WITHDRAWN: The effects of community built environment and physical activity of varying intensity and purpose on depressive trajectories among middle-aged and elderly: a national longitudinal study based on latent growth curve modeling

Abstract

Background The effects of physical activity (PA) with different purposes and intensities on depression are inconclusive, while it is critical to incorporate the contextual community built environment (CBE) into longitudinal reviews of the effects of PA on depression. Methods This longitudinal study included 5993 middle-aged and elderly people from the China Health and Retirement Longitudinal Study, a CBE evaluation indicator system was developed based on the community questionnaire to measure physical built environment attributes for each community. Using latent growth curve modeling to evaluate 3 waves of cohort data (2015–2020) to explore the differential effects of PA with different purposes and intensities on depression and the impact of CBE among them. Results The level of low-intensity PA for exercise and entertainment purposes showed a negative predictive effect on the initial level of depression among middle-aged and elderly people, while the level of moderate-to-vigorous-intensity PA for work purposes showed the opposite effect. In terms of depression trajectories, the initial level of PA for these two different purposes also has opposite effects on the initial level of depression. Among all CBE variables, only the infrastructure condition can significantly and negatively predict the initial level of depression (β=-0.11, p < 0.01). The infrastructure condition (β = 0.12, p < 0.001), diversity of elderly care facilities (β = 0.06, p < 0.05), and accessibility of public transport (β = 0.06, p < 0.01) can significantly and positively predict the initial level of low-intensity PA for exercise and entertainment purposes. The density of public facilities (β = 0.10, p < 0.05) significantly and positively predicts the rising changes in low-intensity PA for exercise and entertainment purposes. Conclusions The study identified the effects of different types of CBE on trajectories of depression and PA among middle-aged and elderly, expanding the insights into the "PA paradox" in the mental health field and emphasizing that the effect of PA on depression varies by purpose and intensity. The findings provide longitudinal evidence for health-promoting environmental planning and public health guidance.