Activity participation reduces the risk of late-life depression: a sex-specific analysis of the AgeCoDe/AgeQualiDe...

The demographic trend towards an ageing society is accompanied by an increase in age-related illnesses, with late-life depression (LLD) being one of the most common mental illnesses in the oldest-old (≥ 80 years). As activity participation potentially prevents LLD, this study examines sex-specific differences in the relationship between activity participation and LLD risk.

Data were derived from the prospective multicenter cohort study AgeCoDe/AgeQualiDe with 9 follow-ups (FU). LLD was assessed using the 15-item Geriatric Depression Scale (GDS-15, cut-off score 6). Activity participation was first assessed at FU1 based on 14 physical, social and cognitive activities (5-point ordinal scale). Statistical analyses included descriptive statistics, Mann-Whitney U-tests and Cox regressions estimating incident LLD from FU2 to FU9. Time at risk began at FU1, where activity participation was first assessed.

Analyses included n = 2,305 at FU1; mean age 81.0; 64% women. Men reported significantly more physical activity (U = 569,468, p = 0.010), women more cognitive activity (U = 658,426, p = 0.002). A higher activity participation at FU1 was associated with a lower risk of LLD with HR = 0.97, 95% CI [0.95, 0.98]. Particularly, participation in physical activities reduced LLD risk with HR = 0.96, 95% CI [0.93, 0.98], which could not be shown for social and cognitive activities. Analyses could not confirm a sex-dependent association.

Activity participation, especially in physical activities, appears preventive for LLD in the oldest-old. Contrary to the hypothesis, these associations did not differ between men and women.