The Longitudinal Association between Multiple Frailty Criteria and Depressive Symptomatology Five Years Later in Older Adults: A Decision Tree Modelling Approach.

Background: To examine the longitudinal association between frailty criteria and depression (DEP) in a large sample of older Europeans using decision tree models, and to examine complex relationships between frailty criteria and DEP symptomatology. Methods: Data come from waves six and eight of the Population Survey of Health, Ageing and Retirement in Europe. DEP was assessed using the EURO-D scale (wave 8) and frailty (wave 6). We included 27,122 people (56.9% women), aged 50 or over. Results: Women indicated a higher rate of DEP (29.0%), as well as a higher prevalence of pre-frailty (21.6%) and frailty (10.8%) than men. For both sexes, fatigue, weight loss, and slowness indicated an increased chance of DEP 5 years later. MPA (moderate physical activity) and grip strength were considered longitudinally protective factors for DEP. The highest prevalence of DEP symptomatology 5 years later was 50.3%, pointing to those with fatigue and slowness. Among women, the highest incidence of DEP was 66.8%, identified through fatigue, slowness, and low MPA. Conclusions: Strategies to reduce frailty and DEP in older European adults may include the creation of policies that encourage the promotion of physical capacity to reach MPA levels, as well as an improvement in muscular strength.

Association between Musculoskeletal Injuries and Depressive Symptoms among Athletes: A Systematic Review.

Musculoskeletal (MSK) injuries have a significant physical and psychological influence on an athlete's life. A systematic review of prospective cohort, cross-sectional, and case-control studies was undertaken in this study to analyze the association between MSK injuries with depressive symptoms in athletes. We searched on PubMed, Web of Science, and Scopus, with data inception to 15 February 2023. The methodological quality was assessed using the Newcastle-Ottawa Scale (NOS). Of the 3677 potential studies only nine were included. These studies showed a bidirectional association between MSK injuries and depressive symptoms. Athletes with MSK injuries had higher levels of depressive symptoms, which raises the likelihood of experiencing depression in the future. Women athletes had higher levels of depressive symptoms compared with men. The presence of depressive symptoms is a significant predictor of disability in athletes. Our findings suggest that coaches should be more aware of depressive symptoms, in order to prevent MSK injuries, and to monitor athletes following an MSK injury.

Evaluation of Reaction Time during the One-Leg Balance Activity in Young Soccer Players: A Pilot Study.

This study's aim was two-fold: (i) to test the intra-session reliability of the one-leg balance activity test; and (ii) to assess the influence of age on reaction time (RT) and the differences between dominant and non-dominant feet. Fifty young soccer players with an average age of 12.4 ± 1.8 years were divided into two groups: younger soccer players (n = 26; 11.6 ± 0.9 years) and older soccer players (n = 24; 14.2 ± 0.8 years). Each group then completed four trials (two with each leg) of the one-leg balance activity (OLBA) to evaluate RT under a single-leg stance. Mean RT and the number of hits were calculated, and the best trial was also selected. T-tests and Pearson correlations were performed for statistical analysis. Values for RT were lower, and the number of hits was higher while standing on the non-dominant foot (p = 0.01). MANOVA revealed that the "Dominant Leg" factor did not affect the multivariate composite (Pillai Trace = 0.05; F(4, 43) = 0.565; p = 0.689; Partial ETA Squared = 0.050; Observed Power = 0.174). The "Age" factor did not present an effect on the multivariate composite (Pillai Trace = 0.104; F(4, 43) = 1.243; p = 0.307; Partial ETA Squared = 0.104; Observed Power = 0.355). The results of the present investigation demonstrate that RT may be lower while standing on the non-dominant foot.

24-h Movement Guidelines and Overweight and Obesity Indicators in Toddlers, Children and Adolescents: A Systematic Review and Meta-Analysis.

