The Impact of Physical Activity and Sleep Quality on Risk of Anxiety and Depression across Cognitive Statuses in Older Adults
Bibliographic record
Abstract
BACKGROUND: Anxiety and depression are common among individuals with mild cognitive impairment (MCI) and dementia. These conditions are associated with accelerated cognitive decline, increased caregiver burden, and reduced quality of life. Given the adverse effects of pharmacological treatments, non-pharmacological approaches are gaining attention. Physical activity and sleep quality have shown promise in reducing the risk of anxiety and depression, but their potential benefits remain largely underexplored in people with cognitive impairment. The objective here is to explore the effects of these modifiable risk factors on the likelihood of screening positive for anxiety and depression across different levels of cognitive status in older adults. METHOD: This is a secondary analysis of the Comprehensive Assessment of Neurodegeneration and Dementia (COMPASS-ND) study. Physical activity and sleep quality were assessed using the Physical Activity Scale for the Elderly (PASE) and the Pittsburgh Sleep Quality Index (PSQI), respectively. Anxiety and depression symptoms were assessed using the Generalized Anxiety Disorder 7-item (GAD-7) and the Geriatric Depression Scale (GDS), with cutoff scores of GAD-7 ≥ 5 and GDS ≥ 10 indicating at least mild anxiety and depression, respectively. Logistic regression models with backward selection of covariates were used to explore the presence of these conditions. RESULT: The study included 956 participants with no cognitive impairment (CU, n = 150), subjective cognitive impairment (SCI, n = 116), mild cognitive impairment (MCI, n = 460), or dementia (n = 230). In regression analyses, physical activity (PASE score) was associated with lower odds of anxiety (p = 0.007) and depression (p = 0.038); however, this association did not vary across cognitive status levels. In contrast, sleep disturbances (PSQI score) were strongly associated with increased odds of both anxiety (p < 0.001) and depression (p = 0.001), with the effect on depression being particularly pronounced among individuals with dementia (PSQI * dementia interaction, p = 0.014). CONCLUSION: This study suggests that both sleep quality and physical activity may be protective factors against anxiety and depressive symptoms among older adults with varying levels of cognitive impairment. Future research should examine the effects of physical activity and/or sleep interventions on anxiety and depression among people with mild cognitive impairment and dementia.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".