Depressive Symptoms Among Older Adults: Long-Term Reduction After a Physical Activity Intervention

  • Robert W. Motl
  • James F. Konopack
  • Edward McAuleyEmail author
  • Steriani Elavsky
  • Gerald J. Jerome
  • David X. Marquez

We examined the effects of two physical activity modes on depressive symptoms over a 5-year period among older adults and change in physical self-esteem as a mediator of changes in depressive symptoms. Formerly sedentary, older adults (N = 174) were randomly assigned into 6-month conditions of either walking or low-intensity resistance/flexibility training. Depressive symptoms and physical self-esteem were measured before and after the 6-month intervention, and 12 and 60 months after intervention initiation. Depressive symptoms scores were decreased immediately after the intervention, followed by a sustained reduction for 12 and 60 months after intervention initiation; there was no differential pattern of change between the physical activity modes. Change in physical self-esteem predicted change in depressive symptoms. This study supports the effectiveness of an exercise intervention for the sustained reduction of depressive symptoms among sedentary older adults and physical self-esteem as a potential mediator of this effect.


older adults depressive symptoms exercise physical self-esteem 



Funding for this study was provided by the National Institute on Aging (Grant 2RO1 AG 12113).


  1. Arbuckle, J. L. (1996). Full information estimation in the presence of incomplete data. In Marcoulides, G. A., and Schumacker, R. E. (Eds.), Advanced Structural Equation Modeling: Issues and Techniques, Lawrence Erlbaum, Mahwah, NJ, pp. 243–277.Google Scholar
  2. Babyak, M., Blumenthal, J. A., Herman, S., Khatri, P., Doraiswamy, M., Moore, K., Craighead, W. E., Baldewicz, T. T., and Krishnan, K. R. (2000). Exercise treatment for major depression: Maintenance of therapeutic benefit at 10 months. Psychosom. Med. 62: 633–638.PubMedGoogle Scholar
  3. Baumeister, R. F. (1993). Understanding the inner nature of self-esteem. In Baumeister, R. F. (Ed.), Self-Esteem: The Puzzle of Low Self-Regard, Plenum, New York, pp. 201–218.Google Scholar
  4. Baumeister, R. F., Campbell, J. D., Krueger, J. I., and Vohs, K. D. (2003). Does high self-esteem cause better performance, interpersonal success, happiness, or healthier lifestyles? Psychol. Sci. Pub. Inter. 4:1–44.CrossRefGoogle Scholar
  5. Begg, C. B., and Iglewicz, B. (1980). A treatment allocation procedure for sequential clinical trials. Biometrics 36: 81–90.PubMedCrossRefGoogle Scholar
  6. Bentler, P. M. (1990). Comparative fit indices in structural models. Psychol. Bull. 107: 238–246.CrossRefPubMedGoogle Scholar
  7. Bentler, P. M., and Bonett, D. G. (1980). Significance tests and goodness of fit in the analysis of covariance structures. Psychol. Bull. 88: 588–606.CrossRefGoogle Scholar
  8. Blair, S. N., and Connelly, J. C. (1996). How much physical activity should we do? The case for moderate amounts and intensities of physical activity. Res. Q. Sport. Exerc. 67: 193–205.Google Scholar
  9. Blumenthal, J. A., Babyak, M. A., Moore, K. E., Craighead, Plenum, W. A., Herman, S., Khatri, P., Waugh, R., Napolitano, M. A., Forman, L. M., Appelbaum, M., Doraiswamy, P. M., and Krishnan, K. R. (1999). Effects of exercise training on older adults with major depression. Arch. Intern. Med. 159: 2349–2356.CrossRefPubMedGoogle Scholar
  10. Boileau, R., McAuley, E., Demetriou, D., Devabhaktuni, N. K., Dykstra, G. L., Katula, J., Nelson, J., Pascale, A., Pena, M., and Talbot, H. (1999). Aerobic exercise training and cardiorespiratory fitness in older adults: A randomized controlled trial. J. Aging Physical Activity 7: 374–385.Google Scholar
  11. Bollen, K. A. (1989). Structural Equations with Latent Variables, Wiley, New York, NY.Google Scholar
  12. Borg, G. (1998). Borg's Perceived Exertion and Pain Scales, Human Kinetics, Champaign, IL.Google Scholar
  13. Broose, A. L., Sheets, E. S., Lett, H. S., and Blumenthal, J. A. (2002). Exercise and the treatment of clinical depression in adults: Recent findings and future directions. Sports. Med. 32: 741–760.PubMedCrossRefGoogle Scholar
