Association of impaired sleep, depressive symptoms and pain with physical activity and exercise intervention adherence

Abstract

Background Physical activity (PA) and exercise interventions are beneficial for health and can reduce dementia risk. However, there might be barriers to engage in PA, such as sleep problems, depressive symptoms and pain, which are common complaints with older adults. We investigated the association between sleep duration, sleep quality, depressive symptoms, and pain with adherence to exercise intervention and self-reported PA in a 2-year randomized controlled trial using multidomain lifestyle intervention (post-hoc analyses). Methods The FINGER trial included 1259 individuals at risk for dementia, aged 60–77 years who were randomized (1:1) to a multidomain lifestyle intervention (exercise, diet, cognitive training, vascular risk factor management) or a control (regular health advice) group. Logistic regression analyses were used with exercise adherence (adherent: ≥66% participation) or self-reported PA (active: ≥2 times/week) as outcomes, adjusted for relevant baseline characteristics. Data on PA at baseline and at 2-years were available for 1100 participants. Results The intervention group participants sleeping < 6h or ≥ 9h per night were less likely to be adherent compared with the participants sleeping ≥ 7–<8h, (OR 0.46, 95% CI 0.21–0.99 and OR 0.38, 95% CI 0.20–0.74, respectively). The intervention group participants were more likely to be physically active than those in the control group at two years. This intervention benefit did not significantly differ by baseline sleep duration, depressive symptoms, or pain (p > 0.3 for all interactions). Regardless of randomization group, those sleeping < 6h were less likely to be physically active at two years, compared with participants sleeping ≥ 7–<8h (OR 0.36, 95% CI 0.18–0.72). Depressive symptoms or pain were not related to PA at two years. Conclusions Older adults with sleep problems, depressive symptoms or pain may benefit from lifestyle interventions. However, both short and long sleep duration can be barriers to engaging in exercise intervention and should be taken into consideration when aiming to promote PA among older populations at risk of dementia. Trial registration: The FINGER trial was registered at ClinicalTrials.gov with identifier NCT01041989.