Key result
Higher physical activity is linked to ~47% lower anxiety risk in patients with non-communicable diseases.
Why the study?
Quarantine due to the COVID-19 pandemic may have created great psychological stress among vulnerable populations with non-communicable diseases, but the prevalence of anxiety and its association with physical activity during lockdown were unclear.
Does moderate or high physical activity reduce the prevalence of anxiety in patients with hypertension and/or diabetes during COVID-19 lockdown?
Cross-Sectional (n=4,877)
Does moderate or high physical activity reduce the prevalence of anxiety in patients with hypertension and/or diabetes during COVID-19 lockdown?
Odds Ratio: 0.53 (95% CI 0.44–0.64)
p-value: p=<0.001
Moderate to high physical activity, particularly housework and trip activities, is associated with a lower prevalence of anxiety in patients with hypertension and diabetes during pandemic lockdowns.
May support physical activity promotion to ease anxiety in NCD patients during lockdowns; hypothesis-generating and needs prospective trials.
BACKGROUND: Quarantine due to the COVID-19 pandemic may have created great psychological stress among vulnerable populations. We aimed to investigate the prevalence of anxiety and explore the association between physical activities (PA) and anxiety risk in people with non-communicable diseases during the period of COVID-19 lockdown. METHODS: We conducted a cross-sectional telephone survey from February 25 to April 20, 2020, the period of COVID-19 lockdown in Shanghai. Up to 8000 patients with type 2 diabetes and/or hypertension were selected using multi-stage cluster random sampling. PA level was measured based on the International Physical Activity Questionnaire using Metabolic Equivalent for Task scores, while symptoms of anxiety were assessed by the 7-item Generalized Anxiety Disorder scale. Multiple logistic regression analyses were performed to evaluate the associations of type and level of PA with the risk of anxiety. RESULTS: Of a total 4877 eligible patients, 2602 (53.4%) reported with anxiety, and 2463 (50.5%), 123 (2.5%) and 16 (0.3%) reported with mild, moderate, and severe anxiety. The prevalence of anxiety was higher in the females, the elders, non-smokers, non-drinkers, and patients with diabetes, and the associations of anxiety with sex, age, smoking, drinking and diagnosis of diabetes were significant. A significant negative association was observed for housework activities (OR 0.53, 95%CI: [0.45, 0.63], p < 0.001) and trip activities (OR 0.55, 95%CI: [0.48, 0.63], p < 0.001) with anxiety, but no significant was found for exercise activities (OR 1.06, 95%CI: [0.94, 1.20], p = 0.321). Compared with patients with a low PA level, those with a moderate (OR 0.53, 95%CI: [0.44, 0.64], p < 0.001) or a high PA level (OR 0.51, 95%CI: [0.43, 0.51], p < 0.001) had a lower prevalence of anxiety. CONCLUSION: This study demonstrates a higher prevalence of anxiety in patients with hypertension, diabetes, or both during the COVID-19 lockdown. The negative associations of housework and trip activities with anxiety highlight the potential benefit of PA among patients with non-communicable diseases.
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Li et al. (2023) conducted a cross-sectional in Type 2 diabetes and/or hypertension (n=4,877). Moderate physical activity vs. Low physical activity (< 600 MET min/week) was evaluated on Prevalence of anxiety (GAD-7 score ≥ 5) (OR 0.53, 95% CI 0.44-0.64, p=<0.001). Moderate and high levels of physical activity were associated with a significantly lower risk of anxiety compared to low physical activity (OR 0.53 and 0.51, respectively) among patients with non-communicable diseases during COVID-19 lockdown.
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