Association between lifestyle factors and mental health measures among community-dwelling older women


  • School of Psychiatry and Clinical Neurosciences, University of Western Australia, Mail Delivery Point M573, 35 Stirling Highway, Crawley, Perth, 6009, Western Australia, Australia. Email:

    Leon Flicker, Professor of Geriatric Medicine

    School of Medicine and Pharmacology, University of Western Australia, Western Australia, Australia

Kellie Cassidy, Research Assistant; Ria Kotynia-English, Research Associate; John Acres, Statistical Consultant; Nicola T. Lautenschlager, Associate Professor of Geriatric Psychiatry; Osvaldo P. Almeida, Professor of Geriatric Psychiatry (Correspondence)


Objective:  To investigate the association between potentially modifiable lifestyle factors and cognitive abilities/depressive symptoms in community-dwelling women aged 70 years and over.

Method:  Cross-sectional study of community-dwelling women aged 70 years and over (n = 278; mean age = 74.6 years). Lifestyle variables assessed included smoking, alcohol consumption, physical activity, nutrition and education. The mental health measures of interest were depression, anxiety, quality of life and cognitive function, as assessed by the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), SF-36, and the Cambridge Cognitive Examination for Mental Disorders of the Elderly (CAMCOG), respectively.

Results:  Physically active women were half as likely to be depressed (BDI score ≥10) and anxious (BAI score ≥ 8) when compared to their physically inactive counterparts (OR = 0.5, 95% CI = 0.3−0.8 for both, adjusted for marital status and smoking in the case of depression). Having ever smoked more than 20 cigarettes per day was associated with increased risk of depression (OR = 2.8, 95% CI = 1.4−5.5, adjusted for marital status and physical activity). Moderate alcohol use was associated with increased likelihood of having a CAMCOG score within the highest 50 percentile (OR = 2.0, 95% CI = 1.1−3.5, adjusted for age and education), as was more than minimum statutory education (OR = 2.0, 95% CI = 1.1−3.5, adjusted for age and alcohol consumption). There was no obvious association between vitamin B12/folate deficiency or obesity with any of the measures of interest.

Conclusions:  The results of this study are consistent with the hypothesis that depression is directly associated with heavy smoking and inversely associated with physical activity. They also support the idea that non-harmful alcohol consumption is associated with better cognitive performance. Randomised clinical trials should be now designed to clarify whether management of lifestyle factors reduces the incidence of mood disorders and cognitive impairment in later life.