BACKGROUND: Engaging in physical activity increases energy expenditure, reducing total body fat. Time spent in sedentary behaviours is associated with overweight and obesity, and adequate sleep duration is associated with improved body composition. This systematic review aimed to analyse the relationship between compliance with the 24-h movement guidelines and obesity indicators in toddlers, children and adolescents. METHODS: A systematic review and meta-analysis was conducted. PubMed, Web of Science and Scopus were searched from inception to December 2021. Cross-sectional and prospective studies that analysed the relationship between 24-h movement guidelines and overweight and obesity written in English, French, Portuguese or Spanish were included. PROSPERO registration number is CRD42022298316. RESULTS: The associations between meeting the 24-h movement guidelines and standardised body mass index were null in the two studies for toddlers. Seven studies analysed the relationship between compliance with the 24-h movement guidelines and overweight and obesity among preschool children. Of these seven studies, six found no association between compliance with 24-h movement guidelines and body composition. Among children and adolescents, 15 articles were analysed. Of these 15 studies, in seven, it was found that children and adolescents who meet the 24-h movement guidelines were more likely to have lower risks of overweight and obesity. The meta-analysis yielded a pooled OR = 0.80 (95% CI = 0.68 to 0.95, p = 0.012, I2 = 70.5%) in favour of compliant participants. Regarding participants' age groups, compliance with 24-h movement guidelines seems to exert greater benefits on overweight and obesity indicators among children-adolescents (OR = 0.62, p = 0.008) compared to participants at preschool (OR = 1.00, p = 0.931) and toddlers (OR = 0.91, p = 0.853). CONCLUSION: Most included studies have not observed a significant relationship between compliance with the 24-h movement guidelines and overweight and obesity in toddlers, children and adolescents.

Sex Differences in Falls: The Mediating Role of Gait Stability Ratio and Body Balance in Vulnerable Older Adults.

This study, conducted on a large sample of older adults at elevated fall risk (1), aimed to verify statistical differences in gait stability ratio (GSR) and body balance (BB) according to sex, (2) to examine and compare GSR and BB performance between older adult fallers and non-fallers, (3) to determine an association between GSR and BB according to the history of falls, and (4) to explore whether GSR and BB mediate the association between sex and falls. We included 619 individuals (69.8 ± 5.6 years) living in the Autonomous Region of Madeira, Portugal. The frequency of falls was obtained by self-report. BB was determined by the Fullerton Advanced Balance scale, while GSR was established by dividing cadence by gait speed and data collected during the 50-foot walk test. Males indicated a lower prevalence of falls in the last 12 months (23.6%), while females had a higher score (48.7%), as well as a lower balance performance (p < 0.001) and higher GSR scores (p < 0.001). Lower BB control (p < 0.001), as well as higher GSR, were more expressive for fallers (p < 0.001). We found a large, negative and significant correlation between GSR and BB for historical falls (r = −0.560; p < 0.001), and between male and female cohorts (r = −0.507; p < 0.001). The total effect of sex on falls mediated by GSR and BB was 16.4%. Consequently, GSR and BB mediated this association by approximately 74.0% and 22.5%, respectively.

The Relation of Having Experienced a Fall in the Past to Lower Cognitive Functioning in Old Age Is Mediated via Less Physical Activity Engagement as Cognitive Reserve Contributor.

Physical activity and exercise contribute to the accumulation of cognitive reserve, which is instrumental for preserving cognitive health in old age. In a large sample of 701 older adults (mean age = 70.36 years), we investigated whether the relationship between having experienced a fall in the past and lower performance in cognitive functioning was mediated via less physical activity engagement as a cognitive reserve contributor. General cognition was assessed using the mini-mental state examination (MMSE), long-term memory using a word-pair delayed recall test and working memory using a backward digit-span test. In face-to-face interviews, individuals reported information on falls during the past 12 months and their habitual physical activity engagement. Our analyses demonstrated that the relationship between having experienced a fall in the past and lower performance in the cognitive functioning measures was partly mediated (by 16.3% for general cognition, 30.6% for long-term memory, and 33.1% for working memory, respectively) via less physical activity engagement. In conclusion, we suggest as a core bio-psychological mechanism that experiencing a fall at an older age is a critical life event that hinders sufficient physical activity engagement and thereby impedes cognitive reserve build-up, resulting in lower cognitive functioning outcomes.

