Skip to main content

Exercise for Older Adults with Mental Health Problems

  • Chapter
  • First Online:

Abstract

Exercise or physical activity is considered as medicine, and both have several positive effects, which outweigh largely the risks. For older adults with mental health issues, physical activity and exercise might be even more important than for healthy people: exercise and physical activity can prevent or at least delay the onset of some mental disorders; they have therapeutic effects, either as the sole intervention or as an adjunct treatment for mental disorders. Patients are more likely to recover from a mental illness if they are regularly physically active. It is recommended for older adults to be physically active for at least 150 min per week at moderate intensity or for at least 75 min at vigorous intensity. Exercise adherence is quite low, and measures to improve exercise adherence should be implemented. Health-care providers should help older adults to find physical activities or exercise modalities that are perceived as pleasant. Caregivers of older adults with mental health issues should also be physically active, as this has a positive effect on the burden of carers of persons with mental health problems.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD   109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Fortier M, Guerin E, Segar ML. Words matter: reframing exercise is medicine for the general population to optimize motivation and create sustainable behaviour change. Appl Physiol Nutr Metab. 2016;41:1212–5.

    Article  PubMed  Google Scholar 

  2. Naci H, Ioannidis JP. Comparative effectiveness of exercise and drug interventions on mortality outcomes: metaepidemiological study. BMJ. 2013;347:f5577.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Vina J, et al. Exercise acts as a drug; the pharmacological benefits of exercise. Br J Pharmacol. 2012;167(1):1–12.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Orgeta V, Miranda-Castillo C. Does physical activity reduce burden in carers of people with dementia? A literature review. Int J Geriatr Psychiatry. 2014;29(8):771–83.

    Article  PubMed  Google Scholar 

  5. American College of Sports Medicine, et al. American College of Sports Medicine position stand. Exercise and physical activity for older adults. Med Sci Sports Exerc. 2009;41(7):1510–30.

    Article  Google Scholar 

  6. de Souto Barreto P, et al. Recommendations on physical activity and exercise for older adults living in long-term care facilities: a taskforce report. J Am Med Dir Assoc. 2016;17(5):381–92.

    Article  PubMed  Google Scholar 

  7. WHO. Physical activity and older adults recommended levels of physical activity for adults aged 65 and above. 2016. http://www.who.int/dietphysicalactivity/factsheet_olderadults/en/.

  8. Glazer NL, et al. Sustained and shorter bouts of physical activity are related to cardiovascular health. Med Sci Sports Exerc. 2013;45(1):109–15.

    Article  PubMed  PubMed Central  Google Scholar 

  9. McPhee JS, et al. Physical activity in older age: perspectives for healthy ageing and frailty. Biogerontology. 2016;17(3):567–80.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Evenson KR, Wen F, Herring AH. Associations of accelerometry-assessed and self-reported physical activity and sedentary behavior with all-cause and cardiovascular mortality among US adults. Am J Epidemiol. 2016;184(9):621–32.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Young J, Angevaren M, Rusted J, Tabet N. Aerobic exercise to improve cognitive function in older people without known cognitive impairment. Cochrane Database Syst Rev. 2015;(4):CD005381. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD005381.pub4/abstract.

  12. Kelly ME, et al. The impact of exercise on the cognitive functioning of healthy older adults: a systematic review and meta-analysis. Ageing Res Rev. 2014;16:12–31.

    Article  PubMed  Google Scholar 

  13. Schuch FB, et al. Are lower levels of cardiorespiratory fitness associated with incident depression? A systematic review of prospective cohort studies. Prev Med. 2016;93:159–65.

    Article  PubMed  Google Scholar 

  14. Krell-Roesch J, et al. Timing of physical activity, apolipoprotein E epsilon4 genotype, and risk of incident mild cognitive impairment. J Am Geriatr Soc. 2016;64:2479.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Jonas S, Phillips EM. ACSM’s exercise is medicine™: a clinician’s guide to exercise prescription. Philadelphia: Lippincott Williams & Wilkins; 2012.

    Google Scholar 

  16. Ngandu T, et al. A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial. Lancet. 2015;385(9984):2255–63.

    Article  PubMed  Google Scholar 

  17. Holden MA, et al. Role of exercise for knee pain: what do older adults in the community think? Arthritis Care Res (Hoboken). 2012;64(10):1554–64.

