Home-Based Activity Program and Social Visits Help Older People With Depressive Symptoms

For older people with depressive symptoms, home-based physical activity can improve mood and quality of life as effectively as social visits, according to a study published in the Annals of Family Medicine (2010; 8 [3], 214–23). Many older adults suffer from low mood and poor physical function. The purpose of this study was to assess whether a home-based physical activity program could help older adults with depressive symptoms to improve function, quality of life and mood. Supervised exercise has improved function in elderly, frail adults in other studies and has reduced depression symptoms in older people in small trials. Evidence on the dose-response effect of exercise on depression, however, is not definitive.

Researchers from the University of Auckland in New Zealand recruited 193 adults aged 75 years and older. At baseline all subjects scored in the at-risk category for depression, with 53% being moderately or severely depressed. Investigators randomly divided subjects into two groups: one group participated in individually designed physical activity programs, while members of the other group spent the same amount of contact time in social visits. For 6 months, physical activity group members participated in balance retraining, resistance training and walking, with periodic visits from a trained nurse. Social-contact participants did not follow an exercise program, but did have the same number of periodic visits. Investigators assessed subjects at the beginning of the study, at 6 months and at 12 months for physical function, quality of life, depression, physical activity and self-reported falls.

Data analysis showed that all study subjects improved in mood and quality of life, with no significant differences between the groups. Over time, those in the physical activity group showed a trend to increase walking, but did not show any statistically significant improvement in physical functioning.

Study authors suggest that perhaps the physical activity component was not more effective because not enough physical activity was required or because participants did not adhere to the home-based program. The authors pointed out that the dose–response relation between exercise and depression in older adults is unclear. Another reason may be that it is very difficult to improve levels of function and disability among older adults. It is also possible that social aspects of an exercise program may provide more of the quality-of-life and mood benefits than the exercise itself, indicating that some of the benefits resulting from participation in an organized exercise program may stem from influences other than physical conditioning. More research is required to tease out these differences.

Study limitations included the fact that there was no true control group, since social visits are also effective in improving mood and quality of life. Further research that includes a group receiving usual care, with no additional personal contact, was recommended.