Original Research ARTICLE
Longitudinal associations of modifiable lifestyle factors with positive depression-screen over 2.5-years in an international cohort of people living with multiple sclerosis
- 1Neuroepidemiology Unit, Melbourne School of Population and Global Health, Australia
- 2Menzies Institute for Medical Research, University of Tasmania, Australia
- 3St Vincent's Hospital (Melbourne), Australia
- 4Centre for Health Equity, Melbourne School of Population and Global Health, Australia
Background: Depression is common and has the most significant impact on quality of life for many people with multiple sclerosis (MS). A preventive management approach via modification of lifestyle risk factors holds potential benefits. We examined the relationship of modifiable lifestyle factors and depression risk and the change in depression over 2.5 years.
Methods: Sample recruited using online platforms. 2,224 (88.9%) at baseline and 1,309 (93.4%) at 2.5 year follow up completed the necessary survey data. Survey data included depression risk, measured by the Patient Health Questionnaire-2 at baseline and Patient Health Questionnaire-9 at 2.5-year follow-up. Multivariable regression models assessed the relationships between lifestyle factors and depression risk, adjusted for sex, age, fatigue, disability, antidepressant medication use, and baseline depression score, as appropriate.
Results: The prevalence of depression risk at 2.5-year follow-up in this cohort was 14.5% using the PHQ-2 and 21.7% using the PHQ-9. Moderate alcohol intake, being a non-smoker, diet quality, no meat or dairy intake, vitamin D supplementation, omega 3 supplements, regular exercise, and meditation at baseline were associated with lower frequencies of positive depression-screen 2.5 years later. Moderate alcohol intake was associated with greater likelihood of becoming depression-free and a lower likelihood of becoming depressed at 2.5-year follow-up. Meditating at least once a week was associated with a decreased change in losing depression risk, against our expectation. After adjusting for potential confounders, smoking, diet, physical activity, and vitamin D and omega-3 supplementation were not associated with a change in risk for depression.
Conclusion: In a large prospective cohort study of people with MS and depression, in line with the emerging treatment paradigm of early intervention, these results suggest a role for some lifestyle factors in depression risk. Further studies should endeavour to explore the impact of positive lifestyle change and improving depression in people living with MS.
Keywords: Multiple Sclerosis, Epidemiology, Depression, lifestyle, Longitudinal, Cohort study [or longitudinal study]
Received: 31 Aug 2018;
Accepted: 04 Oct 2018.
Edited by:Andrea Fiorillo, Università degli Studi della Campania "Luigi Vanvitelli" Naples, Italy
Reviewed by:Anna Comparelli, Università degli Studi di Roma La Sapienza, Italy
Mauro Garcia-Toro, Balearic University
Copyright: © 2018 Simpson Jr, Taylor, Jelinek, Neate, De Livera, Brown, O'Kearney, Marck and Weiland. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Dr. Steve Simpson Jr, Neuroepidemiology Unit, Melbourne School of Population and Global Health, Carlton, 3010, Victoria, Australia, firstname.lastname@example.org