Prevalence of Frailty and Its Association with Depressive Symptoms among European Older Adults from 17 Countries: A 5-Year Longitudinal Study.

BACKGROUND: This study aimed to examine the association between frailty and depressive symptoms. METHODS: Cross-sectional and five-year longitudinal study. Data were from the population-based Survey of Health, Aging, and Retirement in Europe (SHARE) waves six (2015) and eight (2020). Frailty was assessed using the SHARE-Frailty Instrument. Fatigue, appetite, walking difficulties, and physical activity were self-reported, and grip strength was measured using a handgrip dynamometer. The EURO-D 12-item scale was used to measure depressive symptoms. RESULTS: The sample comprised 25,771 older adults (56.2% female) with a mean age of 66.5 (95% CI 66.4, 66.6) years. The prevalence of frailty was 4.2% (95% CI 3.9, 4.4) in 2015 and 6.7% (95% CI 13.5, 14.3) in 2020. Among frail participants, 72.5% and 69.6% had depression in 2015 and 2020, respectively. Frailty was associated with depression over the 5 years. Those with pre-frailty and those with frailty in 2015 had 1.86 (95% CI 1.71, 2.01) and 2.46 (95% CI 2.14, 2.83) greater odds of having depressive symptoms in 2020. CONCLUSIONS: Frailty is a predictor of depression in older adults, and frail participants had greater odds of presenting depressive symptoms.

Residential trajectories across the life course and their association with cognitive functioning in later life.

Previous work has found that later life urban-rural differences in cognitive health can be largely explained by indicators of cognitive reserve such as education or occupation. However, previous research concentrated on residence in limited, specific, periods. This study offers a detailed investigation on the association between urban (vs. rural) residence from birth, and cognitive functioning in older age. Using data from the Survey of Health Ageing and Retirement in Europe we created residential trajectories from birth to survey enrolment with a combination of sequence and cluster analysis. Using mixed-effects models, we investigated the association between residential trajectories in early, mid, and later life and three cognitive functioning outcomes: immediate recall, delayed recall, and verbal fluency. In a sample of 38,165 participants, we found that, even after accounting for differences related to education and occupation, rural (vs. urban) residence in early life remained associated with poorer cognitive performance later in life. This suggests that growing up in rural regions leads to a long-term disadvantage in cognitive functioning. Thus, public health policies should consider that urban-rural inequalities in early life may have long-lasting associations with inequalities in cognitive health in old and very old age.

The Role of Physical Function in the Association between Physical Activity and Gait Speed in Older Adults: A Mediation Analysis.

Adequate levels of physical function (PF) are essential for vulnerable older adults to perform their daily tasks safely and remain autonomous. Our objective was to explore the mediating role of PF in the relationship between physical activity (PA) and gait speed (GS) in a large sample of older adults from the north of Brazil. This is a cross-sectional study that analyzed 697 older adults (mean age 70.35 ± 6.86 years) who participated in the project "Health, Lifestyle, and Physical Fitness in Older Adults in Amazonas" (SEVAAI). PA was assessed using the Baecke Questionnaire, PF using the Senior Fitness Test, and GS using the 50-foot Walk Test. Mediation pathways were analyzed to test the possible mediating role of PF between specific PA domains (PA-total score, PA-housework, PA-sport, PA-leisure) and GS. Regarding PA-total, the analysis showed that high-performance GS was partially mediated in approximately 19% by better PF performance. Moreover, the PF could partially mediate the association between PA-sport and PA-leisure with GS, at levels of approximately 9% and 46%, respectively. An inverse relationship was observed between PA-housework (sedentary lifestyle) and GS. This association was partially mediated to an extent of approximately 9% by better PF performance. We conclude that PF plays a crucial role in mediating the association between PA and GS among vulnerable older adults.

