Physical activity reduces the risk of subsequent depression for older adults.

Previous studies assessing protective effects of physical activity on depression have had conflicting results; one recent study argued that excluding disabled subjects attenuated any observed effects. The authors' objective was to compare the effects of higher levels of physical activity on prevalent and incident depression with and without exclusion of disabled subjects. Participants were 1,947 community-dwelling adults from the Alameda County Study aged 50-94 years at baseline in 1994 with 5 years of follow-up. Depression was measured using criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (Washington, DC: American Psychiatric Association, 1994). Physical activity was measured with an eight-point scale; odds ratios are based upon a one-point increase on the scale. Even with adjustments for age, sex, ethnicity, financial strain, chronic conditions, disability, body mass index, alcohol consumption, smoking, and social relations, greater physical activity was protective for both prevalent depression (adjusted odds ratio (OR) = 0.90, 95% confidence interval (CI): 0.79, 1.01) and incident depression (adjusted OR = 0.83, 95% CI: 0.73, 0.96) over 5 years. Exclusion of disabled subjects did not attenuate the incidence results (adjusted OR = 0.79, 95% CI: 0.67, 0.92). Findings support the protective effects of physical activity on depression for older adults and argue against excluding disabled subjects from similar studies.

[1]  L. Breslow,et al.  Health and Ways of Living: The Alameda County Study , 1983 .

[2]  A. Mackinnon,et al.  The prevalence of depressive disorders and the distribution of depressive symptoms in later life: a survey using Draft ICD-10 and DSM-III-R , 1993, Psychological Medicine.

[3]  Claude Bouchard,et al.  Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. , 1998, WMJ : official publication of the State Medical Society of Wisconsin.

[4]  W H Rogers,et al.  Long-term functioning and well-being outcomes associated with physical activity and exercise in patients with chronic conditions in the Medical Outcomes Study. , 1994, Journal of clinical epidemiology.

[5]  W. Strawbridge,et al.  Does growing old increase the risk for depression? , 1997, The American journal of psychiatry.

[6]  Re: "Physical activity and cardiovascular disease risk in middle-aged and older women". , 2000, American journal of epidemiology.

[7]  M. Weissman,et al.  Cross-national epidemiology of major depression and bipolar disorder. , 1996, JAMA.

[8]  S. Weyerer Physical Inactivity and Depression in the Community , 1992, International journal of sports medicine.

[9]  R S Paffenbarger,et al.  Physical fitness and all-cause mortality. A prospective study of healthy men and women. , 1989, JAMA.

[10]  Claude Bouchard,et al.  Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: Executive summary , 1998 .

[11]  E. Barrett-Connor,et al.  Cross-sectional and prospective study of exercise and depressed mood in the elderly : the Rancho Bernardo study. , 2001, American journal of epidemiology.

[12]  A L Dannenberg,et al.  Physical activity and depressive symptoms: the NHANES I Epidemiologic Follow-up Study. , 1988, American journal of epidemiology.

[13]  A. Stone,et al.  The effect of exercise on normal mood. , 1990, Journal of psychosomatic research.

[14]  L. George,et al.  The association of age and depression among the elderly: an epidemiologic exploration. , 1991, Journal of gerontology.

[15]  R. Paffenbarger,et al.  Physical activity and cardiovascular disease risk in middle-aged and older women. , 1999, American journal of epidemiology.

[16]  T. Revenson,et al.  Handbook of Health Psychology , 2001 .

[17]  D. Jolley,et al.  The Prognosis of Depression in Old Age , 1986, British Journal of Psychiatry.

[18]  Physical activity and mortality in postmenopausal women. , 1997, JAMA.

[19]  P. Lewinsohn,et al.  Age and depression: unique and shared effects. , 1991, Psychology and aging.

[20]  R. Paffenbarger,et al.  Physical activity and reduced occurrence of non-insulin-dependent diabetes mellitus. , 1991, The New England journal of medicine.

[21]  J. Copeland,et al.  Range of Mental Illness Among the Elderly in the Community , 1987, British Journal of Psychiatry.

[22]  I. Rosow,et al.  A Guttman health scale for the aged. , 1966, Journal of gerontology.

[23]  J. Lau,et al.  The Shatin community mental health survey in Hong Kong. II. Major findings. , 1993, Archives of general psychiatry.

[24]  G. Livingston,et al.  The Gospel Oak Study: prevalence rates of dementia, depression and activity limitation among elderly residents in Inner London , 1990, Psychological Medicine.

[25]  G. Alexopoulos,et al.  Outcomes of geriatric depression. , 1992, Clinics in geriatric medicine.

[26]  I. Skoog,et al.  Mental Disorders and the Use of Psychotropic Drugs in an 85-Year-Old Urban Population , 1993, International Psychogeriatrics.

[27]  Debbie A Lawlor,et al.  The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials , 2001, BMJ : British Medical Journal.

[28]  R. Cohen,et al.  Physical activity and depression: evidence from the Alameda County Study. , 1991, American journal of epidemiology.

[29]  S. Z. Nagi An epidemiology of disability among adults in the United States. , 1976, The Milbank Memorial Fund quarterly. Health and society.

[30]  L. Beckett,et al.  Analysis of change in self-reported physical function among older persons in four population studies. , 1996, American journal of epidemiology.

[31]  W. Strawbridge,et al.  Natural history of leisure-time physical activity and its correlates: associations with mortality from all causes and cardiovascular disease over 28 years. , 1996, American journal of epidemiology.

[32]  J. Broadhead,et al.  Mental disorders in the developing world , 1994, BMJ.

[33]  P. Thorén,et al.  Endorphins and exercise: physiological mechanisms and clinical implications. , 1990, Medicine and science in sports and exercise.

[34]  W. Eaton,et al.  Psychopathology and mortality in the general population , 1995, Social Psychiatry and Psychiatric Epidemiology.

[35]  R. Paffenbarger,et al.  Physical activity and personal characteristics associated with depression and suicide in American college men , 1994, Acta psychiatrica Scandinavica. Supplementum.

[36]  D. Goldberg,et al.  Depressive symptoms and increased risk of stroke mortality over a 29-year period. , 1998, Archives of internal medicine.

[37]  D. Ford,et al.  Exercise and depression in midlife: a prospective study. , 1997, American journal of public health.

[38]  K Rodahl,et al.  Physical fitness as a predictor of mortality among healthy, middle-aged Norwegian men. , 1993, The New England journal of medicine.

[39]  R. Neugebauer,et al.  Mind matters: the importance of mental disorders in public health's 21st century mission. , 1999, American journal of public health.

[40]  W. Strawbridge,et al.  Prevalence and correlates of depression in an aging cohort: the Alameda County Study. , 1997, The journals of gerontology. Series B, Psychological sciences and social sciences.

[41]  Adam N. Smith Reoperative Gastro-intestinal Surgery , 1980 .