Women with chronic illness who engaged in vigorous physical activity had less severe depression, according to the results of a study published in the Journal of Affective Disorders, but health-related quality of life (HRQoL) explained much of the variance in depression symptoms.

A bidirectional relationship exists between depression and chronic illness, with depression contributing to poor health behaviors and increasing the risk for a chronic illness developing, whereas the presence of chronic illness can trigger depression.

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Erica McIntyre, PhD, of the University of Technology Sydney, Faculty of Health, Ultimo New South Wales, Australia, and colleagues analyzed data from 1932 women diagnosed with 1 of 5 chronic illnesses — asthma, depression, diabetes, osteoarthritis, or osteoporosis — who had participated in a substudy of the 45 and Up Study. This was a cross-sectional study of people age ≥45 years that measured, among other things, depression symptoms, HRQoL, health-related hardiness, sleep quality, and health behaviors such as physical activity. The investigators used the Center for Epidemiological Studies Depression scale 10-item version to gauge the severity of depression symptoms and an adapted version of the Active Australia Survey to measure physical activity.

A multiple regression model found that intensity of physical activity significantly predicted depression symptoms (P <.001), whereas HRQoL explained the most variance in depression symptoms (B =−10). The mean age of participants was 68.74±8.76 years, and the overall mean Center for Epidemiological Studies Depression scale 10-item version score was 7.59. Nearly one-third (31.4%) of women met the criteria for clinically relevant depression. As for physical activity, 52% of the study cohort participated in ≥5 sessions of physical activity, and only 18% reported no physical activity sessions. The majority (60.4%) of women participated in enough physical activity to confer a health benefit, and nearly two-thirds of those women were highly active.

The study was limited by the self-reported nature of the data on depression and physical activity. Other limits were the cross-sectional design of the study and the complex relationships among the variables. The authors suggested that future studies use sophisticated modeling techniques with longitudinal designs and larger sample sizes to provide adequate power and allow for a better understanding of HRQoL and depression in older women with chronic illness.

The authors contended that improving HRQoL is essential for the prevention and management of depression symptoms in women with chronic illness and that physical activity is an important element of managing chronic illness. Psychological and health-related issues that influence HRQoL, such as sleep quality and health-related hardiness, are crucial factors for physicians to consider in older women with chronic illness.


McIntyre E, Lauche R, Frawley J, Sibbritt D, Reddy P, Adams J. Physical activity and depression symptoms in women with chronic illness and the mediating role of health-related quality of life. J Affect Disord. 2019;252:294-299.