Adherence to a Mediterranean diet and leisure-time physical activity are associated with reduced initiation of antidepressant, anxiolytic, antipsychotic and antiseizure drug use in older adults: a cohort study

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  • dc.contributor.author Hernández, Marta H.
  • dc.contributor.author Fornara, Eleonora
  • dc.contributor.author Lassale, Camille
  • dc.contributor.author Castañer, Olga
  • dc.contributor.author Estruch, Ramón
  • dc.contributor.author Ros, Emilio
  • dc.contributor.author Martínez-González, Miguel Ángel, 1957-
  • dc.contributor.author Corella, Dolores
  • dc.contributor.author Babio, Nancy
  • dc.contributor.author Lapetra, José
  • dc.contributor.author Gómez-Gracia, Enrique
  • dc.contributor.author Arós, Fernando
  • dc.contributor.author Fiol, Miquel
  • dc.contributor.author Serra-Majem, Luis
  • dc.contributor.author Riera-Mestre, Antoni
  • dc.contributor.author Gea, Alfredo
  • dc.contributor.author Ortega-Azorín, Carolina
  • dc.contributor.author Díaz López, Andrés
  • dc.contributor.author Fitó Colomer, Montserrat
  • dc.contributor.author Hernáez, Álvaro
  • dc.date.accessioned 2025-06-18T06:36:18Z
  • dc.date.available 2025-06-18T06:36:18Z
  • dc.date.issued 2025
  • dc.description.abstract Background: We explored how adherence to the Mediterranean diet (MedDiet) and leisure-time physical activity (LTPA) impact psychoactive medication use in older adults. Methods: We assessed the cumulative MedDiet adherence and LTPA's impact on mental health medication initiation in older individuals at high risk of chronic disease. Associations between the cumulative average of MedDiet adherence (per one-point increase in the adherence score) and LTPA (per increase in 20 metabolic equivalents of task-minute/day [METs-min/day]) with drug initiation were assessed by multivariable Cox regressions. We explored non-linear exposure-outcome associations using smoothed cubic splines and the multiplicative interaction between MedDiet and LTPA. Results: A total of 5940-6896 participants (mean age 67, 58% women) over 4.2-4.7 years, each point increase in MedDiet adherence decreased the initiation of antidepressants by 23-28% (HR 0.72, 95% CI 0.67-0.77), anxiolytics (HR 0.75, 0.70-0.81), antipsychotics (HR 0.77, 0.65-0.91), and antiseizures (HR 0.77, 0.69-0.85). Associations for anxiolytics and antiseizures were strong at low MedDiet adherence levels. Relationships between LTPA and initiation of antidepressants and anxiolytics were linear in the lowest LTPA values (0-150 METs-min/day); every 20 METs-min/day increases were associated with 20% lower risk of initiating antidepressants (HR 0.80, 0.75-0.86) and 15% less risk in anxiolytics (HR 0.85, 0.79-0.90). Association with antiseizures was linear (+20 METs-min/day: HR 0.96, 0.94-0.99), and no associations were found for antipsychotics. High MedDiet adherence (≥10) and LTPA (≥150 METs-min/day) reduced psychoactive drug initiation by 42%-59%. Combination was additive for antidepressants, antipsychotics and antiseizures and synergistic for anxiolytics. Conclusions: MedDiet and LTPA adherence reduced psychoactive drugs initiation in older adults.
  • dc.format.mimetype application/pdf
  • dc.identifier.citation Hernandez MH, Fornara E, Lassale C, Castañer-Niño O, Estruch R, Ros E, et al. Adherence to a Mediterranean diet and leisure-time physical activity are associated with reduced initiation of antidepressant, anxiolytic, antipsychotic and antiseizure drug use in older adults: a cohort study. Age Ageing. 2025 Mar 28;54(4):afaf088. DOI: 10.1093/ageing/afaf088
  • dc.identifier.doi http://dx.doi.org/10.1093/ageing/afaf088
  • dc.identifier.issn 0002-0729
  • dc.identifier.uri http://hdl.handle.net/10230/70710
  • dc.language.iso eng
  • dc.publisher Oxford University Press
  • dc.relation.ispartof Age Ageing. 2025 Mar 28;54(4):afaf088
  • dc.rights © The Author(s) 2025. Published by Oxford University Press on behalf of the British Geriatrics Society. This is an Open Access article distributed under the terms of the Creative Commons Attribution NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
  • dc.rights.accessRights info:eu-repo/semantics/openAccess
  • dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
  • dc.subject.keyword Mediterranean diet
  • dc.subject.keyword Antidepressants
  • dc.subject.keyword Antipsychotics
  • dc.subject.keyword Antiseizure drugs
  • dc.subject.keyword Anxiolytics
  • dc.subject.keyword Leisure-time physical activity
  • dc.subject.keyword Older people
  • dc.title Adherence to a Mediterranean diet and leisure-time physical activity are associated with reduced initiation of antidepressant, anxiolytic, antipsychotic and antiseizure drug use in older adults: a cohort study
  • dc.type info:eu-repo/semantics/article
  • dc.type.version info:eu-repo/semantics/publishedVersion

Col·leccions

Articles (Barcelona Institute for Global Health (ISGlobal) – Campus Mar)
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