Clinical research study
Protective Effect of Regular Physical Activity on Depression After Myocardial Infarction: The HUNT Study

https://doi.org/10.1016/j.amjmed.2015.08.012Get rights and content

Abstract

Purpose

To study if physical activity within the recommended level over time was associated with risk of developing depression after the first myocardial infarction in older adults.

Methods

Men (n = 143) and women (n = 46) who had reached the age of 60 years in 2006-2008 who participated in the Nord-Trøndelag Health Study (HUNT1, 1984-1986; HUNT2, 1995-1997; HUNT3, 2006-2008) without any mental illness or cardiovascular disease at baseline in HUNT2 and who experienced their first myocardial infarction before HUNT3 were included. Based on the patterns of physical activity from HUNT1 to HUNT2, the sample was divided into 4 groups: persistently inactive, from active to inactive, from inactive to active, and persistently active. The primary outcome, post-myocardial infarction depression symptoms, was measured with the Hospital, Anxiety and Depression Scale in HUNT3.

Results

In HUNT3, 11% of participants had depression. After multivariable adjustment, those who were persistently active had significantly lower odds of being depressed (odds ratio 0.28; 95% confidence interval, 0.08-0.98) compared with those who were persistently inactive. Additionally, a significant test for trend (P = .033) of lowering odds of depression was observed across all 4 categories of physical activity patterns at baseline.

Conclusions

In this small sample of initially healthy adults, we observed a long-term protective effect of regular physical activity on the development of depression following myocardial infarction.

Section snippets

Study Population

The Nord-Trøndelag Health Study (HUNT) is a Norwegian population-based general health study conducted in 1984-1986 (HUNT1),21 1995-1997 (HUNT2),22 and 2006-2008 (HUNT3).23 Data were collected from questionnaires, blood samples, and clinical measurements. All participants included in the present study had reached the age of 60 years when participating in HUNT3, and they had been hospitalized with their first myocardial infarction after baseline in HUNT2. Change in physical activity level from

Results

Baseline descriptive data are presented in Table 1. Of the 189 participants included, 46 (24%) were women. In general, the majority of covariates did not differ significantly between the categories of physical activity pattern, except for smoking (P = .049), with most smokers among those being persistently inactive (41.3%). The Kruskal-Wallis H test showed that there was a statistically significant difference between at least 2 of the groups in systolic blood pressure, χ2 (3) = 7.92, P = .048,

Discussion

The main finding of this study was that maintaining a recommended level of physical activity in adulthood into older age was significantly associated with lower odds of having depressive symptoms after first incident myocardial infarction. To our knowledge, this is the first study accounting for a protective effect of stable physical activity on post-myocardial infarction depression.

Although we have not been able to find similar studies on the association between pattern of physical activity

Conclusions

In a small sample of initially healthy individuals participating in 3 health surveys with 10-year intervals, we found that persistent patterns of physical activity level before being diagnosed with their first myocardial infarction significantly decreased the odds of post-myocardial infarction depression, which further supports the promotion of physical activity throughout the health care system. Despite the methodological limitations of the study, we believe that the results add important

Acknowledgment

The Nord-Trøndelag Health Study (The HUNT Study) is a collaboration between HUNT Research Centre (Faculty of Medicine, Norwegian University of Science and Technology), Nord-Trøndelag County Council, Central Norway Health Authority, and the Norwegian Institute of Public Health. We also thank the Department of Research and Development at the Department of Internal Medicine at Levanger Hospital at Nord-Trøndelag Hospital Trust for extracting the data from medical records.

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    Funding: This study has been financially supported by the Norwegian Extra Foundation for Health and Rehabilitation through EXTRA funds (grant number 2011-2-0161) and the Liaison Committee between the Central Norway Regional Health Authority (RHA) and the Norwegian University of Science and Technology (NTNU). The sponsors had no role in the design, execution, analysis and interpretation of the data or the writing of the study.

    Conflict of Interest: None.

    Authorship: All authors had access to the data and had a role in writing the manuscript.

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