  14. Browne, M. W., and Cudeck, R. (1993). Alternative ways of assessing model fit. In Bollen, K. A., and Long, J. S. (Eds.), Testing Structural Equation Models, Sage, Newbury Park, CA, pp. 136–162.Google Scholar
  15. Cutrona, C. E., and Russell, D. W. (1987). The provisions of social relationships and adaptations to stress. In Jones, W. H., and Perleman, D. (Eds.), Advances in Personal Relationships, JAI Press, Greenwich, pp. 37–67.Google Scholar
  16. Diener, E. (1984). Subjective well-being. Psychol. Bull. 95: 542–575.CrossRefPubMedGoogle Scholar
  17. Dishman, R. K. (1997). Brain monoamines, exercise, and behavioral stress: Animal models. Med. Sci. Sports Exerc. 29: 63–74.PubMedGoogle Scholar
  18. Duncan, T. E., Duncan, S. C., Strycker, L. A., Li, F., and Alpert, A. (1999). An Introduction to Latent Variable Growth Curve Modeling, Lawrence Erlbaum, Nahwah, NJ.Google Scholar
  19. Dunn, A. L., Trivedi, M. H., and O'Neal, H. A. (2001). Physical activity dose-response effects on outcomes of depression and anxiety. Med. Sci. Sports Exerc. 33: S587–S597.PubMedCrossRefGoogle Scholar
  20. Enders, C. K. (2002). A primer of maximum likelihood algorithms available for use with missing data. Struct. Equat. Model. 8: 128–141.CrossRefGoogle Scholar
  21. Enders, C. K., and Bandalos, D. L. (2001). The relative performance of full information maximum likelihood estimation for missing data in structural equation models. Struct. Equat. Model. 8: 430–457.CrossRefGoogle Scholar
  22. Fox, K. R. (1990). The Physical Self-Perception Manual, Office of Health Promotion, Northern Illinois University, Dekalb, IL.Google Scholar
  23. Fox, K. R. (2000). Self-esteem, self-perceptions and exercise. Int. J. Sport Psychol. 31: 228–240.Google Scholar
  24. Hu, L., and Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Struct. Equat. Model. 6: 1–55.CrossRefGoogle Scholar
  25. Hyer, L., and Blount, J. (1984). Concurrent and discriminant validities of the Geriatric Depression Scale with older psychiatric inpatients. Psychol. Rep. 54: 611–616.PubMedGoogle Scholar
  26. Jöreskog, K. G., and Sörbom, D. (1996). LISREL 8: User's reference guide, Scientific Software International, Chicago, IL.Google Scholar
  27. Lance, C. E., Vandenberg, R. J., and Self, R. M. (2000). Latent growth models of individual change: The case of newcomer adjustment. Organ. Behav. Human Decis. Process. 83: 107–140.CrossRefGoogle Scholar
  28. Larsson, L., Grimby, G., and Karlsson, J. (1979). Muscle strength and speed of movement in relation to age and muscle morphology. J. Appl. Physiol. 46: 451–456.PubMedGoogle Scholar
  29. Li, F., Duncan, T., Duncan, S., McAuley, E., et al. (2001). Enhancing psychological well-being of elderly individuals through tai-chi exercise. Struct. Equat. Model. 8: 53–83.CrossRefGoogle Scholar
  30. Li, F., Harmer, P., Chaumeton, N. R., Duncan, T. E., et al. (2002). Tai Chi as a means to enhance self-esteem: A randomized controlled trial. J. Appl. Gerontol. 21: 70–89.CrossRefGoogle Scholar
  31. Mather, A. S., Rodriguez, C., Guthrie, M. F., McHarg, A. M., M., Reid, I. C., and McMurdo, M. E. (2002). Effects of exercise on depressive symptoms in older adults with poorly responsive depressive disorder. Brit. J. Psychiatry 180: 411–415.CrossRefGoogle Scholar
  32. McAuley, E., Kramer, A. F., and Colcombe, S. J. (2004). Cardiovascular fitness and neurocognitive function in older adults: A brief review. Brain, Behav. Immun. 18: 214–220.CrossRefGoogle Scholar
  33. McAuley, E., Katula, J., Mihalko, S. L., Blissmer, B., et al. (1999). Mode of physical activity and self-efficacy in older adults: A latent growth curve analysis. J. Gerontol. B Psychol. Sci. Soc. Sci. 54: P283–P292.PubMedGoogle Scholar
  34. McMurdo, M. E. T., and Burnett, L. (1992). Randomized controlled trial of exercise in the elderly. Gerontology 38: 292–298.PubMedCrossRefGoogle Scholar
  35. McNeil, J. K., LeBlanc, E. M., and Joyner, M. (1992). The effect of exercise on depressive symptoms in the moderately depressed elderly. Psychol. Aging 6: 487–488.CrossRefGoogle Scholar
