Higher Daily Step Count Linked to Lower Risk for Depression Among Adults

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Higher daily step counts are associated with fewer depressive symptoms in adults, according to a systematic review and meta-analysis published in JAMA Network Open.

The findings from the analysis of 33 observational studies involving over 96 000 adults were consistent with previous studies linking exercise to various risk reductions for mental health disorders and demonstrate that setting step goals “may be a promising and inclusive public health strategy for the prevention of depression,” first author Bruno Bizzozero-Peroni, PhD, MPH, from Universidad De Castilla-La Mancha in Spain, and colleagues wrote.

As wearable technology becomes more prevalent, monitoring daily steps has become increasingly accessible for the general population.

“To our knowledge, the association between the number of daily steps measured with wearable trackers and depression has not been previously examined through a meta-analytic approach,” investigators noted.

Bizzozero-Peroni and colleagues searched multiple databases for analyses assessing the effects of daily step counts on symptoms of depression. They reviewed a total of 27 cross-sectional studies and 6 longitudinal studies comprising 96 173 adults aged 18 years or older, according to the study.

Pooled standardized mean differences (SMDs) from the cross-sectional studies showed that 10 000 or more steps/day; 7500 to 9999 steps/day; and 5000 to 7499 steps/day were significantly associated with fewer depressive symptoms compared with fewer than 5000 steps/day (SMDs, −0.26, −0.27, and −0.17, respectively), according to the results.

In the prospective cohort studies, adults with 7000 or more steps per day had a reduced risk for depression compared with those with fewer than 7000 daily steps (risk ratio [RR] 0.69, 95% CI 0.62-0.77), whereas an increase of 1000 steps a day suggested an association with a lower risk for depression (RR 0.91, 95% CI 0.87-0.94).

Investigators acknowledged limitations to these results, including variability in study quality and the inability to establish causality. They called for more longitudinal and experimental studies to determine optimal step counts tailored to individual demographics and health conditions.

Bizzozero-Peroni and colleagues highlighted several possible biological and psychosocial mechanisms behind the associations, like changes in sleep quality, inflammation, social support, self-esteem, neuroplasticity, and self-efficacy.

Researchers concluded that “a daily active lifestyle may be a crucial factor in regulating and reinforcing these pathways” regardless of the exact combination of mechanisms responsible for the positive link.

Reference: Bizzozero-Peroni B, Díaz-Goñi V, Jiménez-López E, et al. Daily step count and depression in adults: A systematic review and meta-analysis. JAMA Netw Open. Published online December 16, 2024. doi:10.1001/jamanetworkopen.2024.51208