Effects of activity participation and cognitive levels on depression in middle-aged and older adults with chronic illness: a national cross-sectional study

Binary logistic regression results showed that among middle-aged and older adults (age ≥ 50 years) with chronic diseases, participation in physical activity [OR = 1.397; 95% CI (1.181-1.651); <i>p</i> < 0.05] was more effective than participation in social activities [OR = 0.997; 95% CI (0.924-1.076); <i>p</i> < 0.05] for preventing depression. Those with cognitive impairment [OR = 1.206; 95% CI (1.089-1.335); <i>p</i> < 0.05] were more likely to experience depression than those without cognitive impairment. Activity participation (physical activity and social activity) had a more significant effect on mild and moderate depression compared to no depression, and cognitive level had a more pronounced effect on moderate depression [OR = 1.491; 95% CI (1.278-1.740); <i>p</i> < 0.05] and major depression [OR = 2.231; 95% CI (1.282-3.884); <i>p</i> < 0.05]. Within the specific cohort of middle-aged and older adults (age ≥ 50 years) with chronic diseases, both activity participation and cognitive level exert a significant influence on the prevention and intervention of depression. Engagement in physical activity, participation in social activities, and enhanced cognitive functioning emerged as protective factors against depression. Therefore, the policy-maker should strengthen the prevention and treatment of depression in a comprehensive manner through the promotion of physical and social activities and the enhancement of cognitive level, so as to safeguard the mental health of middle-aged and older adults with chronic diseases.