Spanish expert explains how to combat aging with physiotherapy

We all know that physiotherapy can contribute to a healthier aging process from a physical standpoint. But what about emotional issues? Is it also able to help in that regard?

Although we are increasingly reaching old age with a higher quality of life in purely physiological terms, the epidemic of mental health problems is affecting this demographic group more and more. According to the World Health Organization, mental disorders account for 11% of the years lived with disability in the elderly population. The latest study by the Global Health Estimates reveals that a quarter of suicides occur in people over 60 years old.

Culture medium for depression

The main risk factors for developing mental illnesses are age discrimination, isolation, and loneliness. At the time of retirement, social routines are lost, in addition to the increased frequency of deaths among close people or the distancing from children, losses that can be difficult to overcome in the later years of life.

One of the most common emotional health problems in this sector of the population is depression. It affects up to 10% of older adults living in their homes and increases to 25% for those in residential care facilities, exacerbating age-related pain and illnesses.

Depression affects up to 10% of elderly adults living in their homes and increases to 25% for those living in residential care facilities”

Like any other illness, depression should be diagnosed by a healthcare professional. However, certain symptoms, which should last for at least two weeks, may raise suspicions among the elderly person’s environment: sad mood, irritable mood, lack of interest, lack of energy, low self-esteem, feelings of guilt, and lack of concentration.

Although medical treatment is very effective in adults, pharmacological therapy shows poorer results in the elderly. It is necessary to look for other strategies to complement it. And physiotherapy has already proven its effectiveness, in collaboration with other specialties, in pathologies such as Alzheimer’s or Parkinson’s.

Moving is essential

As we have already pointed out, loneliness, isolation, and medical issues often lead older people to gradually decrease their activity, which increases their physical ailments. This, in turn, contributes to the onset and exacerbation of depressive symptoms. Hence, several clinical guidelines such as NICE or the National Health Service Guide recommend exercise as part of the treatment for this condition, especially in older adults.

A systematic review published in 2020 already showed that exercise combined with psychological intervention significantly improves depressive symptoms. Among its numerous benefits, it releases endorphins, substances related to pleasure, pain reduction, and well-being.

In addition, the muscle in motion generates myokines, molecules with multiple functions. One of them is related to the production of a protein called BDNF (brain-derived neurotrophic factor). This protein is linked to a lower cognitive decline, better neuronal regeneration, and antidepressant effects.

We must not forget that a large part of the elderly population suffers from some type of musculoskeletal pain or pathology, which increases the fear of movement in these individuals. Therefore, a protocol must be designed tailored to their individual needs and ailments, taking into account their degree of fragility.

In the hands of the physiotherapist

When it comes to specific physiotherapy techniques, many of them are used both to control chronic pain and to improve mobility, flexibility, and strength, which will impact daily task management and mood. But can isolated symptoms of depression be improved? We will explore some tools that these professionals can apply.

For example, transcranial magnetic stimulation is a procedure that uses magnetic fields in a painless way to stimulate nerve cells, improving the symptoms of major depression and other typical mental illnesses in older people, such as various types of dementia. It is applied externally, so the patient can receive this treatment in the neurologist’s or physiotherapist’s office.

Transcranial Magnetic Stimulation improves the symptoms of major depression and other typical mental illnesses in older people, such as various types of dementia”

Hydrotherapy has also been revealed to be useful, as it facilitates relaxation and movement in the water, along with breathing techniques and muscle relaxation, which enhance the mind-body connection. Other key pillars to help improve depressive symptoms are therapeutic exercise and adapted movement, preferably in a group setting.

In essence, aging is a natural process that we will all go through, but it is not necessarily the cause of depression. And if depression does appear, group exercise and physical activity can be a good strategy, within a multidisciplinary approach, to try to address it.

This article was originally published in The Conversation. José Lesmes Poveda López is a Physiotherapy professor at Universidad San Jorge. Beatriz Carpallo Porcar is a physiotherapist and teaching and research staff member in the Physiotherapy and Nursing degrees at Universidad San Jorge. She is also a member of the iPhysio research group.