Higher Daily Step Counts Linked to Fewer Depressive Symptoms
Higher daily step counts were associated with fewer depressive symptoms, as well as a lower prevalence and risk of depression, in a recent systematic review and meta-analysis published in JAMA Network Open.
“The objective measurement of daily steps may represent an inclusive and comprehensive approach to public health that has the potential to prevent depression,” authors noted.
Related: Are men or women more affected by depressive episodes?
Researchers searched the PubMed, PsycINFO, Scopus, SPORTDiscus, and Web of Science databases for observational studies conducted up to May 18, 2024, that involved physical activity, measures of daily steps, and depression. Included studies had depression data and daily step counts that were objectively measured. Pooled effect sizes with 95% CIs were estimated using the Sidik-Jonkman random-effects method.
A total of 33 studies (27 cross-sectional and 6 longitudinal [3 panel and 3 prospective cohort]) with a total of 96,173 adult participants were included in the final study. Daily steps were inversely correlated with depressive symptoms in both cross-sectional and panel studies. When compared with fewer than 5000 steps/d, pooled SMDs from cross-sectional studies revealed that 10,000 or more steps/d (SMD, −0.26; 95% CI, −0.38 to −0.14), 7500 to 9999 steps/d (SMD, −0.27; 95% CI, −0.43 to −0.11), and 5000 to 7499 steps/d (SMD, −0.17; 95% CI, −0.30 to −0.04) were significantly associated with fewer depressive symptoms. Pooled estimates from prospective cohort studies showed similar results with participants with 7000 or more steps/d having a reduced risk of depression compared with peers with fewer than 7000 steps/d (RR, 0.69; 95% CI, 0.62-0.77). An increase of 1000 steps/d was associated with a lower risk of depression (RR, 0.91; 95% CI, 0.87-0.94).
Researchers highlighted several limitations, including the inability to make causal inferences and the potential for reverse associations. Substantial heterogeneity in pooled estimates was influenced by participant characteristics and step-counting device differences, with residual confounding from unmeasured factors like physical activity modalities and stress. Many studies lacked robust methodologies, which may have impacted reliability, though high-quality studies showed reduced heterogeneity and pooled estimates. Additionally, publication bias and wide 95% prediction intervals suggest the findings should be interpreted cautiously.
“Further prospective cohort studies are needed to clarify the potential protective role of daily steps in mitigating the risk of depression during adulthood,” authors concluded.
