Longitudinal Pathways Between Physical Activity, Depression, and Perceived Stress in Peripheral Artery Disease.

Area of Science:

• Cardiovascular Medicine
• Psychiatry
• Behavioral Science

Background:

• Peripheral artery disease (PAD) affects 20% of patients with depression and stress.
• Depression and stress can impede physical activity, a critical component of PAD management.
• Physical activity is vital for improving PAD symptoms and reducing cardiovascular event risk.

Purpose of the Study:

• To investigate the longitudinal relationship between depression, stress, and physical activity in PAD patients over one year.
• To understand how trajectories of depression, stress, and physical activity interact following a PAD diagnosis.

Main Methods:

• The study enrolled 766 patients with new or worsening PAD symptoms across 10 US vascular clinics.
• Data on depressive symptoms, perceived stress, and physical activity were collected at baseline and at 3, 6, and 12 months.
• Path analysis was employed to examine the longitudinal associations between depression, stress, and physical activity.

Main Results:

• 17.8% of patients had significant depressive symptoms, 36.0% experienced increased stress, and 44.1% were sedentary at diagnosis.
• A decline in physical activity preceded increases in depressive symptoms over one year.
• Low initial physical activity was linked to higher perceived stress at 3 months.

Conclusions:

• Decreased physical activity in PAD patients is associated with increased depressive symptoms and perceived stress over one year.
• Integrated behavioral health interventions targeting physical activity and mental well-being are recommended for PAD care.
• Addressing physical activity and psychological distress collectively can improve PAD treatment outcomes.