Physical Activity as a Non-Pharmacological Intervention for Depressive Symptoms in Older Adults — A Narrative Review

Background. Depression is a common mental health disorder among older adults and is associated with impaired quality of life, functional decline, and increased morbidity. Physical activity has emerged as a promising non-pharmacological intervention; however, uncertainty remains regarding the optimal exercise prescription and the comparative effectiveness of exercise modalities. Aim. To critically evaluate the literature regarding physical activity as a non-pharmacological intervention for depressive symptoms in older adults, with emphasis on exercise modality, exercise dose, intervention duration, long-term outcomes, and methodological limitations. Material and methods. A narrative literature review was conducted using PubMed and Google Scholar. Priority was given to systematic reviews, meta-analyses, network meta-analyses, and randomised controlled trials investigating the effects of physical activity and structured exercise on depressive symptoms in older adults. Results. The accumulated evidence indicates that structured exercise reduces depressive symptoms in older adults, while habitual physical activity is associated with a lower risk of developing depressive symptoms. Although aerobic, resistance, mind–body, walking, neuromotor, and multicomponent exercise have all demonstrated beneficial effects, no single exercise modality has shown consistent superiority among studies. Exercise dose, programme duration, and adherence may influence treatment outcomes, but the optimal exercise prescription remains uncertain because of substantial methodological heterogeneity. Conclusions. Structured exercise is an effective non-pharmacological intervention for reducing depressive symptoms in older adults and should be considered as part of comprehensive depression management. Exercise programmes should be individualised, while further high-quality studies are needed to optimise exercise recommendations and strengthen the evidence base for clinical practice.