A large review of 49 prospective cohort studies (1,837,794 patient-year follow-up) evaluating the incidence of depression compared to levels of physical activity has demonstrated that those with high levels of physical activity had a lower chance of developing depression when compared to those with low levels of physical activity (adjusted odds ration 0.83; 95% CI 0.79,0.88). This effect was observed regardless of age and geographical location (1). A cross-sectional study of 4402 US medical students demonstrated overall higher quality of life scores, and lower features of burnout, in those who followed the recommended Centres for Disease Control & Prevention (CDC) exercise guidelines for both aerobic (51.3% vs 60.8%; p<0.0001) and strength-training exercise (51.8% vs 58.6%; p<0.0001), compared to those who did not meet the activity guidelines, independent of age, sex, relationship status, children & year of study (2). Another prospective cohort study showed that regular moderate exercise for >15 minutes/session, 3x/week is significantly associated with a lower risk of depressive symptoms in older adults (3). A cross-sectional survey-based study of individuals with a history of stroke demonstrated that physical activity reduced the risk of post-stroke depression by between 36.1-42.4%, however this did not take into account all factors, including severity of the stroke, pre-depression status and if there was a previous history of treatment for depression (4).
Quality of evidence
Strength of recommendation
- Physical Activityand Incident Depression: A Meta-Analysis of Prospective Cohort Studies.
Am J Psychiatry. 2018 Apr 25
- Healthy Exercise Habits Are Associated With Lower Risk of Burnout and Higher Quality of Life Among U.S. Medical Students.
Acad Med. 2017 Jul;92(7):1006-1011.
- Effects of different amounts of exercise on preventing depressive symptoms in community-dwelling older adults: a prospective cohort study in Taiwan.
BMJ Open. 2017 May 2;7(4): e014256
- Physical Activity and the Risk of Depression in Community-Dwelling Korean Adults With a History of Stroke.
Phys Ther. 2017 Jan 1;97(1):105-113