Meeting 24-h movement guidelines and markers of adiposity in adults from eight Latin America countries: the ELANS study.

This study aimed to compare compliance with 24-h movement guidelines across countries and examine the associations with markers of adiposity in adults from eight Latin American countries. The sample consisted of 2338 adults aged 18-65 years. Moderate-to-vigorous physical activity (MVPA) and sedentary behavior (SB) data were objectively measured using accelerometers. Sleep duration was self-reported using a daily log. Body mass index and waist circumference were assessed as markers of adiposity. Meeting the 24-h movement guidelines was defined as ≥ 150 min/week of MVPA; ≤ 8 h/day of SB; and between 7 and 9 h/day of sleep. The number of guidelines being met was 0.90 (95% CI 0.86, 0.93) with higher value in men than women. We found differences between countries. Meeting two and three movement guidelines was associated with overweight/obesity (OR: 0.75, 95% CI 0.58, 0.97 and OR: 0.69, 95% CI 0.51, 0.85, respectively) and high waist circumference (OR: 0.74, 95% CI 0.56, 0.97 and OR: 0.77, 95% CI 0.62, 0.96). Meeting MVPA and SB recommendations were related to reduced adiposity markers but only in men. Future research is needed to gain insights into the directionality of the associations between 24-h movement guidelines compliance and markers of adiposity but also the mechanisms underlying explaining differences between men and women.

The Role of Cognitive Performance and Physical Functions in the Association between Age and Gait Speed: A Mediation Study.

INTRODUCTION: With vulnerable aging, gait speed (GS) undergoes progressive changes, becoming slower. In this process, cognitive performance (CP) and physical function (PF) both play an important role. This study aims (1) to investigate the association between CP and PF with GS and (2) to examine whether CP and PF mediate the association between age and GS in a large sample of Brazilian older adults. METHODS: A cross-sectional study analyzed 697 individuals (mean age 70.35 ± 6.86 years) from the state of Amazonas. The CP was evaluated by the COGTEL test battery, PF by the Senior Fitness Test battery, and GS with the 50-foot Walk Test. RESULTS: Older adults with a lower CP and PF had a 70% and 86% chance of slow GS, respectively. When CP and PF were placed simultaneously as mediators, the direct effect estimated by the model revealed a non-significant relationship between age and GS. Specifically, CP and PF mediated the association between age and GS, at approximately 12% and 98%, respectively. CONCLUSIONS: CP and PF show the potential to estimate GS performance among older adults. Moreover, CP and PF indicated a negative and direct association between age and slow GS, especially PF.

Cognitive Reserve Mediates the Relation between Neighborhood Socio-Economic Position and Cognitive Decline.

Introduction: We investigated the mediating role of leisure activity engagement as marker of cognitive reserve in the relation between neighborhood socio-economic position (SEP) and cognitive decline over 6 years. Methods: The study analyzed longitudinal data from 897 older adults who participated in the two waves (2011 and 2017) of the Vivre-Leben-Vivere (VLV) survey in Switzerland (M = 74.33 years in the first wave). Trail Making Test parts A and B were administered in both waves. Leisure activity engagement was assessed during interviews. Neighborhood SEP was derived from the Swiss Neighborhood Index of Socio-Economic Position (Swiss-SEP), provided by the Swiss National Cohort (SNC). Results: Latent change score modeling revealed that 42.5% of the relationship between higher neighborhood SEP and smaller cognitive decline was mediated via a higher frequency of leisure activities in the first wave. Conclusion: Neighborhood SEP constitutes an important contextual factor potentially influencing the pathways of cognitive reserve accumulation and, therefore, should be taken into account to better understand their effects on cognitive decline in old age.

Relationship between socio-demographic correlates and human development index with physical activity and sedentary time in a cross-sectional multicenter study.

