Employment status, depressive symptoms, and waist circumference change in midlife women: the Study of Women's Health Across the Nation (SWAN).
OBJECTIVE
Changes in employment status have shown inconsistent associations with adiposity. This study tested whether the presence of elevated depressive symptoms explains variability in the time-varying association between employment status and central adiposity.


METHODS
Employment status, depressive symptoms, and waist circumference (WC) were assessed annually over 10 years in a multiethnic sample of 3220 midlife women enrolled in the Study of Women's Health Across the Nation. Linear mixed-effects models tested time-varying associations of employment status, depressive symptoms, and their interaction with WC.


RESULTS
WC increases were greatest during the years of combined nonemployment and elevated depressive symptoms (1.00 cm/y) and lowest in the years of full-time employment and elevated depressive symptoms (0.25 cm/y), compared with the years of full-time employment and nonelevated depressive symptoms (0.51 cm/y). Employment status was unrelated to WC in years without elevated depressive symptoms. The pattern of results was unchanged when analyses were restricted to preretirement observations and did not vary according to WC at baseline or ethnicity/race.


CONCLUSIONS
Identifying and managing depressive symptoms in midlife women who are not working may help prevent increases in central adiposity.
Department of Preventive Medicine, Rush University Medical Center, Chicago, IL; Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL. Electronic address: brad_appelhans@rush.edu.
Bradley M
BM
Appelhans
Department of Preventive Medicine, Rush University Medical Center, Chicago, IL.
Eisuke
E
Segawa
Department of Preventive Medicine, Rush University Medical Center, Chicago, IL.
Imke
I
Janssen
Department of Preventive Medicine, Rush University Medical Center, Chicago, IL; Department of Internal Medicine, Rush University Medical Center, Chicago, IL.
Rasa
R
Kazlauskaite
Department of Psychiatry, University of Pittsburgh, PA; Department of Epidemiology, University of Pittsburgh, PA.
Rebecca C
RC
Thurston
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA.
Tené T
TT
Lewis
Department of Preventive Medicine, Rush University Medical Center, Chicago, IL; Department of Psychiatry, Rush University Medical Center, Chicago, IL.
Howard M
HM
Kravitz
D050154:Adiposity; D000328:Adult; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D004651:Employment / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008593:Menopause / Q000502:physiology / Q000523:psychology*; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D014481:United States; D055105:Waist Circumference; D016387:Women's Health
Adiposity; Depression; Employment; Waist circumference; Women's Health