Meeting the WHO Physical Activity Guidelines is Associated With Lower Odds of Depression in Older Adults: Potential Psychosomatic Mechanisms

•What is the primary question addressed by this study?To what extent do psychosomatic mechanisms mediate the association between meeting physical activity guidelines and depressive symptoms in old age?•What is the main finding of this study?Meeting the WHO-recommended physical activity guidelines (i.e., performing ≥600 MET-min/wk) was associated with a 16% lower rate of having depressive symptoms among older adults in the sub-Saharan African context, where research on this topic is limited. This association was partially explained by several psychosomatic factors, including loneliness, sleep problems, functional limitations, and pain.•What is the meaning of the finding?Policy and public health efforts to prevent or manage depressive symptoms among older people through physical activity should exclusively consider several psychosomatic interventions. Limited data exist on the association between physical activity (PA) and depression in older adults from low- and middle-income countries (LMICs). In this study, we examine the association between meeting the World Health Organization (WHO) PA guidelines and depression in adults aged ≥50 years in Ghana and investigate the psychosomatic factors explaining this association. Cross-sectional data from the Aging, Health, Psychological Well-being, and Health-seeking Behavior Study in Ghana (2016–18) were analyzed. Depression was assessed with the Center for Epidemiological Studies Depression Scale (CES-D-10). PA was assessed using the International Physical Activity Questionnaire Short Form (IPAQ-SF). Multivariable logistic regression and Hayes PROCESS macro with bootstrapping mediation analyses were performed to evaluate the hypothesized associations. The study included 1201 individuals (mean [SD] age 66.1 [11.9] years; 63.3% women). The prevalence of meeting PA guidelines and depression was 36.7% and 29.5%, respectively. Meeting the WHO-recommended PA guidelines was associated with a 16% lower rate of developing depression even after adjusting for potential confounders (OR = 0.84, p