BACKGROUND: Socio-demographic correlates and human development index (HDI) are associated with self-reported physical activity, but only a few studies have focused on device-measured physical activity and sedentary time in Latin America. We examined the relationship between socio-demographic correlates and HDI with physical activity and sedentary time in a cross-sectional study. METHODS: We based our analyses on 2522 (53.1% women; 18-65 years [mean age 38.3 years]) adults drawn from the eight Latin America countries. Physical activity (light, moderate, vigorous, and moderate-to-vigorous intensity and steps) and sedentary time were assessed using Actigraph GT3X + accelerometers. Sex, age, and race/ethnicity were self-reported. The HDI country information was obtained from the United Nations Development Program. RESULTS: For the age, ethnicity, vigorous physical activity and steps/day, there were significant differences between high and very high HDI countries. Women and younger age presented lower sedentary time than men and older. In moderate-to-vigorous physical activity, we found lower duration in women (-13.4 min/week), younger age (-0.1 min/week), and white/caucasian (-2.7 min/week) than men, older ages and mixed ethnicity. Women (-1266.5 steps/week) and very high HDI (-847.3 steps/week) presented lower steps than men and high HDI. Black (2853.9 steps/week), other (1785.4 steps/week), and white/caucasian ethnicity (660.6 steps/week) showed higher steps than mixed ethnicity. CONCLUSIONS: Different socio-demographic correlates are associated with physical activity intensity; however, HDI is associated with vigorous physical activity and steps in the Latin American region, which can in turn guide policies to promote physical activity in the region. TRIAL REGISTRATION: ClinicalTrials.Gov NCT02226627 . Retrospectively registered on August 27, 2014.

Impact of Exercise Training on Depressive Symptoms in Cancer Patients: A Critical Analysis.

BACKGROUND: Cancer patients must deal with several health challenges, including emotional distress and depressive symptoms. This study aimed to evaluate evidence from published systematic reviews and meta-analyses about the efficacy of exercise on depressive symptoms in cancer patients. METHODS: We searched for previous meta-analyses of randomised controlled trials on PubMed, Web of Science and Scopus, with data inception to 30 December 2021. Two independent researchers assessed the methodological quality using the Assessment of Multiple Systematic Reviews 2 (AMSTAR2) instrument. Six meta-analyses were integrated. All included middle-aged and older adults. Five presented moderate quality, and one presented low quality. RESULTS: Overall, a significant reduction in depressive symptoms was observed among the included studies. However, the heterogeneity between studies was high, and high-quality evidence for the efficacy of exercise on depressive symptoms was limited. CONCLUSIONS: Exercise could be a possibility in the treatment of depressive symptoms in cancer patients, especially when supervised and outside the home. The better dose of exercise needs to be clarified. More high-quality evidence is needed to better prescribe exercise to this vulnerable population.

The association between physical activity and mental health during the first year of the COVID-19 pandemic: a systematic review.

INTRODUCTION: The Coronavirus disease-19 (COVID-19) pandemic affected countries worldwide and has changed peoples' lives. A reduction in physical activity and increased mental health problems were observed, mainly in the first year of the COVID-19 pandemic. Thus, this systematic review aims to examine the association between physical activity and mental health during the first year of the COVID-19 pandemic. METHODS: In July 2021, a search was applied to PubMed, Scopus, and Web of Science. Eligibility criteria included cross-sectional, prospective, and longitudinal study designs and studies published in English; outcomes included physical activity and mental health (e.g., depressive symptoms, anxiety, positive and negative effects, well-being). RESULTS: Thirty-one studies were included in this review. Overall, the studies suggested that higher physical activity is associated with higher well-being, quality of life as well as lower depressive symptoms, anxiety, and stress, independently of age. There was no consensus for the optimal physical activity level for mitigating negative mental symptoms, neither for the frequency nor for the type of physical activity. Women were more vulnerable to mental health changes and men were more susceptive to physical activity changes. CONCLUSION: Physical activity has been a good and effective choice to mitigate the negative effects of the COVID-19 pandemic on mental health during the first year of the COVID-19 pandemic. Public health policies should alert for possibilities to increase physical activity during the stay-at-home order in many countries worldwide.

