Avoid Depression in Old Age by Being Fit in Middle Age
Being physically fit in middle age may prevent 2 things: developing depression as a senior, and dying from heart disease if you do happen to become depressed.
Researchers looked at 18,000 Medicare individuals and found that those who were the most fit were 16% less likely to develop depression. The fittest were also 56% less likely to die from heart disease if they developed depression, and 61% less likely to die from heart disease if they remained depression-free.
Dr. Benjamin Willis, an epidemiologist at the Cooper Institute in Dallas, said:
“There is a well-known connection between depression and cardiovascular disease.”
The link between depression and heart disease is more of a circle than a straight line. People who have depression are more likely to have heart disease, and people who have heart disease are more likely to develop depression.
For the study, Willis and his colleagues collected data on 17,989 healthy men and women with an average age of 50 who visited a clinic for a preventative medical exam when they were middle-aged. Researchers collected the data from 1971 through 2009. The participants were all eligible for Medicare from 1999 to 2010.
Using treadmill exercise tests, depression from Medicare claim files, and data on heart disease deaths from the U.S. National Death Index records, the team estimated the participants’ fitness levels.
The Medicare claim files did not disclose the severity of depressed participants’ symptoms, which was a limitation of the study.
Willis said of the findings:
“It is never too late to get off the couch.”
He recommended exercises such as cycling, walking, jogging, and swimming.
“Always consider your own health status and check with your physician before embarking on a new physical fitness program.”
About 16 million people in the United States, and 350 million people around the world have depression. The risk of depression increases as people age. 
Lead study author Dr. Madhukar Trivedi, director of the center for depression research and clinical care at University of Texas Southwestern Medical Center in Dallas, said:
“Depression doesn’t exist in a vacuum. Especially for people who are older, depression has a complicated relationship with other major medical diseases.”
Previous studies have established that exercise can improve depression and lower heart disease risk, and scientists believe that being physically fit may lower depression- and heart disease-causing inflammation, but more research is needed to understand the mechanism.
In some of Trivedi’s earlier research, he was able to show that exercise can be just as effective as antidepressants and psychotherapy at treating depression. He hopes that the latest findings will change the way doctors approach treating depression.
“I want primary care physicians to prescribe not only antidepressants but also prescribe a dose of exercise for the treatment of depression.”
The study is published in JAMA Psychiatry.