Effects of different walking intensities on improving depression in older adults with major depressive disorder: A pilot randomized controlled trial.

Abstract

INTRODUCTION: World Health Organization (WHO) stated major depressive disorder (MDD) as the third leading cause of burden of disease globally in 2008 and projected it to be the first cause in 2020. Over 9% of older adults have major depressive disorders, whereas up to 37% of older adults have depressive symptoms. Currently, WHO global physical activity recommendation suggests older adults to perform 150 min moderateintensity or 75 min vigorous-intensity aerobic-type physical activity or an equivalent combination of moderate- and vigorous-intensity activities to gain health benefits. This pilot study aimed to examine the effects of 12-week moderate- or vigorous-intensity walking exercise on improving depression in older adults with MDD. METHODS: In this study, older adults aged above 50 years with diagnosed MDD were recruited between January 2019 and March 2020. Participants were randomly assigned to waitlist control group (n=5), vigorous-intensity (6.5 metabolic equivalents) walking group (n=5), or moderateintensity (3.25 metabolic equivalents) walking exercise group (n=2). The walking intervention lasted for 12 weeks and the exercise frequency was thrice a week. Beck depression Inventory (BDI) and Generalized Anxiety Disorder 7 (GAD-7) were used to measure the depression and anxiety level, respectively, at baseline and post-intervention measurement. The treatment effects were assessed using generalized estimated equation model. RESULTS: A decreasing trend in depression was observed in vigorous-intensity walking exercise group (p=0.051). The anxiety level was significantly reduced (p<0.05) compared with control group. There is 27.5% decrease in BDI scores and 34% decrease in GAD-7 scores in vigorousintensity walking group compared to 3.4% decrease in BDI scores and 23.5% increase in GAD-7 scores in control group. We observed a 65% decrease in BDI scores while no change in the anxiety level in moderate-intensity walking exercise group. CONCLUSION: Following the WHO physical activity guidelines, our results demonstrated that 12-week walking training at either vigorous- or moderateintensity improved depression in older adults with MDD. Walking exercise is safe, easily accessible, and cost-effective, which can be considered as a therapeutic adjuvant treatment component for older adults with MDD.