Prevalence and sociodemographic correlates of meeting the Canadian 24-hour movement guidelines among latin american adults: a multi-national cross-sectional study.

BACKGROUND: 24-hour movement behaviors, including moderate-to-vigorous physical activity (MVPA), sedentary time (ST), and sleep duration, have important implications for health across the lifespan. However, no studies exist that have examined the integration of these 24-hour movement behaviors in Latin America. The purpose of this study was to examine the prevalence of meeting the Canadian 24-Hour Movement Guideline recommendations and sociodemographic correlates of meeting the guidelines in adults from eight Latin American countries. METHODS: This was a multi-national cross-sectional study of 2338 adults aged 18 to 64 years from the Latin American Study of Nutrition and Health. MVPA and ST data were collected using accelerometers. Sleep duration was self-reported using a daily log. Socio-demographic correlates included sex, age, education level, and marital status. Meeting the 24-hour movement guidelines was defined as: ≥150 min/week of MVPA; ≤8 h/day of ST; and between 7 and 9 h/day of sleep. Logistic regression models were estimated on pooled data. RESULTS: The prevalence of adults who met the MVPA, ST, sleep duration, and integrated recommendations was 48.3, 22.0, 19.4, and 1.6%, respectively. Overall, being a woman (OR: 0.72; 95%CI: 0.55,0.93) and having a middle (0.63; 0.47,0.85) or high education level (0.31; 0.17,0.56) was associated with lower odds of meeting all three of the 24-hour movement guideline recommendations. Being married (1.70; 1.25,2.29) was associated with greater odds of meeting all three recommendations. Being a woman (0.46; 0.39,0.55), aged 50-64 years (0.77; 0.60,0.97), and married (0.79; 0.65,0.96) were associated with lower odds of meeting the MVPA recommendation. Having a middle (0.64; 0.50,0.80) or high (0.36; 0.23,0.55) education level was associated with lower odds and being married (1.86; 1.46,2.36) was associated with greater odds of meeting the ST recommendation. Being a woman (0.63; 0.51,0.78) was associated with lower odds; whereas being aged 50-64 years (1.40; 1.04,1.88) and having a middle education level (1.37; 1.09,1.73) were associated with greater odds of meeting the sleep duration recommendation. CONCLUSIONS: Overall, the proportion of Latin American adults achieving healthy levels of 24-hour movement behaviors was low. Further efforts are needed to promote more MVPA, less ST, and sufficient sleep in Latin American adults. TRIAL REGISTRATION: Clinical Trials NCT02226627 . Retrospectively registered on August 27, 2014.

How Welfare Regimes Moderate the Associations Between Cognitive Aging, Education, and Occupation.

OBJECTIVES: Previous studies have shown the importance of individual markers of cognitive reserve, such as education and occupation, for cognitive health in old age. However, there has been only little investigation so far on how this relationship varies across contexts. METHODS: We analyzed data from the Survey of Health, Ageing, and Retirement in Europe, using second-order latent growth models, to assess the moderating role of welfare regimes on the relationship between education and occupation skill level in explaining overall cognitive functioning and decline in old age. Our sample includes 13 European countries using data from 5 regular waves of the survey (2004-2007 and 2011-2015) and 2 retrospective ones (2008-2009 and 2017). Cognitive functioning was modeled as a latent variable measured by immediate and delayed recall, verbal fluency, and numeracy. RESULTS: 74,193 participants were included from the survey. Our analysis showed that the association of education with cognition was weaker overall in Scandinavian countries, but stronger in Southern European countries, relative to Bismarckian ones. However, educational differences in the decline of cognition were more pronounced only in Scandinavian compared to Bismarckian countries. Additionally, higher-skilled occupations in Scandinavian countries had better overall functioning compared to the same occupations in Bismarckian countries, but there was no difference in the decline in cognitive functioning. DISCUSSION: Our findings indicate that the associations of cognitive functioning and its decline with individuals' cognitive reserve markers (education and occupational skill level) vary according to welfare regimes, showing the importance of contextual factors in cognitive aging processes.

