Age-varying associations between physical activity and psychological outcomes among rural cancer survivors
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Age‑varying associations between physical activity and psychological outcomes among rural cancer survivors Nishat Bhuiyan1 · Ashley N. Linden‑Carmichael3 · Stephanie T. Lanza2,3 · Kathryn H. Schmitz4 · Scherezade K. Mama1,5
Received: 4 March 2020 / Accepted: 25 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract We examined the prevalence of psychological outcomes (i.e., symptoms of depression and anxiety) by age and age-varying associations between physical activity and psychological outcomes among rural cancer survivors. Participants (N = 219; ages 22–93) completed sociodemographic, psychological, and physical activity questionnaires. Time-varying effect models estimated the prevalence of psychological outcomes and assessed associations between physical activity and psychological outcomes as a flexible function of age. Depression and anxiety symptoms decreased with age among cancer survivors aged 22–40 years and were relatively stable across age among those > 40 years. Positive associations between vigorous physical activity and psychological outcomes in those aged 22–40 years were identified. In those > 70–80 years, there were negative associations between vigorous physical activity and psychological outcomes. Results suggest there is variation across age in the associations between physical activity and psychological Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10865-020-00187-6) contains supplementary material, which is available to authorized users. * Nishat Bhuiyan [email protected] 1
Department of Kinesiology, The Pennsylvania State University, 23B Recreation Building, University Park, PA 16802, USA
2
Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA
3
Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, PA, USA
4
Department of Public Health Sciences, College of Medicine, The Pennsylvania State University, Hershey, PA, USA
5
Penn State Cancer Institute, Hershey, PA, USA
outcomes among rural survivors. Future research should further explore these age-varying relationships to identify important intervention targets. Keywords Physical activity · Cancer survivorship · Depression · Anxiety · Rural health disparities
Introduction When compared to their urban counterparts, rural populations in the United States (U.S.) face an increased burden of cancer across the cancer care continuum (McCullough & Flowers, 2018; Yao, 2015). Although the overall incidence rates of cancer are higher in urban areas than in rural areas, rural populations face higher cancer mortality rates (180 deaths per 100,000 individuals in rural areas vs. 158 deaths per 100,000 individuals in urban areas), with the differences in mortality rates between rural and urban populations increasing over time (Henley et al., 2017). Despite an overall nationwide reduction in cancer death rates, the decrease in cancer death rates in rural populations h
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