    Article  Google Scholar 

  18. Holden MA, et al. UK-based physical therapists’ attitudes and beliefs regarding exercise and knee osteoarthritis: findings from a mixed-methods study. Arthritis Care Res. 2009;61(11):1511–21.

    Article  Google Scholar 

  19. Fransen M, McConnell S, Bell M. Exercise for osteoarthritis of the hip or knee. Physiotherapy. 2003;89(9):516.

    Article  Google Scholar 

  20. Vannini F, et al. Sport and early osteoarthritis: the role of sport in aetiology, progression and treatment of knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc. 2016;24(6):1786–96.

    Article  CAS  PubMed  Google Scholar 

  21. Ni GX. Development and prevention of running-related osteoarthritis. Curr Sports Med Rep. 2016;15(5):342–9.

    Article  PubMed  Google Scholar 

  22. Williams PT. Effects of running and walking on osteoarthritis and hip replacement risk. Med Sci Sports Exerc. 2013;45(7):1292–7.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Timmins KA, et al. Running and knee osteoarthritis: a systematic review and meta-analysis. Am J Sports Med. 2017;45:1447.

    Article  PubMed  Google Scholar 

  24. Chakravarty EF, et al. Long distance running and knee osteoarthritis. A prospective study. Am J Prev Med. 2008;35(2):133–8.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Lefèvre-Colau M-M, et al. Is physical activity, practiced as recommended for health benefit, a risk factor for osteoarthritis? Ann Phys Rehabil Med. 2016;59:196.

    Article  PubMed  Google Scholar 

  26. Anwer S, Alghadir A, Brismée J-M. Effect of home exercise program in patients with knee osteoarthritis: a systematic review and meta-analysis. J Geriatr Phys Ther. 2016;39(1):38–48.

    Article  PubMed  Google Scholar 

  27. Morley JE, et al. Frailty consensus: a call to action. J Am Med Dir Assoc. 2013;14(6):392–7.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Bauman A, et al. Updating the evidence for physical activity: summative reviews of the epidemiological evidence, prevalence, and interventions to promote “active aging”. Gerontologist. 2016;56(Suppl 2):S268–80.

    Article  PubMed  Google Scholar 

  29. Bray NW, et al. Exercise prescription to reverse frailty. Appl Physiol Nutr Metab. 2016;41(10):1112–6.

    Article  PubMed  Google Scholar 

  30. de Labra C, et al. Effects of physical exercise interventions in frail older adults: a systematic review of randomized controlled trials. BMC Geriatr. 2015;15:154.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Zschucke E, Gaudlitz K, Ströhle A. Exercise and physical activity in mental disorders: clinical and experimental evidence. J Prev Med Public Health. 2013;46(Suppl 1):S12–21.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Zheng G, et al. Aerobic exercise ameliorates cognitive function in older adults with mild cognitive impairment: a systematic review and meta-analysis of randomised controlled trials. Br J Sports Med. 2016;50:1443.

    Article  PubMed  Google Scholar 

  33. Styliadis C, et al. Neuroplastic effects of combined computerized physical and cognitive training in elderly individuals at risk for dementia: an eLORETA controlled study on resting states. Neural Plast. 2015;2015:172192.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Suo C, et al. Therapeutically relevant structural and functional mechanisms triggered by physical and cognitive exercise. Mol Psychiatry. 2016;21:1645.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Fiatarone Singh MA, et al. The Study of Mental and Resistance Training (SMART) study-resistance training and/or cognitive training in mild cognitive impairment: a randomized, double-blind, double-sham controlled trial. J Am Med Dir Assoc. 2014;15(12):873–80.

    Article  PubMed  Google Scholar 

  36. Groot C, et al. The effect of physical activity on cognitive function in patients with dementia: a meta-analysis of randomized control trials. Ageing Res Rev. 2016;25:13–23.

    Article  CAS  PubMed  Google Scholar 

  37. de Andrade LP, et al. Benefits of multimodal exercise intervention for postural control and frontal cognitive functions in individuals with Alzheimer’s disease: a controlled trial. J Am Geriatr Soc. 2013;61(11):1919–26.

