Journal of Obesity & Metabolic Syndrome



Korean J Obes 2014; 23(2): 125-130

Published online June 30, 2014

Copyright © Korean Society for the Study of Obesity.

Association between Depression and Physical Fitness, Body Fatness and Serum Vitamin D in Elderly Population

In-Hwan Lee, Young-Yun Jin, Jin-Kyung Cho, Jin-Hwan Yoon1, Hyun-Sik Kang*

College of Sport Science, Sungkyunkwan University, Suwon; Department of Kinesiology1, Hannam University, Daejeon, Korea

Received: December 24, 2013; Reviewed : January 15, 2014; Accepted: January 16, 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background: This study examined the association of depression with functional physical fitness, body fatness, and serum vitamin D in elderly persons.
Methods: This was a cross sectional study involving 21 men with mean age of 75.4±6.8 years and 96 women with mean age of 75.0± 6.8 years. Body mass index, percent body fat, and waist circumference were measured according to a standardized protocol. Functional physical fitness including strength, cardiorespiratory endurance, agility, dynamic balance and flexibility was measured in accordance to a standardized fitness assessment manual. Serum levels of vitamin D, lipoprotein lipids, fasting glucose and insulin were measured with standardized procedures. Korean form of Geriatric Depression Scale (K-GDS) was used to assess depression level and status. Pearson correlation analyses were used to calculate bivariate correlations between measured variables. Multiple linear regression analyses were used to identify any independent predictors for K-GDS-based depression score.
Results: Depression score was significantly and inversely associated with functional physical fitness including strength (P<0.001), cardiorespiratory endurance (P<0.001), agility (P=0.002) and dynamic balance (P<0.001). A similar trend in correlation was observed between depression and serum vitamin D level. Multiple linear regression analyses showed that strength (P<0.001), cardiorespiratory endurance (P=0.005), and percent body fat (P=0.045) were significant independent predictors of depression in this study population.
Conclusion: The finding of the study suggest that fitness promotion along with a healthy diet habit should be a key component of intervention against depression in elderly persons.

Keywords: Depression, Functional physical fitness, Body fat, Vitamin D, Elderly persons

