Acceso usuarios
Danilo Dias Santana, Andreia Alexandra Machado Miranda, Michele Santos da Cruz, Alex Antonio Florindo
Background and objectives Depression and anxiety are leading causes of disability worldwide, however longitudinal data from low- and middle-income countries (LMICs) are scarce. This study aimed to examine trends and associated factors of depression and anxiety over a 10-year period in a Brazilian urban cohort.
Methods Data from the prospective cohort ‘Health Survey of Sao Paulo: Physical Activity and Environment’ were used. Participants (n = 978) were assessed in 2014-15, 2020-21, and 2023-24. Sociodemographic, health and physical activity-related characteristics, as well as self-reported measures of depression and anxiety, were investigated through a structured questionnaire. Associations were examined using hierarchical logistic regression models.
Results The prevalence of depression increased from 4.2 % in 2014-15 to 15.3 % in 2023-24, while anxiety increased from 10.1 % to 28.9 %. Women consistently showed three- to fourfold higher odds of both mental health conditions compared to men. Poor sleep quality was strongly associated with two- to fivefold higher odds depression and anxiety across waves. Presence of comorbidities and obesity were also associated with higher depression and anxiety prevalences. Leisure-time physical activity was inversely associated with depression in 2014-15. Participants who used bicycles for transportation were the only subgroup in which depression and anxiety prevalence did not increase significantly.
Conclusions This 10-year cohort study highlights a substantial increase in depression and anxiety in São Paulo. The protective associations of physical activity with mental health conditions reinforces the importance of promoting active lifestyles. The longitudinal design of the study and recent data collection in 2023-24 offer updated and representative insights for LMICs.
