Examining the longitudinal effect of depressive symptoms on physical activity in persons with type 2 diabetes during the COVID-19 pandemic

Background and aims

The American Diabetes Association recommends that individuals with type 2 diabetes (T2D) engage in at least 150 min of physical activity per week for optimal health. However, depressive symptoms, prevalent in this population, may hinder the ability to follow this recommendation, particularly during stressful events like the COVID-19 pandemic. This longitudinal study aimed at investigating the impact of depressive symptoms on physical activity levels among individuals with T2D during the COVID-19 pandemic.

Methods

We analyzed data from 5348 individuals with T2D participating in the All of Us Research Program's COVID-19 Participant Experience (COPE) survey. Depressive symptoms and physical activity levels were measured using the Patient Health Questionnaire (PHQ-9) and the International Physical Activity Questionnaire (IPAQ), respectively. Stabilized inverse probability weights (sIPW)-weighted mixed-effect logistic regression models evaluated the association between depressive symptoms and physical activity across three time points: May, June, and July 2020.

Results

Participants had a mean age of 61.43 (11.63) years, with majority being female (56.49%) and non-Hispanic White (76.25%). At baseline, 50% of the participants had moderate-to-severe depressive symptoms, and 20% were physically active. The predicted probability of being physically active decreased with increasing depressive symptoms (aOR = 0.66; 95%CI: 0.60, 0.73). The inverse association between depressive symptoms and physical activity was strongest among non-Hispanic White.

Conclusions

Depressive symptoms were significantly associated with lower odds of engaging in physical activity among individuals with T2D during the COVID-19 period. Further studies capturing pre- and post-pandemic data are needed to clarify the pandemic's impact on these associations.