Preprint / Version 1

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



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



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


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. 


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