Journal List > Korean J Adult Nurs > v.29(4) > 1096349

Kim and Hwang: Impact of Physical Activity, Central Obesity and Depression on the Quality of Life according to the Presence of Cardiovascular Risk among Menopausal Middle-aged Women: Secondary Data Analysis

Abstract

Purpose

This study was a secondary data analysis using the 6th Korea National Health and Nutritional Examination Survey 2014. The purpose of the study was to identify and compare the impacts of Physical Activity (PA), central obesity and depression on health-related quality of life (HRQoL). The study sample was post-menopausal women aged 45~65 years of aged with or without cardiovascular risk factors. Specifically, the sample consisted of 472 women who had cardiovascular risk factors (risk group) and 374 women with no reported risk factors (no risk group).

Methods

The degree of PA (MET-min/week) was estimated based on the International PA Questionnaire and depression was measured by the Patient Health Questionnaire-9.

Results

The scores from the PA were lower than the recommended PA scores among both groups, and muscle strengthening was significantly lower within the risk group compared to those in the no risk group (p<.001). Multiple linear regression analyses showed that depression, PA and WHtR accounted for 32.8% of the HRQoL in the risk group (R2=.328, F=64.49, p<.001), while depression and WHtR accounted for 28.5% of the HRQoL in the no risk group (R2=.256, F=35.18, p<.001).

Conclusion

It is essential to correct low PA, central obesity, and depression in order to improve the HRQoL of middle-aged women with cardiovascular risk factors. For those who have cardiovascular risk factors, the PA intervention program including muscle strengthening exercise might be needed.

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Figure 1.
Flow chart of the study sample.
kjan-29-382f1.tif
Figure 2.
Performance rate by type of physical activity according to cardiovascular disease risk factors.
kjan-29-382f2.tif
Table 1.
General Characteristics according to Cardiovascular Risk (N=846)
Variables Categories Risk group (n=472) Non-risk group (n=374) x2 or t p
n (%) or M± SE n (%) or M± SE)
Age (year) 59.92±0.32 56.95±0.35 7.48 <.001
Age at menopause 51.62±1.42 49.68±0.19 1.84 .177
Living with Spouse or children 373 (77.6) 307 (84.7) 32.70 <.001
Divorced/unmarried 96 (22.4) 65 (15.3)
Education Elementary school 235 (46.7) 107 (24.3) 172.28 <.001
Junior high school 94 (20.3) 75 (21.2)
High school 105 (25.0) 123 (36.2)
≥ College 38 (8.0) 68 (18.4)
Monthly household income 1st quartile 109 (21.1) 56 (13.6) 37.20 <.001
2nd quartile 153 (31.1) 106 (26.5)
3rd quartile 107 (23.3) 93 (25.5)
4th quartile 100 (24.5) 119 (34.4)
Occupation Professional 12 (3.4) 23 (7.1) 138.57 <.001
Clerk 13 (2.8) 11 (2.2)
Service or sales 70 (15.9) 65 (17.7)
Manual 134 (28.5) 91 (23.8)
Unemployed/housewives 243 (49.4) 183 (49.2)
Perceived health status Good 91 (18.8) 64 (25.3) 135.56 <.001
Moderate 241 (51.3) 212 (56.2)
Poor 140 (29.9) 64 (18.6)

n=unweighted count, %=weighted count.

