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Exercise as Medicine for Elder Depression

Published October 27, 2015 8:01 AM by Brian Garavaglia
Depression in the elderly is common. Many older adults with depression often go undiagnosed or misdiagnosed. Those that are diagnosed are often placed on medication. Since many older adults are already on an average of four medications, with the potential for adverse effects increasing as more medications are added, it is welcoming news to often see modalities of treatment that do not use medications and can frequently even produce superior results to those that are treated with medication. Exercise appears to be a treatment modality that is showing great promise toward reducing depression and as such, doing so without adding to many older adult’s already cluttered plethora of prescription drug use. 
 
Researchers at Duke University have found that exercise could have dramatic effects on treating depression in older adults. What is even more compelling are the findings that exercise may be more effective in relieving depression than prescription medications, as well as even being more beneficial in reducing the likelihood for relapses in depression. This is very good new since abating depressive symptoms without adding additional medications provides a healthier and often safer benefit. Furthermore, not only do more medications add to the likelihood of adverse effects through problematic interactions, but adding additional medications to an already large number that many older adults take on a daily basis leads to medication management issues that often further lead to many failing to take certain medications in a timely and appropriate manner. 
 
The study that was undertaken at Duke University demonstrates some very compelling results of exercise being a superior modality for treating depression than traditional pharmacological intervention. The study examined 156 individuals who were 50 years of age and older with a diagnosis of major depression. They looked at three groups:  a group that engaged in exercise, a second group that only received medication and a third group that used medication and also engaged in exercise. The results were surprising. First, it was found that exercise had a superior effect in reducing depression when compared to medication. However, what was even more surprising is that one may think that if exercise was efficacious for depression, than exercise and medication combined would even be more effective. This was not so. Exercise by itself was found to be the most effective form of therapeutic modality, superior to both medication and exercise combined and medication alone. Furthermore, in a six-month follow-up examining the return of depression, those that engaged in exercise alone had the lowest rate of return at only 8%. This compared to 31% among the medication and exercise combined group and 38% found in the medication alone group. 
 
These are eye-opening results. First and most startling is the finding that exercise alone was superior to exercise and medication combined. However, although this is a very startling finding, it is also a very welcome one as well. Given that older adults are on large amounts of medication, finding a modality that is highly effective without adding additional pharmacological substances to the older adult’s body is a very uplifting finding. Furthermore, the rate of depression relapse being lowest among the exercise group is again a very inspiring finding by the study. 
What is also very interesting is the amount of exercise that led to these results was really quite modest. The exercise group was individuals that engaged in exercise three days each week. The exercise amounted to one-half hour of brisk walking. Here again this is a very encouraging result. Most individuals think of exercise, especially at a therapeutic level, involving high intensity, sweat, and based on arduous levels of exertion. Yet, what was therapeutic levels of exercise that significantly impacted the level of depression among those in the study was anything but high intensity and arduous. This is further good news. Most individuals frequently shy away from exercise, especially older adults, given the level of work it is thought to entail. Going to the gym, sweating, lifting weights, running until one is panting and short of breath, and feeling sore and uncomfortable afterwards is what goes through most individuals minds and most do not think that something as simple as walking can be a highly favorable and therapeutic modality of exercise. Learning that something as simple as a brisk walk that does not entail going to the gym, sweating and having sore and tight muscles afterwards is good news that may encourage many who have depressed moods to get out and start walking.  
 
This study is quite important on a number of levels. First, treating depression in the elderly, or for that matter any age group, without having to use medication is much more favorable than using pharmacological intervention. The potential for adverse medication effects increases with each additional medication added to a person’s total medication use. This is not to say that medication should not be used. Medication can be very important for treatment, especially in cases where the therapeutic effects of exercise on mood are refractory, where one may not be able to exercise due to physical disability or impairment, or where the melancholic features of the individual are precluding individuals from engaging in exercise. 
 
However additionally, and maybe even more important is that encouraging many older adults to engage in exercise may not only be instrumental in ameliorating depression or preventing depressive mood changes, but lead to pervasive health changes among older adults. The ramifications here go beyond just enhancing one’s mood. They encompass enhancing all phases of the individual’s health. It entails health care providers encouraging their clientele to become less sedentary and engage in modest levels of activity. Although most health care providers, when they make such recommendations, do so for the physical benefits that can be accrued, they must also be mindful, as this study shows, that modest levels of exercise impacts the psychological nature of the individual as well and ultimately the quality of life they live.   
 
The American College of Sports Medicine views “exercise as medicine.”  As this study shows, the medicinal impact of exercise on reducing or eliminating one’s depression is highly significant. Future studies need to be done to see if these impressive finding can be replicated. However, at this time, the findings from this study demonstrate how important healthy life changes can be for the quality of our life, especially for those older adults that are suffering from depression. Possibly, the most powerful therapeutic modality for addressing depression may not come from an exogenous chemical agent provided by the prescription pad, but from endogenous chemical changes created through our volitional ability to engage in exercise as an antidepressant medication. 
 
References:
Study: Exercise Treats Elderly Depression (http://abcnews.go.com/Health/Depression/story?id=117946&page=1 

posted by Brian Garavaglia

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About this Blog


    Brian Garavaglia, PhD
    Occupation: Long-term care administrator
    Setting: Sterling Heights, Mich.
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