    Article  PubMed  Google Scholar 

  38. Paillard T. Preventive effects of regular physical exercise against cognitive decline and the risk of dementia with age advancement. Sports Med Open. 2015;1(1):4.

    Article  Google Scholar 

  39. Burton E, et al. Effectiveness of exercise programs to reduce falls in older people with dementia living in the community: a systematic review and meta-analysis. Clin Interv Aging. 2015;10:421–34.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Catalan-Matamoros D, et al. Exercise improves depressive symptoms in older adults: an umbrella review of systematic reviews and meta-analyses. Psychiatry Res. 2016;244:202–9.

    Article  PubMed  Google Scholar 

  41. Adamson BC, Ensari I, Motl RW. Effect of exercise on depressive symptoms in adults with neurologic disorders: a systematic review and meta-analysis. Arch Phys Med Rehabil. 2015;96(7):1329–38.

    Article  PubMed  Google Scholar 

  42. Rosenbaum S, et al. Physical activity interventions for people with mental illness: a systematic review and meta-analysis. J Clin Psychiatry. 2014;75(9):964–74.

    Article  PubMed  Google Scholar 

  43. Bridle C, et al. Effect of exercise on depression severity in older people: systematic review and meta-analysis of randomised controlled trials. Br J Psychiatry. 2012;201(3):180–5.

    Article  PubMed  Google Scholar 

  44. Ravindran AV, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 clinical guidelines for the management of adults with major depressive disorder: section 5. Complementary and alternative medicine treatments. Can J Psychiatry. 2016;61(9):576–87.

    Article  PubMed  PubMed Central  Google Scholar 

  45. WHO Mental Health. Physical activity. 2012. https://www.who.int/mental_health/mhgap/evidence/depression/q6/en/. Last accessed 22 March 2019.

  46. NICE. Depression in adults: recognition and management. Published 2009, updated 2016. 2016 [cited 13.11.2016]. https://www.nice.org.uk/guidance/cg90/ifp/chapter/treatments-for-mild-to-moderate-depression.

  47. Hallgren M, et al. Treatment guidelines for depression: greater emphasis on physical activity is needed. Eur Psychiatry. 2016;40:1–3.

    Article  PubMed  Google Scholar 

  48. Liu X, et al. A systematic review and meta-analysis of the effects of Qigong and Tai Chi for depressive symptoms. Complement Ther Med. 2015;23(4):516–34.

    Article  PubMed  Google Scholar 

  49. Dunn AL, et al. Exercise treatment for depression: efficacy and dose response. Am J Prev Med. 2005;28(1):1–8.

    Article  PubMed  Google Scholar 

  50. Schuch FB, et al. Exercise as a treatment for depression: a meta-analysis adjusting for publication bias. J Psychiatr Res. 2016;77:42–51.

    Article  PubMed  Google Scholar 

  51. Heinzel S, et al. Using exercise to fight depression in older adults: a systematic review and meta-analysis. GeroPsych. 2015;28(4):149.

    Article  Google Scholar 

  52. Blumenthal JA, Smith PJ, Hoffman BM. Is exercise a viable treatment for depression? ACSMs Health Fit J. 2012;16(4):14.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Jayakody K, Gunadasa S, Hosker C. Exercise for anxiety disorders: systematic review. Br J Sports Med. 2014;48(3):187–96.

    Article  PubMed  Google Scholar 

  54. Wegner M, et al. Effects of exercise on anxiety and depression disorders: review of meta-analyses and neurobiological mechanisms. CNS Neurol Disord Drug Targets. 2014;13(6):1002–14.

    Article  CAS  PubMed  Google Scholar 

  55. Lamego MK, et al. Aerobic exercise reduces anxiety symptoms and improves fitness in patients with panic disorder. MedicalExpress. 2016;3(3). https://doi.org/10.5935/medicalexpress.2016.03.06.

  56. Baldwin DS, et al. Evidence-based pharmacological treatment of anxiety disorders, post-traumatic stress disorder and obsessive-compulsive disorder: a revision of the 2005 guidelines from the British Association for Psychopharmacology. J Psychopharmacol. 2014;28(5):403–39.

