An exercise regime designed to help elderly people with depression is no better than a befriending programme, researchers say, suggesting that social contact could be the key to helping depressed older people feel better.

What do we know already?

While severe depression is quite unusual among the elderly, about 14 percent of older people suffer from some kind of depression or low mood. Low mood often makes it harder for people to get out and get on with their lives.

Exercise has been seen as a promising treatment for low mood. Exercise itself can boost your mood, and getting involved in an exercise programme would lead to more social contact. In fact, some researchers think that the majority of an exercise programme's effects come from the social element, rather than from the exercise itself. A new study has compared an exercise programme with a type of social contact called befriending, where someone visited and talked to elderly people with symptoms of depression.

What does the new study say?

Social contact helped just as much as the exercise programme. There were 193 people who took part, with an average age of 81.

Depression was measured with a questionnaire, which asked whether people were satisfied with their life, whether they had dropped off activities they used to enjoy, and how much energy they had. Average scores improved for the whole group over the six-month study, regardless of whether they did exercise or had social visits.

People's ability to get out and about dropped during the study, whatever treatment they'd had. Ratings of people's quality of life stayed the same, although their quality of life as it related to their mental health improved slightly, for people who had social contact as well as people who did the exercise programme.

One interpretation of the study is that the benefits of exercise come from the social element of being taught exercises by an instructor or being more active as part of a group. Of course, it's also possible that neither treatment made much difference, and that people would have improved over time anyway.

How reliable is the research?

The research only looked at older people, and although all of them had low mood, only about half had moderate or severe depression. So, the results might not apply to younger people, or people who are very depressed.

The main problem with the study is that there wasn't a control group of people getting no treatment. So, we know that exercise is no better than social contact, but not whether social contact is better than nothing.

Where does the study come from?

The study took place in Auckland, New Zealand. It was published in a journal called the Annals of Family Medicine.

What does this mean for me?

While hardly conclusive, this study suggests that more social contact may be helpful for older people with depression. Depression is seen as an illness, but there are lots of causes of low mood. Not all the people in the study had been diagnosed with clinical depression, so for some of them, it may be that they felt down because they were isolated. It's possible that social contact could boost mood for people in this situation.

What should I do now?

If you're feeling depressed, talk to your doctor. There are lots of treatments that can be helpful. Doctors should be able to recommend self-help groups and support groups, as well as talking therapies and drug treatments. Doctors sometimes recommend exercise as part of treating depression, especially if you're having trouble sleeping.

If you have an elderly relative who you think might be depressed, it may be worth considering whether there's anything you can do to help them have more social contact. If you're looking for help or advice, your GP is a good place to start, and there may also be carer support groups or voluntary organisations that can help you.

Reference:

Kerse N, Hayman KJ, Moyes SA, et al. Home-based activity program for older people with depressive symptoms. Annals of Family Medicine. 2010; 8: 214-223.

© BMJ Publishing Group Limited ("BMJ Group") 2010