Home-Based Physical Activity Program Improves Depression and Anxiety in Older Adults

in Journal of Physical Activity and Health
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Background: Late-life depression and anxiety among older adults is an important public health concern. This study examined the effect of a DVD-delivered exercise intervention on the secondary outcomes of depression and anxiety in older adults and the extent to which physical self-worth mediated the relationship between leisure-time physical activity and depression and anxiety. Methods: Older adults (N = 307) were randomized to a 6-month flexibility, toning, and balance DVD (FlexToBa™, FTB) or healthy aging DVD control. Self-reported physical activity and questionnaires were administered at baseline and postintervention. Statistical analyses were conducted in the total sample and in a subsample of participants with elevated levels of depression or anxiety. Results: FTB participants with elevated depression and anxiety symptoms at baseline had significantly greater reductions in depression and anxiety (d = 1.66 and 2.90) than the control condition (d = 0.77 and 0.73). The effect of physical activity on depression and anxiety was partially mediated by increases in physical self-worth in the total sample but not in those with elevated depression or anxiety. Conclusion: A home-based physical activity intervention may be a viable treatment for reducing depression and anxiety in older adults with elevated baseline scores.

Aguiñaga and McAuley are with the Dept of Kinesiology & Community Health, University of Illinois at Urbana-Champaign, Urbana, IL. Ehlers is with the Dept of Exercise Science, University of South Carolina, Columbia, SC. Salerno is with National Cancer Institute, Rockville, MD. Fanning is with the Wake Forest School of Medicine, Winston-Salem, NC. Motl is with The University of Alabama at Birmingham, Birmingham, Alabama.

Aguiñaga (saguina2@illinois.edu) is corresponding author.
  • 1.

    Schuurmans J, van Balkom A. Late-life anxiety disorders: a review. Curr Psychiatry Rep. 2011;13(4):267273. PubMed doi:10.1007/s11920-011-0204-4

  • 2.

    Blazer DG. Depression in late life: review and commentary. J Gerontol Ser A Biol Sci Med Sci. 2003;58(3):249265. doi:10.1093/gerona/58.3.M249

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 3.

    Bryant C, Jackson H, Ames D. The prevalence of anxiety in older adults: methodological issues and a review of the literature. J Affect Disord. 2008;109(3):233250. PubMed doi:10.1016/j.jad.2007.11.008

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 4.

    Brenes GA, Guralnik JM, Williamson JD, et al. The influence of anxiety on the progression of disability. J Am Geriatr Soc. 2005;53(1):3439. PubMed doi:10.1111/j.1532-5415.2005.53007.x

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Liu SY, Wrosch C, Miller GE, Pruessner JC. Self-esteem change and diurnal cortisol secretion in older adulthood. Psychoneuroendocrinology. 2014;41:111120. doi:10.1016/j.psyneuen.2013.12.010

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Sowislo JF, Orth U. Does low self-esteem predict depression and anxiety? A meta-analysis of longitudinal studies. Psychol Bull. 2012;139(1):213240. PubMed doi:10.1037/a0028931

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Schuch FB, Vancampfort D, Rosenbaum S, et al. Exercise for depression in older adults: a meta-analysis of randomized controlled trials adjusting for publication bias. Rev Bras Psiquiatr. 2016;38(3):247254. PubMed doi:10.1590/1516-4446-2016-1915

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8.

    Stubbs B, Vancampfort D, Rosenbaum S, et al. An examination of the anxiolytic effects of exercise for people with anxiety and stress-related disorders: a meta-analysis. Psychiatry Res. 2017;249:102108. PubMed doi:10.1016/j.psychres.2016.12.020

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Li FZ, Harmer P, Chaumeton NR, Duncan TE, Duncan SC. Tai Chi as a means to enhance self-esteem: a randomized controlled trial. J Appl Gerontol. 2002;21(1):7089. doi:10.1177/073346480202100105

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10.

    Motl RW, Konopack JF, McAuley E, Elavsky S, Jerome GJ, Marquez DX. Depressive symptoms among older adults: long-term reduction after a physical activity intervention. J Behav Med. 2005;28(4):385394. PubMed doi:10.1007/s10865-005-9005-5

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Legrand FD. Effects of exercise on physical self-concept, global self-esteem, and depression in women of low socioeconomic status with elevated depressive symptoms. J Sport Exerc Psychol. 2014;36:357365. PubMed doi:10.1123/jsep.2013-0253

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Fox KR. Self esteem, self perceptions and exercise. Int J Sport Psychol. 2000;31:228240.