    Article  PubMed  CAS  Google Scholar 

  57. Bartley CA, Hay M, Bloch MH. Meta-analysis: aerobic exercise for the treatment of anxiety disorders. Prog Neuro-Psychopharmacol Biol Psychiatry. 2013;45:34–9.

    Article  Google Scholar 

  58. Hovland A, et al. Comparing physical exercise in groups to group cognitive behaviour therapy for the treatment of panic disorder in a randomized controlled trial. Behav Cogn Psychother. 2013;41(4):408–32.

    Article  PubMed  Google Scholar 

  59. Brown S, et al. Twenty-five year mortality of a community cohort with schizophrenia. Br J Psychiatry. 2010;196(2):116–21.

    Article  PubMed  PubMed Central  Google Scholar 

  60. Rosa Rimes R, et al. Effects of exercise on physical and mental health, and cognitive and brain functions in schizophrenia: clinical and experimental evidence. CNS Neurol Disord Drug Targets. 2015;14(10):1244–54.

    Article  CAS  Google Scholar 

  61. Stubbs B, et al. Falls in older adults with major depressive disorder (MDD): a systematic review and exploratory meta-analysis of prospective studies. Int Psychogeriatr. 2016;28(1):23–9.

    Article  PubMed  Google Scholar 

  62. Bunn F, et al. Preventing falls among older people with mental health problems: a systematic review. BMC Nurs. 2014;13(1):4.

    Article  PubMed  PubMed Central  Google Scholar 

  63. Sherrington C, et al. Exercise to prevent falls in older adults: an updated systematic review and meta-analysis. Br J Sports Med. 2017;51:1750.

    Article  PubMed  Google Scholar 

  64. Kosmat H, Vranic A. The efficacy of dance intervention as a cognitive training for old-old. J Aging Phys Act. 2017;25:32.

    Article  PubMed  Google Scholar 

  65. Merom D, et al. Social dancing and incidence of falls in older adults: a cluster randomised controlled trial. PLoS Med. 2016;13(8):e1002112.

    Article  PubMed  PubMed Central  Google Scholar 

  66. Scherr J, et al. Associations between Borg’s rating of perceived exertion and physiological measures of exercise intensity. Eur J Appl Physiol. 2013;113(1):147–55.

    Article  PubMed  Google Scholar 

  67. Hofmann P, Tschakert G. Special needs to prescribe exercise intensity for scientific studies. Cardiol Res Pract. 2010;2011:209302.

    PubMed  PubMed Central  Google Scholar 

  68. Woltmann ML, et al. Evidence that the talk test can be used to regulate exercise intensity. J Strength Cond Res. 2015;29(5):1248–54.

    Article  PubMed  Google Scholar 

  69. Yu F, Demorest SL, Vock DM. Testing a modified perceived exertion scale for Alzheimer’s disease. Psych J. 2015;4(1):38–46.

    Article  PubMed  Google Scholar 

  70. Yu F, Bil K. Correlating heart rate and perceived exertion during aerobic exercise in Alzheimer’s disease. Nurs Health Sci. 2010;12(3):375–80.

    Article  PubMed  PubMed Central  Google Scholar 

  71. Reed JL, Pipe AL. The talk test: a useful tool for prescribing and monitoring exercise intensity. Curr Opin Cardiol. 2014;29(5):475–80.

    Article  PubMed  Google Scholar 

  72. Reed JL, Pipe AL. Practical approaches to prescribing physical activity and monitoring exercise intensity. Can J Cardiol. 2016;32(4):514–22.

    Article  PubMed  Google Scholar 

  73. Gearhart RF Jr, et al. Strength tracking using the OMNI resistance exercise scale in older men and women. J Strength Cond Res. 2009;23(3):1011–5.

    Article  PubMed  Google Scholar 

  74. Csapo R, Alegre LM. Effects of resistance training with moderate vs heavy loads on muscle mass and strength in the elderly: a meta-analysis. Scand J Med Sci Sports. 2016;26(9):995–1006.

    Article  CAS  PubMed  Google Scholar 

  75. Bolmont B, et al. Mood states and anxiety influence abilities to maintain balance control in healthy human subjects. Neurosci Lett. 2002;329(1):96–100.

    Article  CAS  PubMed  Google Scholar 

  76. Nitz JC, Choy NL, Ogilvie M. The effect of depression on balance decline in mature women. Hong Kong Physiother J. 2005;23(1):27–35.

