title: Association between physical activity and major depressive disorder among current or former smokers with pulmonary disease.
abstract: OBJECTIVE
  To examine the association between physical activity and major depressive disorder (MDD) in a nationally representative sample of current or former smokers with pulmonary impairments.
  
  
  METHODS
  The analyzed sample from the National Health and Nutrition Examination Survey (NHANES) 2007-2010 included 536 adults who indicated that they were current or former smokers, had at least mild pulmonary impairment (FEV1/FVC<0.70), and provided depression and physical activity data.
  
  
  RESULTS
  After controlling for asthma status, pulmonary impairment, age, poverty-to-income ratio (PIR), education, gender, marital status, body mass index (BMI), cotinine, comorbidity index, race-ethnicity, and smoking status, those who met physical activity guidelines had a 59% (odds ratio (OR)=0.41; 95% confidence interval (CI): 0.18-0.94) lower odds of having MDD. Using multivariate linear regression with depression symptoms as the outcome variable, and after adjustments, physical activity was inversely associated with depression symptoms in a dose-response manner; lowest tertile was the referent group, middle tertile coefficient: -1.06 (95% CI: -1.98 to -0.14), and highest tertile coefficient: -1.10 (95% CI: -1.84 to -0.34).
  
  
  CONCLUSIONS
  Physical activity inversely associates with MDD in adults with pulmonary impairments, and does so in a dose-response manner. This suggests that individuals with pulmonary impairments should be encouraged to engage in enjoyable, safe forms of physical activity in a progressive manner.
authors.affiliation: Department of Exercise Science, Lansing School of Nursing and Health Sciences, Bellarmine University, Louisville, KY 40205, USA. Electronic address: ploprinzi@bellarmine.edu.
authors.forename: Paul D
authors.initials: PD
authors.lastname: Loprinzi
authors.forename: Christy
authors.initials: C
authors.lastname: Kane
authors.forename: Jerome F
authors.initials: JF
authors.lastname: Walker
mesh_terms: D015897:Comorbidity; D003865:Major Depressive Disorder / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D019983:Guideline Adherence; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009749:Nutrition Surveys; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology*; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation / Q000706:statistics & numerical data*; D013223:Statistics as Topic; D014481:United States
keywords: Depression; Epidemiology; Exercise; Lung disease