Associação da atividade física na saúde física e mental de adultos com depressão durante a pandemia de COVID-19: achados da Coorte PAMPA

Abstract

It is estimated that by 2030 depression will be the most frequent disease in the world and the leading cause of global disability. In addition, it is possible to observe an increase in the prevalence of depression and anxiety after major events such as health crises or disasters such as COVID-19. It is known that the practice of physical activity (PA) benefits the population, reducing anxiety and subjective memory decline symptoms. Still, there are few studies on people’s behavior during the pandemic in the trajectory of depressive disorders, anxiety, and cognitive function with depression during the pandemic. The present study used data from the PAMPA Cohort, an ambispective cohort developed with adults in southern Brazil. Self-administered online questionnaires were used in three consecutive waves in June/2020, December/2020, and June/2021. PA, depressive and anxiety symptoms, and subjective memory function were measured prior to social distancing. The cross-sectional and longitudinal associations of PA practice before and during the COVID-19 pandemic with anxiety symptoms and subjective memory decline in adults living with depression were analyzed. Among the different outcomes, the impact of PA (volume in minutes; type: aerobic, strength or combined; and place of practice: away from home, at home, or in more than one place) on the trajectory of depressive symptoms, anxiety and cognitive function in the population affected by depression with consequences of social distancing and the COVID-19 pandemic were analyzed. Generalized linear models were used to investigate the interaction between time and PA and its influences on symptoms, adjusting for confounding variables (age, sex, skin color, marital status, schooling, daily routine during the pandemic, and the presence of other chronic diseases). Subjective memory decline was assessed using multivariate Cox proportional hazards regression models to obtain the hazard ratio (HR) and respective 95% confidence interval (95%CI) of the crude and adjusted analyses. Among the respondents, 424 subjects presented depression and were included in the study. A non-linear trajectory of depression was observed during the first year of the COVID-19 pandemic. PA was associated with a slower trajectory of depressive disorders (slope 1.89; 95% CI: -3.34, -0.43 points). Those who remained active had a lower risk of subjective memory decline during follow-up than those who remained inactive in the same period (HR: 0.20; 95% CI: 0.07, 0.55). Those who did not practice PA in the first wave presented worse anxiety symptoms than those who practiced PA at home or outside the home during the same period. In addition, active participants during the first three months of the pandemic presented lower anxiety symptom scores than those who remained inactive during the same period. In short, PA practice mitigated the impact of the COVID-19 pandemic on depressive symptoms in adults living with depression in southern Brazil. Persisting on being physically active was associated with lower symptoms of depression and anxiety and a lower risk of subjective memory decline. Future face-to-face interventions combined with PA practice strategies should be emphasized.