Physical characteristics of the subjects

Comparison of body composition variables between case and control group

Relations of K-GDS scores to functional physical fitness parameters

Relations of K-GDS scores to age, sex and body fatness

Relations of K-GDS scores to metabolic risk factors and vitamin D

Regression analyses for independent predictors of K-GDS score-based depression

  1. Statistics Korea. 2009 Statistics on the Aged. [accessed 2013 Dec 24]; Available from: URL:
  2. Ministry of Health & Welfare. Ministry of health and welfare statistical yearbook 2012. 58th ed. Seoul: Ministry of Health & Welfare;2012. p. 6-9.
  3. Carney RM, Freedland KE, Miller GE, Jaffe AS. Depression as a risk factor for cardiac mortality and morbidity: a review of potential mechanisms. J Psychosom Res 2002;53:897-902.
  4. Newcomer JW, Haupt DW, Fucetola R, Melson AK, Schweiger JA, Cooper BP, et al. Abnormalities in glucose regulation during antipsychotic treatment of schizophrenia. Arch Gen Psychiatry 2002;59:337-45.
    Pubmed CrossRef
  5. National Health Insurance Service. Geriatric depression disorders over the past five years. [accessed 2013 Apr 29]; Available from:URL:
  6. Villareal DT, Chode S, Parimi N, Sinacore DR, Hilton T, Armamento-Villareal R, et al. Weight loss, exercise, or both and physical function in obese older adults. N Engl J Med 2011;364:121829.
    Pubmed KoreaMed CrossRef
  7. Park IS, Kim YH. Influence of line dance participants’ physical self-efficacy and heath promotion acts on mental happiness. Journal of Sport and Leisure Studies 2011;43:127-39.
  8. Kim SH. The development of gymnastic program for elderly in aging society. Journal of Sport and Leisure Studies 2003;20:687-94.
  9. Morgan WP, O’Connor PJ. Exercise and Mental Health. In: Dishman RK, editor. Exercise adherence: Its impact on public health. Champaign (IL): Human Kinetics; 1988. p. 91-121.
  10. Yamagata E, Yamada Y, Sugihara Y, Komatsu M, Kimura M, Okayama Y. Physical fitness and depression symptoms in community-dwelling elderly women. Nihon Koshu Eisei Zasshi 2013;60:231-40.
  11. Enright PL, McBurnie MA, Bittner V, Tracy RP, McNamara R, Arnold A, et al. The 6-min walk test: a quick measure of functional status in elderly adults. Chest 2003;123:387-98.
    Pubmed CrossRef
  12. Ho RC, Niti M, Kua EH, Ng TP. Body mass index, waist circumference, waist-hip ratio and depressive symptoms in Chinese elderly:a population-based study. Int J Geriatr Psychiatry 2008;23:401-8.
    Pubmed CrossRef
  13. Vogelzangs N, Kritchevsky SB, Beekman AT, Newman AB, Satterfield S, Simonsick EM, et al. Depressive symptoms and change in abdominal obesity in older persons. Arch Gen Psychiatry 2008;65:1386-93.
    Pubmed KoreaMed CrossRef
  14. Hamilton B. Vitamin D and human skeletal muscle. Scand J Med Sci Sports 2010;20:182-90.
    Pubmed KoreaMed
  15. Ceglia L. Vitamin D and skeletal muscle tissue and function. Mol Aspects Med 2008;29:407-14.
    Pubmed CrossRef
  16. Milaneschi Y, Shardell M, Corsi AM, Vazzana R, Bandinelli S, Guralnik JM, et al. Serum 25-hydroxyvitamin D and depressive symptoms in older women and men. J Clin Endocrinol Metab 2010;95:3225-33.
    Pubmed KoreaMed CrossRef
  17. Wilkins CH, Birge SJ, Sheline YI, Morris JC. Vitamin D deficiency is associated with worse cognitive performance and lower bone density in older African Americans. J Natl Med Assoc 2009;101:349-54.
    Pubmed KoreaMed
  18. Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res 1982-1983;17:37-49.
  19. Jung IK, Kwak DI, Joe SH, Lee HS. A study of standardization of Korean form of geriatric depression scale (K-GDS). J Korean Geriatr Psychiatry 1997;1:61-72.
  20. Rikli RE, Jones CJ. Senior fitness test manual. Champaign (IL):Human Kinetics; 2001.
  21. Gerber M, Lindwall M, Lindeg?rd A, B?rjesson M, Jonsdottir IH. Cardiorespiratory fitness protects against stress-related symptoms of burnout and depression. Patient Educ Couns 2013;93:146-52.
    Pubmed CrossRef
  22. Singh NA, Stavrinos TM, Scarbek Y, Galambos G, Liber C, Fiatarone Singh MA. A randomized controlled trial of high versus low intensity weight traning versus general practitioner care for clinical depression in older adults. J Gerontol A Biol Sci Med Sci 2005;60:768-76.
    Pubmed CrossRef
  23. Rantanen T, Penninx BW, Masaki K, Lintunen T, Foley D, Guralnik JM. Depressed mood and body mass index as predictors of muscle strength decline in old men. J Am Geriatr Soc 2000;48:613-7.
    Pubmed CrossRef
  24. Wiltink J, Michal M, Wild PS, Zwiener I, Blettner M, M?nzel T, et al. Associations between depression and different measures of obesity (BMI, WC, WHtR, WHR). BMC Psychiatry 2013;13:223.
    Pubmed KoreaMed CrossRef
  25. Hoogendijk WJ, Lips P, Dik MG, Deeg DJ, Beekman AT, Penninx BW. Depression is associated with decreased 25-hydroxyvitamin D and increased parathyroid hormone levels in older adults. Arch Gen Psychiatry 2008;65:508-12.
    Pubmed CrossRef
  26. Stewart R, Hirani V. Relationship between vitamin D levels and depressive symptoms in older residents from a national survey population. Psychosom Med 2010;72:608-12.
    Pubmed CrossRef
  27. Ho RC, Niti M, Kua EH, Ng TP. Body mass index, waist circumference, waist-hip ratio and depressive symptoms in Chinese elderly:a population-based study. Int J Geriatr Psychiatry 2008;23:401-8.
    Pubmed CrossRef