OBJECTIVES: To review the literature on the (I) possible protective effect of physical activity on the incidence of depression, and (II) on the efficacy of physical exercise as a therapeutic intervention in depression. METHODS: Systematic review of ISI, PubMed, LILACS and SciELO articles in English and Portuguese from January 1993 to May 2005 using the keywords "depression," "elderly," and "exercise." Articles assessing the effect of physical exercise in the elderly with clinical diseases or that used depression scales only for initial diagnosis were excluded. RESULTS: We found 155 articles, 22 of which met the inclusion criteria. Other eight studies were included after a manual search. Cross-sectional studies (n = 8) used only self-evaluation questionnaires to measure the levels of physical activity. Longitudinal studies (n = 22) also used digital pedometer, direct measurements of oxygen consumption and physical exercise as methodological intervention. The studies meeting the first objective pointed to an inverse relationship between physical activity and changes in levels of depression. The studies that used physical activity as a therapeutic intervention in depression found divergent results and pointed to the interference of physiological and psychological factors on this relation. CONCLUSION: There are two aspects involved in the role of physical activity and exercise in the treatment of depression. Depression decreases the practice of physical activities; physical activity may be useful in the treatment and prevention of depression in the elderly.
Depression; elderly; physical activity; exercise; systematic review
