Patterns of physical activity and their relationship with depression among community-dwelling older adults in Shanghai, China: a latent class approach

Background Few studies have explored patterns of physical activity (PA) and examined their relationship with depression among community-dwelling older adults. We aimed to identify the patterns of PA through a person-centered analytical approach and examine the association between quantity and patterns of PA, and depression among community-dwelling older adults. Methods We conducted a cross-sectional survey study in the Minhang district, Shanghai, China, in August 2019, and used a self-administered questionnaire to collect data through home visits. The total sample included 2525 older adults. This study used the Physical Activity Scale for the Elderly (PASE) to assess the quantity of PA in older adults. Depression was evaluated with the Geriatric Depression Scale (GDS). Latent class analysis (LCA) was used to identify subpopulations by shared item response patterns. Logistic regressions were performed to estimate the relationship between PASE score, patterns of PA, and depression. An exploratory analysis of joint levels and patterns of PA effects on depression was based on sample subgroups with combinations of levels and patterns of PA. Logistic regression was used to calculate the odds ratio for combined subgroups. Results Four latent classes were identified: "domestic types," "athletic types," "gardening/caring types," and "walkers." PASE scores and patterns of PA both were associated with depression. Older adults who were the most active (PASE quartile: 75-100%) and the athletic types had the strongest significant association with depression (OR = 0.19, 95% CI: 0.06-0.65), followed by those who were the most active (PASE quartile: 75-100%) and the walkers (OR = 0.28, 95% CI: 0.14-0.57) when compared with older adults with the least activity (PASE quartile: 0-25%) and domestic types. Conclusion This study suggests both the quantity and patterns of physical activity are associated with depressive symptoms among community-dwelling older adults. Population-level intervention should encourage community-dwelling older adults to increase their quantity of PA to reduce the risk of depression. Athletics and walkers are recommended. To develop individual-level tailored interventions, more attention should be paid to older adults who are highly engaged in gardening/caring for others.