N E W Y O R K, Sept. 21, 2000 -- Exercising three times a week could be more effective than medication in relieving the symptoms of major depression in elderly people and may also decrease the chances that the depression will return over time.
Researchers at Duke University Medical Center, in Durham N.C., studied 156 majorly depressed patients 50 and older and found that after 16 weeks, those who exercised showed significant improvement compared to those who either took medication alone or those who combined the therapies. In a six-month follow-up study, Duke psychologists found that depression returned in only 8 percent of the patients in the exercise group, versus 38 percent for the drug-only group and 31 percent for the drug and exercise combined group.
Study participants in the exercise group engaged in one half-hour of brisk walking three times a week.
“The main conclusion is that maintaining an exercise program can significantly help in reducing depression,” says the study’s lead researcher, Duke psychologist James Blumenthal, whose work is published in the current issue of the journal Psychosomatic Medicine. He believes this is the first study that actually looks at exercise as a treatment for depression for any age group, but says the results, “just confirm what a lot of people think exercise can do anyway.”
Number One Anti-Aging Medicine
“If exercise could be put in a pill it would be the number one anti-aging medicine and the number one anti-depression medicine,” agrees Dr. Robert N. Butler, President of the International Longevity Center, at Mount Sinai Medical School in New York City. “It’s also cheap, and it avoids problems such as the side-effects of medication.”
Depression is prevalent for the elderly. A recent report by the National Institute of Mental Health called depression in the elderly “widespread” and “a serious public health concern.” Surveys suggest more than 15 percent of the elderly population experiences depression at some point, while an additional 25 percent of elderly individuals have periods of persistent sadness that last two weeks or longer.
Contributing to depression in the elderly are medication side effects; the onset of Alzheimer’s disease and other ailments and a sense of loss that is perhaps different from depression younger people may experience. The elderly are more subject to depression because they tend to experience more loss and they “no longer get the income of self-esteem” that comes with working, says Norman Abeles, professor of psychology at Michigan State University in East Lansing.
Abeles, who is the former president of the American Psychological Association, called the Duke finding “interesting” and added that exercise could serve as an adjunct to the counseling often recommended for the elderly because antidepressants may adversely interact with the other medications the elderly take.
“If you bring up medication, often people don’t want to take it,” says Dr. Joseph Gallo, assistant professor of Family Practice and Community Medicine at the University of Pennsylvania in Philadelphia. He says that elderly patients often deny depressive symptoms, and that using exercise to treat those symptoms could be effective because exercise builds on “self-efficacy and self-confidence.”
But not everyone will benefit from exercise, cautions Gallo. Because depression plays a role in how people take care of themselves, he points out it’s unlikely all depressed people will be motivated to start or keep exercising. Additionally, older adults may have medical complications that prohibit them from being active. The disability can contribute to their depression, he says, but also makes movement an impossible treatment for them.
Study leader Blumenthal says it’s still unclear how exercise affects depression. Further studies will examine whether the improvements experienced in the exercising group actually came from the social support of exercising with others. He plans to look at a home-based exercise versus group-exercise group to establish what impact the exercise is actually having.