Table 2.
Physical Activity, Central Obesity, Depression, and Quality of Life according to Cardiovascular Risk (N=846)
Variables Risk group (n=472) Non-risk group (n=374) x2 or t p
n (%) or M± SE n (%) or M± SE
PA (MET-min/week)
 Low (≤599) 230 (47.0) 172 (43.9) 0.53 .466
 Moderate (600~1,499) 134 (28.0) 109 (31.6)
 High (≥1,500) 108 (25.0) 93 (24.5)
WHtR 0.54±0.1 0.48±0.1 216.14 <.001
 ≥0.52 306 (61.7) 81 (27.9) 13.90 <.001
 <0.52 166 (38.3) 293 (72.1)
Systolic blood pressure (mmHg) 126.2±1.0 114.9±1.0 69.00 <.001
Diastolic blood pressure (mmHg) 77.4±0.6 73.3±0.5 28.33 <.001
Total cholesterol (mg/dL) 194.6±1.9 202.2±1.8 8.71 .040
HDL (mg/dL) 52.6±0.6 56.0±0.7 16.91 <.001
LDL (mg/dL) 122.1±4.6 127.4±5.9 0.48 .489
Triglyceride (mg/dL) 138.8±4.3 112.1±4.2 20.80 <.001
Fasting blood sugar (mg/dL) 105.9±1.3 95.1±0.9 45.71 <.001
HbA1c (%) 6.1±0.1 5.7±0.3 54.68 <.001
CVD risk factors
 Diabetes 78 (15.7) - - -
 Hypertension 243 (50.3) - - -
 Dyslipidemia 173 (33.3) - - -
 Angina, ESRD 50 (10.3) - - -
 BMI (≥25 kg/m2), Smoking 295 (63.3) - - -
Depression (PHQ-9≥10) 39 (8.6) 26 (6.6) 3.88 .186
3.3±0.2 3.1±0.3
EQ-5D score 0.90±0.1 0.94±0.1 9.89 .002
Smoking
 Current smoker 22 (5.2) - 302.52 <.001
 Ex-smoker or never 450 (94.8) 374 (100.0)
Alcohol drinking
 Daily 8 (2.0) 64 (17.6) 120.60 <.001
 ≥2/week 165 (18.0) 140 (38.2)
 <1/months 212 (36.1) 164 (42.4)
 None 212 (43.8) 6 (1.8)

PA=physical activity; PHQ=patient health questionnaire; CVD=cardiovascular disease; WHtR=waist to height ratio; BMI=body mass index; HDL=high-density lipoprotein; LDL=low-density lipoprotein; ESRD=endstage renal disease; MET=metabolic equivalent of task; SE=standard error; n=unweighted count; %=weighted count; EQ-5D score=EuroQol five dimensions questionnaire;

Multiple responses.

Table 3.
Predicting Factors on Quality of Life in Groups with or without Cardiovascular Risk (N=846)
Variable Categories Model 1 Model 2
B β t p B β t p
At Risk for CVD (n=472) (Constant) 1.05 13.11 <.001 1.18 14.59 <.001
Age -0.01 -.13 -2.82 .005 -0.03 -.10 -2.55 .011
Household income 1.21E-01 .59 1.30 .195 6.88E-01 .03 0.87 .383
Occupation(yes) 0.23 .13 2.84 .045 0.23 .08 2.01 .045
Physical activity (MET-min/week) 5.91E-06 .87 2.25 .025
Depression(PHQ-9) -0.18 -.52 -13.45 <.001
WHtR -0.19 -.08 -2.34 .044
R2=.05, F=7.43, p<.001 R2=.33, Δ R2=.282, F=64.49, p<.001
No Risk for CVD (n=374) (Constant) 0.92 12.05 <.001 1.16 14.37 <.001
Age -0.01 -.03 -0.64 .522 5.14E-005 .01 0.05 .963
Household income 4.96E-006 .15 2.88 .004 2.58E-006 .08 1.66 .097
Occupation (yes) 0.30 .12 2.36 .019 0.02 .09 1.90 .058
Physical activity (MET-min/week) -1.41E-006 -.02 -0.38 .704
Depression (PHQ-9) -0.01 -.46 -9.93 <.001
WHtR -0.46 -.16 -3.27 .001
R2=.04, F=5.07, p=.002 R2=.26, Δ R2=.216, F=35.18, p<.001

MET=metabolic equivalent of task(min/week); MET means physical activity from calculating physical activity using international physical activity questionnaire; PHQ=patient health questionnaire; WHtR=waist to height ratio. E=exponential.

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