24-Hour Compositional Data Analysis on Women’s Psychological Health during the Menopause Transition

Menopause presents a challenging phase for midlife women, with changes in physical activity, sleep, body composition, and psychological symptoms often accompanying the change in menstrual patterns. We used compositional data analysis (CoDA) to investigate how predicted changes in the 24-hour activity cycle (24-HAC: sleep, sedentary behaviors, and physical activity) might benefit these challenges for menopausal midlife women. 112 midlife women (aged 52.85 ± 6.2 years) were assessed for demographics, 24-HAC time-use behaviors obtained by ActiGraph accelerometry, the Pittsburgh Sleep Quality Index, the Menopause-Specific Quality of Life (MENQOL) Questionnaire, the Center for Epidemiologic Studies Depression Scale, the Perceived Stress Scale, and body composition via dual-energy X-ray absorptiometry. CoDA analyzed predicted changes in menopausal and depressive symptoms, stress, and body composition, with 20-min time reallocations of behaviors in the 24-HAC. Estimated response curves were based on significant regressions with isometric log ratio coordinates of time-use composition, adjusted for age, with 95% CI. Significant R 2 changes were observed for the psychosocial domain of the MENQOL (adj R 2 = 0.063, p = .014), depressive symptoms (adj R 2 = 0.088, p = .003), and fat mass (adj R 2 = 0.054, p = .027). A predicted 20-min increase in MVPA and sleep, at the expense of LPA and sedentary time, was significantly associated with reduced psychological and depressive symptoms and fat mass, during menopause, with 95% CI. Reducing sedentary time and LPA, and reallocating time toward sleep and MVPA by 20 minutes a day, could improve psychological health and depressive symptoms. • Menopause presents a challenging phase for midlife women, with common reports of low physical activity rates, changes in body composition, disrupted sleep, and adverse psychological symptoms. However, the impact of the 24-hour activity cycle on mental health has yet to be investigated within this population. • 24-hour activity cycle models were observed for depressive symptoms from the Center for Epidemiologic Studies Depression Scale (CES-D), and the psychosocial domain of the Menopause-Specific Quality of Life (MENQOL) Questionnaire, but not for stress or the MENQOL domains of physical, vasomotor, or sexual symptoms, thus highlighting the unique role of psychological health during menopause. • Reducing sedentary time and LPA, and reallocating time toward sleep and MVPA, by 20 minutes a day, could improve psychological health and depressive symptoms for midlife women. • CoDA highlights a unique statistical approach and provides an evidence-based rationale for future PA interventions for targeted symptom improvement for women in the menopause transition.