The effectiveness of a randomised clinical trial of PLE2 NO self-management and exercise programme for knee osteoarthritis to improve self-efficacy.

OBJECTIVE: This study aims to assess the effectiveness of a 12-weeks self-management and exercise intervention to improve self-efficacy in older individuals with knee osteoarthritis (KOA) DESIGN: Randomised Controlled Trial. SETTING: Four different community settings. SUBJECTS: Eighty individuals aged 60 years or over with clinical and radiographic knee osteoarthritis. INTERVENTION: The subjects were randomly assigned to (1) a combined self-management and exercise programme (treatment group) and (2) an educational programme (control group). MAIN MEASURES: The primary outcome was self-efficacy and secondary outcomes were physical activity, health-related quality of life and skill-related physical fitness measures. RESULTS: Sixty-seven participants, mean age 69.1 (5.8) years, completed the study: 32 in the control group and 35 in the treatment group. A significant group effect favourable to the treatment group was observed in the following variables: self-efficacy (F[2,64] = 9.2, p = 0.003), physical activity (F[2,64] = 43.6, p < 0.001) and balance for most painful knee (F(2,64) = 4.87, p = 0.031) and less painful knee (F[2,64] = 6.94, p = 0.010). No improvements regarding health-related quality of life, gait speed and agility were found. This study supports the importance of a combined self-management and exercise intervention to improve self-efficacy and physical activity in KOA individuals.

Effects of Exercise during Pregnancy on Postpartum Depression: A Systematic Review of Meta-Analyses.

Postpartum depression (PPD) is a public health issue. Exercise is a nonpharmacologic alternative to deal with PPD. This study conducted a systematic review of previous meta-analyses and an exploratory pooled analysis regarding the effects of exercise on depressive symptoms among women during the postpartum period. We searched for previous meta-analyses of randomised controlled trials on PubMed, Web of Science and Scopus, date of inception to 31 May 2021. The methodological quality was assessed using the Assessment of Multiple Systematic Reviews 2 (AMSTAR2) instrument. We pooled the standardised mean differences from the selected studies. Of the 52 records screened, five were included. The results revealed a significant moderate effect of exercise on depressive symptoms among women during the postpartum period (SMD = -0.53; 95% CI: -0.80 to -0.27, p < 0.001). The pooled effect of the five meta-analyses established that exercise had a significant, small effect on depressive symptoms (SMD = -0.41; 95% CI: -0.50 to -0.32, p < 0.001). Our study indicates that exercise is effective in reducing PPD symptoms. Compared with traditional control approaches (psychosocial and psychological interventions), exercise seems have a superior effect on PPD symptoms. The implications of the present synthesis of past meta-analytical findings to guide health policies and research are discussed.

Grip strength as a predictor of depressive symptoms among vulnerable elderly Europeans with musculoskeletal conditions.

The present study aimed to investigate the grip strength (GS) discrimination capacity and cutoffs points for depressive symptoms among vulnerable elderly individuals with musculoskeletal conditions. The Survey of Health, Aging, and Retirement in Europe wave 6 was analyzed. GS was measured by a handgrip dynamometer, and EURO-D scale was used to assess depressive symptoms. GS cutoff values for depressive symptoms were calculated using the receiver operating characteristics curve. 2206 participants, mean age 74.0 (73.7-74.3), 78.8% with osteoarthritis/other rheumatism, enrolled in the study. Sensitivity varies between 0.44 (men, ≥ 85 years) and 0.82 (men, 75-84 years), and specificity varying between 0.35 (women, 75-84 years) and 0.70 (men 75-84 years). GS is associated with depressive symptoms just for women and it is not possible to use a GS cutoff point for screening depressive symptoms for vulnerable men and women with musculoskeletal conditions over the age of 65 years.