Preprint / Version 1

Education and mental health trajectories in older age: the mediating role of wealth and physical activity

EDUCATION, PHYSICAL ACTIVITY & MENTAL HEALTH

##article.authors##

  • Boris Cheval University of Geneva
  • Silvio Maltagliati
  • Ilyes Saoudi
  • Layan Fessler
  • Ata Farajzadeh
  • Stefan Sieber
  • Stéphane Cullati
  • Matthieu Boisgontier

DOI:

https://doi.org/10.51224/SRXIV.228

Keywords:

Educational status, exercise, mental health, aging, longitudinal studies

Abstract

Objective. Financial conditions, such as low wealth, have been highlighted as a factor explaining why people with lower levels of educational attainment have poorer mental health than people with higher levels. However, whether behavioral factors can further explain this association remains unclear. Here, we examined the extent to which physical activity behavior mediates the effect of education on mental health trajectories in old age, independently of the financial condition pathway.

Methods. Data from 54,818 adults 50 years of age or older (55% women) included in the Survey of Health, Ageing and Retirement in Europe (SHARE) were analyzed using longitudinal mediation and growth curve models to estimate the mediating role of wealth and physical activity (initial status and change) in the association between education and mental health trajectories. Education, wealth, and physical activity were self-reported. Depressive symptoms and well-being were measured using validated scales.

Results. Lower education was associated with a lower level and steeper decrease in physical activity over time, which predicted more depressive symptoms and greater decrease in well-being. In other words, education affected mental health through both the level and trajectories of physical activity. Physical activity explained 30.5% of additional variance in depressive symptoms and 49.1% in well-being, relative to the model including wealth as the only mediator.

Conclusions. Physical activity may be at least as important as socioeconomic factors (e.g., wealth) in explaining the association between low education attainment and poor mental health trajectories in adults 50 years of age or older. 

Metrics

Metrics Loading ...

References

Lépine J-P, Briley M. The increasing burden of depression. Neuropsychiatr Dis Treat 2011;7(Suppl 1):3.

WHO. Depression and other common mental disorders: global health estimates: World Health Organization, 2017.

Kok RM, Reynolds CF. Management of depression in older adults: a review. JAMA 2017;317(20):2114-22.

WHO. Mental health of older adults. https://www.who.int/news-room/fact-sheets/detail/mental-health-of-older-adults. 2017

Sperandei S, Page A, Spittal MJ, et al. Low education and mental health among older adults: the mediating role of employment and income. Soc Psychiatry Psychiatr Epidemiol 2021:1-9.

Dalgard OS, Mykletun A, Rognerud M, et al. Education, sense of mastery and mental health: results from a nation wide health monitoring study in Norway. BMC psychiatry 2007;7(1):1-9.

Murrell SA, Salsman NL, Meeks S. Educational attainment, positive psychological mediators, and resources for health and vitality in older adults. J Aging Health 2003;15(4):591-615.

Stewart-Brown S, Samaraweera PC, Taggart F, et al. Socioeconomic gradients and mental health: implications for public health. Br J Psychiatry 2015;206(6):461-65.

Srivastava S, Purkayastha N, Chaurasia H, et al. Socioeconomic inequality in psychological distress among older adults in India: a decomposition analysis. BMC psychiatry 2021;21(1):1-15.

Andrade L, Caraveo‐Anduaga JJ, Berglund P, et al. The epidemiology of major depressive episodes: results from the International Consortium of Psychiatric Epidemiology (ICPE) Surveys. Int J Methods Psychiatr Res 2003;12(1):3-21.

Bromet E, Andrade LH, Hwang I, et al. Cross-national epidemiology of DSM-IV major depressive episode. BMC medicine 2011;9(1):1-16.

de Graaf R, Ten Have M, van Gool C, et al. Prevalence of mental disorders and trends from 1996 to 2009. Results from the Netherlands Mental Health Survey and Incidence Study-2. Soc Psychiatry Psychiatr Epidemiol 2012;47(2):203-13.

Lorant V, Deliège D, Eaton W, et al. Socioeconomic inequalities in depression: a meta-analysis. Am J Epidemiol 2003;157(2):98-112.

