A Longitudinal Investigation of Anxiety and Depressive Symptomatology and Exercise Behaviour Among Adults With Type 2 Diabetes Mellitus

Can J Diabetes. 2017 Feb;41(1):73-81. doi: 10.1016/j.jcjd.2016.07.006. Epub 2016 Sep 30.


Objectives: Evidence suggests that symptoms of depression and anxiety predict lower exercise behaviour and, inversely, that less exercise predicts higher symptomatology. The present longitudinal study examined this reciprocal association in adults with type 2 diabetes mellitus. We predicted that symptoms of anxiety or depression would intensify over time as a consequence of lower exercise frequency and, similarly, that exercise frequency would decrease as a consequence of greater symptoms of anxiety or depression.

Methods: We studied 1691 adults with type 2 diabetes who provided baseline measures in 2011 and 2 subsequent annual assessments (Follow-up 1 and Follow-up 2). Symptoms of depression and anxiety were measured using the Patient Health Questionnaire-9 and the Generalized Anxiety Disorder-7, respectively. A single item assessed exercise frequency in the past month (in days).

Results: Separate 3-wave cross-lagged path models for symptoms of anxiety and depression tested the reciprocal associations. Contrary to our hypotheses, the reciprocal associations were not supported and, by extension, the predicted secondary associations were not tested. In sum, only depressive symptoms negatively predicted subsequent exercise frequency (Follow-up 1 and Follow-up 2).

Conclusions: Symptoms of depression were prospectively associated with lower exercise frequency, which is consistent with evidence from population-based studies that identify depressive symptoms as a barrier to exercise participation.

Keywords: anxiety; anxiété; depression; diabète sucré de type 2; dépression; exercise frequency; fréquence de l'exercice physique; type 2 diabetes mellitus.

MeSH terms

  • Adult
  • Aged
  • Anxiety / diagnosis
  • Anxiety / epidemiology
  • Anxiety / psychology*
  • Cohort Studies
  • Cross-Sectional Studies
  • Depression / diagnosis
  • Depression / epidemiology
  • Depression / psychology*
  • Diabetes Mellitus, Type 2 / diagnosis
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / psychology*
  • Exercise / physiology
  • Exercise / psychology*
  • Female
  • Follow-Up Studies
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Prospective Studies