Associations of Physical Activity Levels with Depressive Symptoms among Patients with Radiographic Axial Spondyloarthritis: A Cross-Sectional Study

Objective This study aimed to examine the associations between physical activity (PA) levels and depressive symptoms in patients with radiographic axial spondyloarthritis (r-axSpA). Methods We conducted a cross-sectional analysis of patients with r-axSpA identified from the UK Biobank. Total physical activity (TPA) was assessed using a modified version of the short-form International Physical Activity Questionnaire (IPAQ-SF), and leisure-time physical activity (LTPA) was derived from self-reported frequency and duration of five leisure activities during the preceding four weeks. Depressive symptoms were assessed using the Patient Health Questionnaire-2 (PHQ-2). Multivariable logistic regression models were used to examine the associations between PA levels and depressive symptoms. Results Among 1542 patients with r-axSpA, those engaging in moderate-level PA had the lowest prevalence of depressive symptoms. After full adjustment, moderate-level TPA was associated with lower odds of depressive symptoms compared with low-level TPA (OR 0.55; 95% CI 0.36-0.82), whereas the association for high-level TPA was not statistically significant (OR 0.63; 95% CI 0.39-1.01). Moderate-level LTPA was also associated with lower odds of depressive symptoms (OR 0.58; 95% CI 0.34-0.996), while low- and high-level LTPA showed no significant associations after full adjustment. Conclusion Moderate-level PA was associated with a lower prevalence of depressive symptoms in patients with r-axSpA, whereas associations for high-level PA were less consistent. Our findings suggest that PA levels may be an important correlate of depressive symptoms in patients with r-axSpA, warranting confirmation in longitudinal studies.