Milner A, Blakely T, Disney G, et al. Do employment factors reduce the effect of low education on mental health? A causal mediation analysis using a national panel study. Int J Epidemiol 2018;47(5):1423-31.

Oakes JM, Kaufman JS. Methods in social epidemiology: John Wiley & Sons 2017.

Droomers M, Schrijvers CTM, Mackenbach J. Educational level and decreases in leisure time physical activity: predictors from the longitudinal GLOBE study. J Epidemiol Community Health 2001;55(8):562-68.

Clouston SA, Richards M, Cadar D, et al. Educational inequalities in health behaviors at midlife: Is there a role for early-life cognition? J Health Soc Behav 2015;56(3):323-40.

Cheval B, Sieber S, Guessous I, et al. Effect of early-and adult-life socioeconomic circumstances on physical inactivity. Med Sci Sports Exerc 2018;50(3):476-85.

Beenackers MA, Kamphuis CB, Giskes K, et al. Socioeconomic inequalities in occupational, leisure-time, and transport related physical activity among European adults: a systematic review. Int J Behav Nutr Phys Act 2012;9(1):116.

O’Donoghue G, Kennedy A, Puggina A, et al. Socio-economic determinants of physical activity across the life course: A" DEterminants of DIet and Physical ACtivity"(DEDIPAC) umbrella literature review. Plos One 2018;13(1):e0190737.

Kari JT, Viinikainen J, Böckerman P, et al. Education leads to a more physically active lifestyle: Evidence based on Mendelian randomization. Scand J Med Sci Spor 2020;30(7):1194-204.

Chekroud SR, Gueorguieva R, Zheutlin AB, et al. Association between physical exercise and mental health in 1· 2 million individuals in the USA between 2011 and 2015: a cross-sectional study. Lancet Psychiatr 2018;5(9):739-46.

Schuch FB, Vancampfort D, Firth J, et al. Physical activity and incident depression: a meta-analysis of prospective cohort studies. Am J Psychiatry 2018;175(7):631-48.

Boisgontier M, Orsholits D, von Arx M, et al. Adverse Childhood Experiences, Depressive Symptoms, Functional Dependence, and Physical Activity: A Moderated Mediation Model. J Phys Act Health 2020;17:79-799.

Choi KW, Chen C-Y, Stein MB, et al. Assessment of bidirectional relationships between physical activity and depression among adults: a 2-sample mendelian randomization study. JAMA Psychiat 2019;76(4):399-408.

De Sousa RAL, Rocha-Dias I, de Oliveira LRS, et al. Molecular mechanisms of physical exercise on depression in the elderly: a systematic review. Mol Biol Rep 2021;48(4):3853-62.

Kandola A, Ashdown-Franks G, Hendrikse J, et al. Physical activity and depression: Towards understanding the antidepressant mechanisms of physical activity. Neurosci Biobehav Rev 2019;107:525-39.

Read S, Grundy E, Foverskov E. Socio-economic position and subjective health and well-being among older people in Europe: a systematic narrative review. Aging Ment Health 2016;20(5):529-42.

Pinquart M, Sörensen S. Influences of socioeconomic status, social network, and competence on subjective well-being in later life: a meta-analysis. Psychol Aging 2000;15(2):187.

Börsch-Supan A, Brandt M, Hunkler C, et al. Data resource profile: the Survey of Health, Ageing and Retirement in Europe (SHARE). Int J Epidemiol 2013;42(4):992-1001.

Aartsen MJ, Cheval B, Sieber S, et al. Advantaged socioeconomic conditions in childhood are associated with higher cognitive functioning but stronger cognitive decline in older age. PNAS 2019;116(12):5478-86.

Copeland JR, Beekman AT, Braam AW, et al. Depression among older people in Europe: the EURODEP studies. World Psychiatry 2004;3(1):45.

Prince MJ, Reischies F, Beekman AT, et al. Development of the EURO–D scale–a European Union initiative to compare symptoms of depression in 14 European centres. Br J Psychiatry 1999;174(4):330-38.

