Effectiveness of Physical Exercise in Older Adults With Mild to Moderate Depression

The "Effectiveness of Physical Exercise in Older Adults with Mild to Moderate Depression" study analyzed the effect of supervised physical exercise sessions versus antidepressants on depressive symptoms, over a 6 month time period, in Spanish adults aged ≥ 65 years. (1) This study opens doors for researchers and practitioners to explore different strategies in the care of the aging population in the future. Although the major conclusion of the study was antidepressants were “superior” at 6 months, the physical activity group had a significantly lower incidence of adverse effects. (1) In addition to these findings, physical activity has many other health-related benefits (e.g. chronic disease prevention, improved balance, and improved cardiovascular health). (2) Both groups reported significant improvements in self-perceived health status, and when the data were analyzed per-protocol analysis, there was no significant difference between the groups. (1) Therefore, patients ≥ 65 years of age should be educated on these findings when deciding appropriate treatment for mild to moderate depression.

Two key areas to expand upon through future research, include 1) the addition of a third experimental group and 2) consideration of strategies to improve physical activity retention rates. There were two experimental groups within this study: physical activity (PA) and antidepressant treatment (AT). (1) Future research should look into the effect of both AT and PA compared to each administered separately. Sixty-six of the 158 individuals allocated to the PA group completed the study, and the average number of exercise sessions attended was 18.9 out of 48 total over 6 months. (1) Therefore, it is difficult to determine if this exercise program would be effective if participants attended all 48 sessions as prescribed. Future studies could look at different types of PA and different settings to enhance participant involvement. This is important in order to explore the long-term effects of exercise on depression and to implement exercise progressions, as discussed in the methods. PA involves a daily time commitment, and should include exercises that older adults enjoy in order to help maintain the habit. As a physical therapy student, I see potential to collaborate with physicians and exercise physiologists to prescribe an aerobic and resistance training program individualized to the patient based on their precautions, cardiovascular fitness, comorbidities, and goals as part of a treatment plan for older adults who are appropriate for exercise and experience adverse effects to pharmaceutical treatments, or chose to pursue a non-pharmacological intervention.

References:

1. Hidalgo JL, Sotos JR; DEP-EXERCISE Group. Effectiveness of Physical Exercise in Older Adults With Mild to Moderate Depression. Ann Fam Med. 2021;19(4):302-309. doi:10.1370/afm.2670

2. Galloza J, Castillo B, Micheo W. Benefits of Exercise in the Older Population. Phys Med Rehabil Clin N Am. 2017;28(4):659-669. doi:10.1016/j.pmr.2017.06.001