Physical exercise may be an additional way to help older adults fight depression.

Heinzel S, Lawrence JB, Kallies G, et al. Using exercise to fight depression in older adults: A systematic review and meta-analysis GeroPsych. 2015;28:149-162.  

Review question

Does exercise help fight depression in older adults?

Background

Depression is the most common psychiatric condition among older adults (60+ years old) and can lead to other health problems and lowered quality of life. Yet, it is a difficult issue to treat for several reasons, including the fact that commonly used treatments are not always effective for older adults. Past studies show exercise can help treat depression; however more research needs to be done to measure how well exercise works as a treatment, whether the benefits are consistently seen across studies and which types of exercise and settings are most useful. 

How the review was done

This is a systematic review and meta-analysis of 18 randomized control trials published between 1991 and 2014. The studies included 1063 older adults with depressive symptoms.  The average age of participants in all included studies was 60 years or older. Studies including participants with severe cognitive challenges (eg. Alzheimer’s disease) were excluded from the review.

Key features of the included studies:

• Participants completed a supervised or home-based physical exercise program.
• Types of exercises varied widely and included aerobic exercise (6 studies), resistance training (4 studies), and alternative exercises such as Tai Chi and dancing (5 studies). Three studies combined aerobic and resistance exercises.
• Exercise sessions took place 1-3x/week.  Programs ranged from 8 – 26 weeks.
• Depression ‘scores’ were measured before and after the program/treatment. Six studies also measured physical function or fitness.
• Results were compared with people in control groups who did not take part in the same exercise programs.

What the researchers found

All types of exercises included in these studies significantly improved depressive symptoms in comparison to the control groups, with at least a moderate effect.

Alternative exercises such as Tai Chi and Qi Gong were especially effective and the authors recommend future research on the benefits of exercises like these which include mental as well as physical components. 

Supervised exercise programs were more effective than home-based programs.

The authors state that conclusions from this research should be interpreted with caution since only a small number of people were included in many of the studies. The amount of time and intensity of exercise, and the individual circumstances of the participants (eg. severity of depression and prescribed medications) may also influence the benefits of exercise on depression. 

Conclusion

Supervised exercise programs may be a useful addition to depression treatment for older adults.