Hyde M, Wiggins RD, Higgs P, et al. A measure of quality of life in early old age: the theory, development and properties of a needs satisfaction model (CASP-19). Aging Ment Health 2003;7(3):186-94.

Siegrist J, Wahrendorf M, Von Dem Knesebeck O, et al. Quality of work, well-being, and intended early retirement of older employees—baseline results from the SHARE Study. Eur J Public Health 2007;17(1):62-68.

United Nations Educational. International Standard Classification of Education 1997. UNESCO, Paris 2006

Cullati S, Kliegel M, Widmer E. Development of reserves over the life course and onset of vulnerability in later life. Nat Hum Behav 2018;2(8):551-58.

Cheval B, Orsholits D, Sieber S, et al. Relationship between decline in cognitive resources and physical activity. Health Psychol 2020;39(6):519-28.

Cheval B, Rebar AL, Miller MM, et al. Cognitive resources moderate the adverse impact of poor neighborhood conditions on physical activity. Prev Med 2019;126:105741.

de Souto Barreto P, Cesari M, Andrieu S, et al. Physical activity and incident chronic diseases: a longitudinal observational study in 16 European countries. Am J Prev Med 2017;52(3):373-78.

Baranyi G, Sieber S, Cullati S, et al. The longitudinal associations of perceived neighborhood disorder and lack of social cohesion with depression among adults aged 50 years or older: An individual-participant-data meta-analysis from 16 high-income countries. Am J Epidemiol 2020;189(4):343-53.

Jürges H. Health inequalities by education, income and wealth: a comparison of 11 European countries and the US. Appl Econ Lett 2010;17(1):87-91.

Breeze E, Jones D, Wilkinson P, et al. Area deprivation, social class, and quality of life among people aged 75 years and over in Britain. Int J Epidemiol 2005;34(2):276-83.

von Soest T, Hagtvet KA. Mediation analysis in a latent growth curve modeling framework. Struct Equ Modeling 2011;18(2):289-314.

Littlefield AK, Sher KJ, Wood PK. Do changes in drinking motives mediate the relation between personality change and “maturing out” of problem drinking? J Abnorm Psychol 2010;119(1):93.

Seltzer M, Choi K, Thum YM. Examining relationships between where students start and how rapidly they progress: Using new developments in growth modeling to gain insight into the distribution of achievement within schools. Educ Eval Policy Anal 2003;25(3):263-86.

Maydeu-Olivares A. Maximum likelihood estimation of structural equation models for continuous data: Standard errors and goodness of fit. Struct Equ Modeling 2017;24(3):383-94.

Rosseel Y. lavaan: An R package for structural equation modeling. J Stat Softw 2012;48:1-36.

Cheong J, MacKinnon DP, Khoo ST. Investigation of mediational processes using parallel process latent growth curve modeling. Struct Equ Modeling 2003;10(2):238-62.

MacKinnon DP. Introduction to statistical mediation analysis: Routledge 2012.

Prince SA, Adamo KB, Hamel ME, et al. A comparison of direct versus self-report measures for assessing physical activity in adults: a systematic review. Int J Behav Nutr Phys Act 2008;5(1):56.

Cullati S, Kliegel M, Widmer E. Development of reserves over the life course and onset of vulnerability in later life. Nat Hum Behav 2018:1.

Hällsten M, Thaning M. Wealth as one of the “big four” SES dimensions in intergenerational transmissions. Soc Forces 2022;100(4):1533-60.

Lochner L. Non-production benefits of education: Crime, health, and good citizenship. 2011

Brunello G, Fort M, Schneeweis N, et al. The causal effect of education on health: What is the role of health behaviors? Health Econ 2016;25(3):314-36.

Ross CE, Wu C-l. The links between education and health. Am Sociol Rev 1995:719-45.

Cheval B, Saoudi I, Maltagliati S, et al. Initial status and change in cognitive function mediate the association between academic education and physical activity in adults over 50 years of age. preprint

Henriques A, Silva S, Severo M, et al. Socioeconomic position and quality of life among older people: The mediating role of social support. Prev Med 2020;135:106073.

Downloads

Posted

2022-12-01