Comparison of moderate and vigorous walking exercise on reducing depression in middle‐aged and older adults: A pilot randomized controlled trial

Abstract

The optimal intensity of physical activity for alleviating depression in middle-aged and older adults remains unclear. The World Health Organization (WHO) physical activity guidelines recommend adults and older adults to accumulate at least 150-300 minutes of moderate or 75-150 minutes of vigorous aerobic-type physical activity weekly or an equivalent combination of both for health benefits including reduced risk of depression. This parallel, assessor-blinded, pilot randomized controlled trial preliminarily compared the effectiveness of the minimal volume of aerobic-type physical activity at different intensities as recommended by WHO (150 minutes of moderate walking exercise and 75 minutes of vigorous walking exercise weekly) on alleviating depression in middle-aged and older adults. Thirty-five participants were randomized to the control group (CON), moderate walking exercise group (MOD), or vigorous walking exercise group (VIG). The exercise frequency was three times a week and the intervention duration was 12 weeks. The primary outcome was the severity of depression assessed by Beck Depression Inventory. Secondary outcomes included severity of anxiety, sleep quality, quality of life, and cardiorespiratory fitness. Thirty participants completed the study (CON: n = 10, MOD: n = 10, VIG: n = 10). Participants in both MOD and VIG had significantly decreased depression severity after the intervention compared to CON (both p < 0.001). There was no significant difference between MOD and VIG (p = 0.92). Both MOD and VIG interventions also mitigated anxiety severity, improved quality of life and cardiorespiratory fitness. The minimum volume of walking exercise at either moderate or vigorous intensity was found to alleviate depression in middleaged and older adults.Trial registration: ClinicalTrials.gov identifier: NCT04403373. Highlights. The 12-week 150-minute moderate walking exercise and 75-minute vigorous walking exercise (the minimal weekly volumes of aerobic-type physical activity recommended by WHO guidelines) similarly reduced the severity of depression in middle-aged and older adults. . The 12-week walking exercise interventions significantly reduced anxiety severity concomitant with improved quality of life and cardiorespiratory fitness in middle-aged and older adults with depression.

Effects of exercise intensity and frequency on improving cognitive performance in middle-aged and older adults with mild cognitive impairment: A pilot randomized controlled trial on the minimum physical activity recommendation from WHO

“…Estimation of sample size was performed using G*Power 3.0 by setting the test family and statistical test to “F tests” and “ANOVA: Repeated measures, within-between interaction”. Based on a medium effect size of interaction Cohen’s d = 0.3 and a five-arm pretest-posttest design, 40 participants were needed to achieve an 80% statistical power with α = 0.05 ( Heyn et al, 2004 ; Yu et al, 2022b ). Considering a 15% drop-out rate, a total of 50 participants (rounded up from 48) were required ( Yu et al, 2022a ).…”

“…Cardiorespiratory fitness (VO 2max ) was measured by the symptom-free cardiorespiratory treadmill test using a modified Bruce protocol ( Yu et al, 2022b ). The VO 2max responses were determined as meeting at least two of the following criteria: 1) plateau of VO 2 with increasing intensity, 2) respiratory exchange ratio (RER) ≥1.10, and 3) heart rate ≥95% age-predicted maximal heart rate (220-age) ( Yu et al, 2022b ).…”

“…The linear equation between the VO 2 and the heart rate was computed using the Frontiers in Physiology frontiersin.org "Display Equation on chart" function. Using the linear equation and the exercise intensity (3.5 METs or 7 METs) assigned to the specific participant, the THR was then calculated (Yu et al, 2022b). Participants were required to maintain the heart rate within the THR range (THR ±10 beats per minute) during the walking sessions.…”

Health benefits of physical activity for people with mental disorders: From the perspective of multidimensional subjective wellbeing

“…Third, this paper systematically examines the heterogeneity of benefits brought by physical activity. Literature demonstrates variations in exercise habits among people with different characteristics (31)(32)(33)(34)(35)(36)(37)(38)(39), but it is unclear whether there also exist heterogeneities in the health benefits of physical activity. Based on this, this paper systematically examines whether physical exercise brings health benefits to people with depressive disorders using a large-scale representative micro dataset in China, and conducts mechanism analysis from the perspective of multidimensional subjective wellbeing.…”

“…For example, regular exercise is an effective way to maintain a good psychological state and its benefits are more prominent for older people ( 33 ). Among the elderly, moderate exercise is very helpful in promoting mental health ( 34 , 35 ). In addition, women exhibit higher levels of depression and therefore are more likely to gain health benefits from regular exercises ( 17 , 32 ).…”