.498
Han, A. L. (2022). Association between lipid ratio and depression: A cross-sectional study. Scientific Reports, 12(1), 6190. https://doi.org/10.1038/s41598-022-10350-5
Hu, Z., Zhu, X., Kaminga, A. C., Zhu, T., Nie, Y., & Xu, H. (2020). Association between poor sleep quality and depression symptoms among the elderly in nursing homes in Hunan province, China: A cross-sectional study. BMJ Open, 10(7), e036401. https://doi.org/10.1136/bmjopen-2019-036401
Institute for Public Health (IPH). (2015). National Health and Morbidity Survey 2015 (NHMS 2015). Vol. II: Non-Communicable Diseases, Risk Factors & Other Health Problems. Ministry of Health Malaysia. https://www.moh.gov.my/moh/resources/nhmsreport2015vol2.pdf
Köhler-Forsberg, O., Gasse, C., Berk, M., & Østergaard, S. D. (2017). Do Statins Have Antidepressant Effects? CNS Drugs, 31(5), 335–343. https://doi.org/10.1007/s40263-017-0422-3
Li, L., Wang, P., Li, S., Liu, Q., Yu, F., Guo, Z., Jia, S., & Wang, X. (2023). Canonical correlation analysis of depression and anxiety symptoms among college students and their relationship with physical activity. Scientific Reports, 13(1), 11516. https://doi.org/10.1038/s41598-023-38682-w
Lin, C.-F., Chang, Y.-H., Chien, S.-C., Lin, Y.-H., & Yeh, H.-Y. (2018). Epidemiology of Dyslipidemia in the Asia Pacific Region. International Journal of Gerontology, 12(1), 2–6. https://doi.org/10.1016/j.ijge.2018.02.010
Liu, R.-Q., Bloom, M. S., Wu, Q.-Z., He, Z.-Z., Qian, Z., Stamatakis, K. A., Liu, E., Vaughn, M., Lawrence, W. R., Yang, M., Lu, T., Hu, Q.-S., & Dong, G.-H. (2019). Association between depressive symptoms and poor sleep quality among Han and Manchu ethnicities in a large, rural, Chinese population. PloS One, 14(12), e0226562. https://doi.org/10.1371/journal.pone.0226562
Marconcin, P., Werneck, A. O., Peralta, M., Ihle, A., Gouveia, É. R., Ferrari, G., Sarmento, H., & Marques, A. (2022). The association between physical activity and mental health during the first year of the COVID-19 pandemic: A systematic review. BMC Public Health, 22(1), 209. https://doi.org/10.1186/s12889-022-12590-6
Maslakçı, A., & Sürücü, L. (2022). Gender Effects on Depression, Anxiety, and Stress Regarding the Fear of COVID-19. Trends in Psychology, 1–13. https://doi.org/10.1007/s43076-022-00227-x
Ministry of Health. (2019). FactSheet on Hyperlipidemia.National Health and Morbidity Survey. IPTK. https://iptk.moh.gov.my/images/technical_report/2020/FactSheet_BI_AUG2020.pdf
Molero, Y., Cipriani, A., Larsson, H., Lichtenstein, P., D’Onofrio, B. M., & Fazel, S. (2020). Associations between statin use and suicidality, depression, anxiety, and seizures: A Swedish total-population cohort study. The Lancet Psychiatry, 7(11), 982–990. https://doi.org/10.1016/S2215-0366(20)30311-4
Pearce, M., Garcia, L., Abbas, A., Strain, T., Schuch, F. B., Golubic, R., Kelly, P., Khan, S., Utukuri, M., Laird, Y., Mok, A., Smith, A., Tainio, M., Brage, S., & Woodcock, J. (2022). Association Between Physical Activity and Risk of Depression: A Systematic Review and Meta-analysis. JAMA Psychiatry, 79(6), 550–559. https://doi.org/10.1001/jamapsychiatry.2022.0609
Shephard, R. J., & Aoyagi, Y. (2014). Physical activity and the risk of cardio-metabolic disease in the elderly: Dose recommendations as seen in the Nakanojo study. Current Cardiovascular Risk Reports, 8, 1-8. https://doi.org/10.1007/s12170-014-0387-4
Singh, B., Olds, T., Curtis, R., Dumuid, D., Virgara, R., Watson, A., Szeto, K., O’Connor, E., Ferguson, T., Eglitis, E., Miatke, A., Simpson, C. E., & Maher, C. (2023). Effectiveness of physical activity interventions for improving depression, anxiety and distress: An overview of systematic reviews. British Journal of Sports Medicine, 57(18), 1203–1209. https://doi.org/10.1136/bjsports-2022-106195
Wang, X., Sun, M., Wang, L., Li, J., Xie, Z., Guo, R., Wang, Y., & Li, B. (2023). The role of dietary inflammatory index and physical activity in depressive symptoms: Results from NHANES 2007–2016. Journal of Affective Disorders, 335, 332–339. https://doi.org/10.1016/j.jad.2023.05.012
Wong, B., Kruse, G., Kutikova, L., Ray, K. K., Mata, P., & Bruckert, E. (2016). Cardiovascular Disease Risk Associated With Familial Hypercholesterolemia: A Systematic Review of the Literature. Clinical Therapeutics, 38(7), 1696–1709. https://doi.org/10.1016/j.clinthera.2016.05.006
World Health Organization. (WHO), (2023). Cardiovascular Diseases. Cardiovascular Diseases. https://www.who.int/health-topics/cardiovascular-diseases . Accessed on 18th July, 2022.
Zheng, Z., Zhao, W., Zhou, Q., Yang, Y., Chen, S., Hu, J., Jiang, W., Zhang, W., Cai, J., & Qiu, J. (2023). Sex differences in depression, anxiety and health-promoting lifestyles among community residents: A network approach. Journal of Affective Disorders, 340, 369–378. https://doi.org/10.1016/j.jad.2023.07.107
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