    Article  Google Scholar 

  77. Bolbecker AR, et al. Postural control in bipolar disorder: increased sway area and decreased dynamical complexity. PLoS One. 2011;6(5):e19824.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  78. Horak FB, Wrisley DM, Frank J. The balance evaluation systems test (BESTest) to differentiate balance deficits. Phys Ther. 2009;89(5):484–98.

    Article  PubMed  PubMed Central  Google Scholar 

  79. Tamura T, et al. The impaired balance systems identified by the BESTest in older patients with knee osteoarthritis. PM R. 2016;8(9):869–75.

    Article  PubMed  Google Scholar 

  80. Toots A, et al. Effects of a high-intensity functional exercise program on dependence in activities of daily living and balance in older adults with dementia. J Am Geriatr Soc. 2016;64(1):55–64.

    Article  PubMed  PubMed Central  Google Scholar 

  81. Zhu X, et al. The more the better? A meta-analysis on effects of combined cognitive and physical intervention on cognition in healthy older adults. Ageing Res Rev. 2016;31:67–79.

    Article  PubMed  Google Scholar 

  82. Lampit A, Hallock H, Valenzuela M. Computerized cognitive training in cognitively healthy older adults: a systematic review and meta-analysis of effect modifiers. PLoS Med. 2014;11(11):e1001756.

    Article  PubMed  PubMed Central  Google Scholar 

  83. Lampit A, Valenzuela M, Gates NJ. Computerized cognitive training is beneficial for older adults. J Am Geriatr Soc. 2015;63(12):2610–2.

    Article  PubMed  Google Scholar 

  84. Firth J, et al. Motivating factors and barriers towards exercise in severe mental illness: a systematic review and meta-analysis. Psychol Med. 2016;46(14):2869–81.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  85. Mielke MM, et al. Assessing the temporal relationship between cognition and gait: slow gait predicts cognitive decline in the Mayo Clinic Study of Aging. J Gerontol Ser A Biol Med Sci. 2013;68(8):929–37.

    Article  Google Scholar 

  86. Beauchet O, et al. Poor gait performance and prediction of dementia: results from a meta-analysis. J Am Med Dir Assoc. 2016;17(6):482–90.

    Article  PubMed  PubMed Central  Google Scholar 

  87. Deshpande N, et al. Gait speed under varied challenges and cognitive decline in older persons: a prospective study. Age Ageing. 2009;38:509.

    Article  PubMed  PubMed Central  Google Scholar 

  88. Lundin-Olsson L, Nyberg L, Gustafson Y. Stops walking when talking as a predictor of falls in elderly people. Lancet. 1997;349(9052):617.

    Article  CAS  PubMed  Google Scholar 

  89. Montero-Odasso M, et al. Gait variability is associated with frailty in community-dwelling older adults. J Gerontol Ser A Biol Med Sci. 2011;66(5):568–76.

    Article  Google Scholar 

  90. Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142–8.

    Article  CAS  PubMed  Google Scholar 

  91. Nordin E, Rosendahl E, Lundin-Olsson L. Timed “Up & Go” test: reliability in older people dependent in activities of daily living—focus on cognitive state. Phys Ther. 2006;86(5):646–55.

    PubMed  Google Scholar 

  92. Barry E, et al. Is the Timed Up and Go test a useful predictor of risk of falls in community dwelling older adults: a systematic review and meta-analysis. BMC Geriatr. 2014;14(1):1.

    Article  Google Scholar 

  93. Guralnik JM, et al. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol. 1994;49(2):M85–94.

    Article  CAS  PubMed  Google Scholar 

  94. Alzheimer’s Society Factsheet: exercise and physical activity. 2015. https://www.alzheimers.org.uk/sites/default/files/migrate/downloads/factsheet_exercise_and_physical_activity.pdf. Last accessed 22 March 2019.

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Hilfiker, R. (2019). Exercise for Older Adults with Mental Health Problems. In: de Mendonça Lima, C., Ivbijaro, G. (eds) Primary Care Mental Health in Older People. Springer, Cham. https://doi.org/10.1007/978-3-030-10814-4_11

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-10814-4_11

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-10812-0

  • Online ISBN: 978-3-030-10814-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics