Physical activity and sedentary behavior in people with bipolar disorder: A systematic review and meta-analysis

- People with bipolar disorder engage in similar levels of physical activity compared to matched controls.
- People with bipolar disorder engage in high levels of sedentary behavior.
- Objectively assessed physical activity levels are lower than self-reported levels.
- Older age and a higher body mass index predict lower physical activity levels.

BackgroundMortality rates are approximately two to three times higher in people with bipolar disorder (BD) than in general population. Lack of physical activity (PA) and sedentary behavior (SB) are independent risk factors for cardiovascular disease and premature mortality.AimsWe conducted a meta-analysis to investigate PA and SB levels and its predictors in BD.MethodsMajor electronic databases were searched from inception till 02/2016 for articles measuring PA and SB with a self-report questionnaire (SRQ) or objective measure (e.g. accelerometer) in BD. A random effects meta-analysis and meta-regression analysis were conducted.ResultsSix studies were eligible including 279 (129♂) people with BD (mean age=43.9 years; range: 32.0-51.5 years). The trim and fill analysis demonstrated people with BD spent in total 210.1 min (95%CI=146.3-273.9 min) per day being physically active and 613.3 min (95%CI=389.9-836.6 min) during waking hours being sedentary. No significant difference in total PA per day was observed between people with BD and controls (g=−0.62, 95% CI=−1.55 to 0.31, I2=88.5%, n BD =82, n controls =86). Objective measures of PA recorded significantly lower levels (P=0.03) compared to self-report PA. Meta-regression demonstrated that older age and a higher body mass index predicted lower PA levels.LimitationsOnly a limited number of studies were identified assessing SB in people with BD.ConclusionsAdults with BD engage in high levels of sedentary behavior during waking hours. Given that sedentary behavior is an independent predictor of cardiovascular disease, future lifestyle interventions specifically targeting the prevention of sedentary behavior are warranted.