Neighborhood social cohesion as a moderator of the association between epilepsy status and physical activity:...

Physical activity benefits people with epilepsy, but participation is lower than in the general population. We examined whether epilepsy status (active vs. inactive) is associated with meeting aerobic physical activity guidelines and whether neighborhood social cohesion (NSC) moderates this association.

Our study utilized data from the National Health Interview Survey, conducted in 2013, 2015, and 2017, involving 1410 individuals with epilepsy. The outcome was meeting aerobic physical activity guidelines (≥150 min of moderate-intensity, ≥75 min of vigorous-intensity activity, or an equivalent combination per week). Binary logistic regression was used to explore the association between epilepsy status and physical activity, as well as the moderating effect of neighborhood social cohesion. Propensity score matching was used as a sensitivity analysis.

Those with active epilepsy were less likely than those with inactive epilepsy to meet the aerobic guideline (OR = 0.69, 95% CI: 0.51-0.94). After adjustment, adherence among people with active epilepsy was similar for low versus high NSC (33.3% [95% CI: 26.5-40.1] vs 34.1% [95% CI: 25.9-42.2]). In contrast, among people with inactive epilepsy, adherence was 34.4% (95% CI: 27.1-41.7) for low NSC versus 56.1% (95% CI: 46.4-65.7) for high NSC. This moderating effect of NSC remained significant after propensity score matching.

People with inactive epilepsy and with a high level of NSC had a significantly higher physical activity level than all other groups, suggesting that the positive effect of NSC on physical activity only existed in this subgroup. Enhancing neighborhood social support networks may be a viable approach to promote physical activity among people with inactive epilepsy.