  36. Meredith, W., and Tisak, J. (1990). Latent curve analysis. Psychometrika 55: 107–122.CrossRefGoogle Scholar
  37. National Institute of Aging (2002). Older Americans 2000: Key Indicators of Well-Being. (Federal Interagency Forum on Aging-Related Statistics), US Government Printing Office, Washington, DC.Google Scholar
  38. O'Connor, P. J., Aenchbacher, L. E., and Dishman, R. K. (1993). Physical activity and depression in the elderly. J. Aging Physical Activity 1: 34–58.Google Scholar
  39. O'Neal, H. A., Dunn, A. L., and Martinsen, E. W. (2000). Depression and exercise. Int. J. Sport Psychol. 31: 110–135.Google Scholar
  40. Penninx, B. W., Guralnik, J. M., Ferrucci, L., Simonsick, E. M., Deeg, D. J., and Wallace, R. B. (1998). Depressive symptoms and physical decline in community-dwelling older persons. JAMA 279: 1720–1726.CrossRefPubMedGoogle Scholar
  41. Penninx, B. W., Rejeski, W. J., Pandya, J., Miller, M. E., et al. (2002). Exercise and depressive symptoms: A comparison of aerobic and resistance exercise effects on emotional and physical function in older persons with high and low depressive symptomatology. J. Gerontol. B Psychol. Sci. Soc. Sci. 57: P124–P132.PubMedGoogle Scholar
  42. Pfeiffer, E. (1975). A Short Portable Mental Status Questionnaire for the assessment of organic brain deficit in elderly patients. J. Am. Geriatr. Soc. 23: 433–441.PubMedGoogle Scholar
  43. Rosenberg, M., Schooler, C., Schoenbach, C., and Rosenberg, F. (1995). Global self-esteem and specific self-esteem: Different concepts, different outcomes. Am. Sociol. Rev. 60: 141–156.CrossRefGoogle Scholar
  44. Singh, N. A., Clements, K. M., and Fiatarone, M. A. (1997). A randomized controlled trial of progressive resistance training in depressed elders. J. Gerontol. A Med. Sci. 52: M27–M35.Google Scholar
  45. Singh, N. A., Clements, K. M., and Singh, M. A. F. (2001). The efficacy of exercise as a long-term antidepressant in elderly subjects: A randomized controlled trial. J. Gerontol. A Med. Sci. 56: M497–M504.Google Scholar
  46. Sonstroem, R. J. (1997). Physical activity and self-esteem. In Morgan, W. P. (Ed.), Physical Activity and Mental Health, Taylor and Francis, Washington, DC, pp. 128–143.Google Scholar
  47. Sonstroem, R. J., and Morgan, W. P. (1989). Exercise and self-esteem: Rationale and model. Med. Sci. Sports Exerc. 21: 329–337.PubMedGoogle Scholar
  48. Sonstroem, R. J., and Potts, S. A. (1996). Life adjustment correlates of physical self-concepts. Med. Sci. Sports Exerc. 28: 619–625.PubMedCrossRefGoogle Scholar
  49. Strawbridge, W. J., Deleger, S., Roberts, R. E., and Kaplan, G. A. (2002). Physical activity reduces the risk of subsequent depression for older adults. Am. J. Epidemiol. 156: 328–334.CrossRefPubMedGoogle Scholar
  50. Willett, J. B., and Sayer, A. G. (1994). Using covariance structure analysis to detect correlates and predictors of individual change over time. Psychol. Bull. 116: 363–381.CrossRefGoogle Scholar
  51. Wothke, W. (2000). Longitudinal and multigroup modeling with missing data. In Little, T. D., Schnabel, K. U., and Baumert, J. (Eds.), Modeling Longitudinal and Multilevel Data: Practical Issues, Applied Approaches, and Specific Examples, Lawrence Erlbaum, Mahwah, NJ, pp. 219–240.Google Scholar
  52. Yesavage, J. A., Brink, T. L., Rose, T. L., Lum, O., Huang, V., Adey, M., and Leirer, V.O. (1982). Development and validation of a geriatric depression screening scale: A preliminary report. J. Psychiatric Res. 17: 37–49.CrossRefGoogle Scholar

Copyright information

© Springer Science + Business Media, Inc. 2005

Authors and Affiliations

  • Robert W. Motl
    • 1
  • James F. Konopack
    • 1
  • Edward McAuley
    • 1
    • 4
    Email author
  • Steriani Elavsky
    • 1
  • Gerald J. Jerome
    • 2
  • David X. Marquez
    • 3
  1. 1.Department of KinesiologyUniversity of Illinois at Urbana-ChampaignUrbanaUSA
  2. 2.Johns Hopkins University College of MedicineBaltimoreUSA
  3. 3.University of MassachusettsAmherstUSA
  4. 4.Department of KinesiologyUniversity of IllinoisUrbanaUSA

Personalised recommendations