Clinical Question

Does regular exercise improve clinical depression symptoms in adults older than 60 years?

Evidence-Based Answer

Exercise is beneficial for treating depression in adults older than 60 years. Exercise training is recommended for healthy older adults because it significantly decreases depressive symptoms. (Strength of Recommendation [SOR]: A, meta-analysis of randomized controlled trials [RCTs].) Exercise improves depression in older patients with normal or impaired cognition. (SOR: A, meta-analysis of RCTs and cohort studies.) High-intensity resistance exercise also improves depression in older patients (number needed to treat [NNT] = 3). (SOR: B, systematic review of an RCT.)

Evidence Summary

A 2022 meta-analysis of 18 studies (n = 1,354) explored the effect of exercise training on depressive symptoms in healthy older adults.¹ Study participants were 60 years and older and did not exercise regularly. Exercise interventions were aerobic, resistance, or a combination of the two, and the study included a nonexercise control group. Preand postdepression scores were measured using the Geriatric Depression Scale, Goldberg Depression Scale, Mental Health Functioning Index, and Beck Depression Inventory-II. The review used standardized mean difference (SMD) because the studies used different depression scales. There was moderate heterogeneity between trials. Exercise significantly decreased depressive symptoms in participants with a moderate effect size (SMD = −0.52; 95% CI, −0.76 to −0.28; P < .001). Interventions lasting more than 24 weeks had a greater effect (SMD = −0.66; 95% CI, −1.08 to −0.24; P = .002) than interventions lasting less than 24 weeks (SMD = −0.37; 95% CI, −0.63 to −0.11; P = .006).