Exercise: A powerful tool for seniors’ to combat depression

Exercise and mental health in older adults: The superiority of physical activity

A recent study, conducted by Australian researchers from the University of Queensland and published in the British Medical Journal (BMJ), has shed new light on the significant impact of exercise on mental health, including seniors. The study, the largest of its kind, highlights the effectiveness of physical activity in alleviating depression, surpassing the benefits of antidepressant drugs alone. With concerns rising over the adverse effects and discontinuation challenges associated with antidepressants, the study urges doctors to prioritise exercise as a first-line intervention for seniors.

At least one in ten people have depression at some point in their lives, with some estimates closer to one in four. It’s one of the worst things for someone’s wellbeing – worse than debt, divorce or diabetes. This new research shows that exercise should be considered alongside therapy and antidepressants. It can be just as impactful in treating depression as therapy, but it matters what type of exercise you do and how you do it.

Diverse exercises show promise in combating depression

In the study, researchers examined 218 randomised trials involving 14,170 participants to assess the effectiveness of various exercises in alleviating depression. Using a network meta-analysis approach, they compared different exercise types instead of grouping them together, providing valuable insights into their relative effectiveness.

The study found that walking, running, strength training, yoga, and mixed aerobic exercise were as effective as cognitive behavioral therapy, a widely used treatment for depression. Other exercise types, however, had stronger evidence supporting their effectiveness. (Refer to infographic below.)

Compared to antidepressant medication alone, walking, running, strength training, yoga, and mixed aerobic exercise were more effective and were on par with exercise combined with antidepressants. Among these exercises, strength training and yoga were found to be the most sustainable options, with participants more likely to adhere to these forms of exercise.

This research highlights the diverse range of exercises that can help manage depression and underscores the importance of personalised exercise plans tailored to individual preferences and needs.

The benefits for seniors

Seniors, in particular, stand to gain immense benefits from incorporating exercise into their routine. The study found that exercise is about twice as effective as antidepressants in the short term for seniors, with even gentle forms showing notable benefits. Additionally, the more vigorous the activity, the greater the mental health gains. Surprisingly, dance emerged as a highly effective form of exercise, nearly five times more effective than SSRIs in lifting mood among depressed individuals.

Tailoring exercise to seniors’ needs

The study also highlighted significant differences between men and women, as well as across age groups, regarding the most beneficial forms of exercise. While walking or jogging proved effective for both genders, strength training was more beneficial for women, and yoga or qigong for men. Yoga was also found to be somewhat more effective among older adults, while strength training was more effective among younger people.

The role of social connection

One of the key factors contributing to the effectiveness of exercise in managing depression is the social connection it provides. Group environments, such as those led by a physio or exercise physiologist, can enhance the sense of social support and connection, which is particularly beneficial for seniors.

In conclusion, the study’s findings underscore the importance of prescribing exercise as a primary intervention for seniors’ mental health. By incorporating exercise into their routine, seniors can not only improve their mental well-being but also enjoy a range of physical benefits, including reduced cardiovascular risk, increased muscle mass, and a toned appearance. Ultimately, exercise offers a holistic approach to mental health that surpasses the benefits of antidepressant drugs alone.

“Exercise does seem to have effects that are stronger than antidepressants for most people.”

Infographic: So what kind of exercise is the best for lifting mood?

The BMJ study ranked 14 interventions, including a variety of exercises, cognitive behavioural therapy and SSRIs, in order of effectiveness. The effects of dancing were also powerful, sitting atop the league table. However, this came from analysing just five studies, mostly involving young women. Other exercise types had more evidence to back them.. In order of effectiveness, the interventions ranked as follows:

Interestingly, it may be factors that are supplementary to the exercise mode itself that holds the key to why some physical activity seems to confer a bigger benefit than others. For instance, being out in nature as with jogging has beneficial effects; in yoga and tai chi the breathing aspect is calming for the nervous system, and dance involves music and is generally fun.

“I think the fact that even gentle exercise helps means that it isn’t just the runner’s high that you get from vigorous exercise that is helpful for depression,” says the lead author of the BMJ study, University of Queensland senior lecturer Michael Noetel. “There could be a range of factors at play here. One is that a lot of these interventions in our research were in group environments, so they were supported by, say, a physio or an exercise physiologist or trainer. So there’s a degree of social connection that comes from going for a walk with a friend or having a session with a trainer.

Source:
– British Journal of Sports Medicine. Effectiveness of physical activity interventions for improving depression, anxiety and distress: an overview of systematic reviews . View study
– The Australian. The most effective exercise for depression. Article by Natasha Robinson 19 February 2024. Read article

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