title: Relationship of the perceived social and physical environment with mental health-related quality of life in middle-aged and older adults: mediating effects of physical activity.
abstract: BACKGROUND
  Mental health conditions are among the leading non-fatal diseases in middle-aged and older adults in Australia. Proximal and distal social environmental factors and physical environmental factors have been associated with mental health, but the underlying mechanisms explaining these associations remain unclear. The study objective was to examine the contribution of different types of physical activity in mediating the relationship of social and physical environmental factors with mental health-related quality of life in middle-aged and older adults.
  
  
  METHODS
  Baseline data from the Wellbeing, Eating and Exercise for a Long Life (WELL) study were used. WELL is a prospective cohort study, conducted in Victoria, Australia. Baseline data collection took place in 2010. In total, 3,965 middle-aged and older adults (55-65 years, 47.4% males) completed the SF-36 Health Survey, the International Physical Activity Questionnaire, and a questionnaire on socio-demographic, social and physical environmental attributes. Mediation analyses were conducted using the MacKinnon product-of-coefficients test.
  
  
  RESULTS
  Personal safety, the neighbourhood physical activity environment, social support for physical activity from family or friends, and neighbourhood social cohesion were positively associated with mental health-related quality of life. Active transportation and leisure-time physical activity mediated 32.9% of the association between social support for physical activity from family or friends and mental health-related quality of life. These physical activity behaviours also mediated 11.0%, 3.4% and 2.3% respectively, of the relationship between the neighbourhood physical activity environment, personal safety and neighbourhood social cohesion and mental health-related quality of life.
  
  
  CONCLUSIONS
  If these results are replicated in future longitudinal studies, tailored interventions to improve mental health-related quality of life in middle-aged and older adults should use a combined strategy, focusing on increasing physical activity as well as social and physical environmental attributes.
authors: Research Foundation Flanders, Egmontstraat 5, 1000 Brussels, Belgium; Ghent University, Department of Movement and Sports Sciences, Watersportlaan 2, 90000 Ghent, Belgium.
authors: Delfien
authors: D
authors: Van Dyck
authors: Deakin University, Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, 221 Burwood Highway, Burwood, Victoria 3125, Australia.
authors: Megan
authors: M
authors: Teychenne
authors: Deakin University, Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, 221 Burwood Highway, Burwood, Victoria 3125, Australia.
authors: Sarah A
authors: SA
authors: McNaughton
authors: Ghent University, Department of Movement and Sports Sciences, Watersportlaan 2, 90000 Ghent, Belgium.
authors: Ilse
authors: I
authors: De Bourdeaudhuij
authors: Deakin University, Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, 221 Burwood Highway, Burwood, Victoria 3125, Australia.
authors: Jo
authors: J
authors: Salmon
mesh_terms: D000368:Aged; D001315:Australia; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009043:Motor Activity; D011446:Prospective Studies; D011788:Quality of Life; D012931:Social Environment; D012959:Socioeconomic Factors