  • 13.

    Katula JA, Blissmer BJ, McAuley E. Exercise intensity and self-efficacy effects on anxiety reduction in healthy, older adults. J Behav Med. 1999;22(3):233247. PubMed doi:10.1023/A:1018768423349

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Bridle C, Spanjers K, Patel S, Atherton NM, Lamb SE. Effect of exercise on depression severity in older people: systematic review and meta-analysis of randomised controlled trials. Br J Psychiatry. 2012;201(3):180185. doi:10.1192/bjp.bp.111.095174

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Rhyner KT, Watts A. Exercise and depressive symptoms in older adults: a systematic meta-analytic review. J Aging Phys Act. 2016;24(24):234246. doi:10.1123/japa.2015-0146

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    McAuley E, Wójcicki TR, White SM, et al. Physical activity, function, and quality of life: design and methods of the FlexToBa™ trial. Contemp Clin Trials. 2012;33(1):228236. doi:10.1016/j.cct.2011.10.002

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 17.

    McAuley E, Wójcicki TR, Gothe NP, et al. Effects of a DVD-delivered exercise intervention on physical function in older adults. J Gerontol A Biol Sci Med Sci. 2013;68(9):10761082. PubMed doi:10.1093/gerona/glt014

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Roberts S, Awick E, Fanning JT, Ehlers D, Motl RW, McAuley E. Long-term maintenance of physical function in older adults following a DVD-delivered exercise intervention. J Aging Phys Act. 2017;25(1):2731. PubMed doi:10.1123/japa.2015-0284

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Wójcicki TR, Fanning J, Awick EA, Olson EA, Motl RW, McAuley E. Maintenance effects of a DVD-delivered exercise intervention on physical function in older adults. J Gerontol A Biol Sci Med Sci. 2015;70(6):785789. doi:10.1093/gerona/glu188

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Gothe NP, Wójcicki TR, Olson EA, et al. Physical activity levels and patterns in older adults: the influence of a DVD-based exercise program. J Behav Med. 2015;38(1):9197. PubMed doi:10.1007/s10865-014-9581-6

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Awick E, Ehlers D, Fanning J, et al. Effects of a home-based DVD-delivered physical activity program on self-esteem in older adults. Psychosom Med. 2017;79(1):7180. PubMed doi:10.1097/PSY.0000000000000358

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Upadhyaya AK, Stanley I. Hospital anxiety depression scale. Br J Gen Pract. 1993;43(373):349350. PubMed

  • 23.

    Godin G, Shephard RJ. A simple method to assess exercise behavior in the community. Can J Appl Sport Sci. 1985;10(3):141146. PubMed

  • 24.

    Fox KR, Corbin CB. The physical self-perception profile: development and preliminary validation. J Sport Exerc Psychol. 1989;11(4):408430. doi:10.1123/jsep.11.4.408

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25.

    Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361370. PubMed

  • 26.

    Cohen J. Statistical Power Analysis for the Behavioral Sciences. 2nd ed. Hillsdale, NJ: Lawrence Erlbaum Associates; 1988.

  • 27.

    Hayes SM, Alosco ML, Hayes JP, et al. Physical activity is positively associated with episodic memory in aging. J Int Neuropsychol Soc. 2015;21(10):780790. PubMed doi:10.1017/S1355617715000910

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Ciechanowski P, Wagner E, Schmaling K, et al. Community-integrated home-based depression treatment in older adults. JAMA. 2004;291(13):1569. PubMed doi:10.1001/jama.291.13.1569

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29.

    Pfaff JJ, Alfonso H, Newton RU, Sim M, Flicker L, Almeida OP. ACTIVEDEP: a randomised, controlled trial of a home-based exercise intervention to alleviate depression in middle-aged and older adults. Br J Sports Med. 2014;48(3):226232. PubMed doi:10.1136/bjsports-2013-092510

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Posternak MA, Solomon DA, Leon AC, et al. The naturalistic course of unipolar major depression in the absence of somatic therapy. J Nerv Ment Dis. 2006;194(5):324329. PubMed doi:10.1097/01.nmd.0000217820.33841.53

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
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