TY - JOUR
T1 - 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
T2 - a cohort study
AU - Hernandez, Marta H.
AU - Fornara, Eleonora
AU - Lassale, Camille
AU - Castañer-Niño, Olga
AU - Estruch, Ramón
AU - Ros, Emilio
AU - Martínez-González, Miguel Ángel
AU - Corella, Dolores
AU - Babio, Nancy
AU - Lapetra, José
AU - Gómez-Gracia, Enrique
AU - Arós, Fernando
AU - Fiol, Miquel
AU - Serra-Majem, Lluís
AU - Riera-Mestre, Antonio
AU - Gea, Alfredo
AU - Ortega-Azorín, Carolina
AU - Díaz-López, Andrés
AU - Fitó, Montserrat
AU - Hernáez, Álvaro
N1 - Publisher Copyright:
© The Author(s) 2025. Published by Oxford University Press on behalf of the British Geriatrics Society.
PY - 2025/4/1
Y1 - 2025/4/1
N2 - 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.
AB - 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.
KW - Mediterranean diet
KW - Anxiolytics
KW - Leisure-time physical activity
KW - Antipsychotics
KW - Antiseizure drugs
KW - Antidepressants
KW - Older people
UR - http://www.scopus.com/inward/record.url?scp=105002740658&partnerID=8YFLogxK
U2 - 10.1093/ageing/afaf088
DO - 10.1093/ageing/afaf088
M3 - Article
AN - SCOPUS:105002740658
SN - 0002-0729
VL - 54
JO - Age and ageing
JF - Age and ageing
IS - 4
M1 - afaf088
ER -
