After 50, take up a hobby and keep at it, but do not use it instead of treatment for depression

Cost depends on what you choose. Beginner instruments, fishing gear and craft materials often cost around a few hundred yuan. Set aside a few hours each week. The hard part is the slow progress at the start, when it is easy to give up.

Five longitudinal studies of older adults in 16 countries were pooled, covering 93,263 people aged 65 and over. The analysis compared each person with themselves, examining the difference between years with and without a hobby (a fixed-effects model). This accounts for factors that do not change over time, such as genes, personality and background. Hobby participation varied widely: 51.0% in Spain and 96.0% in Denmark. After adjustment for confounders, the pooled coefficient for depressive symptoms when having a hobby was −0.10 (95% CI −0.13 to −0.07; the confidence interval). The outcomes were converted to standard-deviation units, so this means 0.1 standard deviations fewer symptoms—a very small difference. Self-rated health was 0.06 (0.03 to 0.08), happiness 0.09 (0.06 to 0.13), and life satisfaction 0.10 (0.08 to 0.12), all in a favorable direction. Country-level factors explained less than 9% of variation in results between countries. Using another method that considered temporal ordering in the English data, the authors still found fewer depressive symptoms after hobby engagement. They wrote that the association was not simply healthier psychological states leading people to take up hobbies; the relationship was likely bidirectional. Another English study followed 8,780 adults aged 50 and over, surveying them every two years from 2004 to 2017 and again using within-person comparisons. Taking up a hobby was associated with an odds ratio (OR) for depression of 0.70 (95% CI 0.64–0.76). Among those initially without depression or a hobby, the OR for developing depression after taking up a hobby was 0.68 (0.56–0.83). Among those initially with depression but no hobby, the OR for recovery after taking up a hobby was 2.72 (2.09–3.53). Changes in reading, social engagement and physical activity explained only about 7% of this association. Two randomized trials both involved choirs, with inconsistent results. An English trial individually assigned 258 adults aged 60 and over at 5 centers to a choir or usual activities. At 3 months, depression scores were 1.52 points lower in the choir group (95% CI for the difference −2.13 to −0.92), and anxiety scores were 1.78 points lower (−2.5 to −1.06). At 6 months, mental health-related quality-of-life scores remained 2.35 points higher (0.06 to 4.76). A US trial assigned 390 adults aged 60 and over at 12 senior centers by center. One group began weekly 90-minute choir sessions immediately; the other waited six months. At six months, the choir group showed less loneliness and greater interest in life, with effect sizes of 0.34 and 0.39, between small and moderate. No statistically significant between-group differences were found for any of the three prespecified primary outcomes: depressive symptoms (PHQ-8), executive function or lower-body strength.

Mak HW, Noguchi T, Bone JK, Wels J, Gao Q, Kondo K, Saito T, Fancourt D (2023). Hobby engagement and mental wellbeing among people aged 65 years and older in 16 countries. Nature Medicine, 29(9), 2233-2240. https://doi.org/10.1038/s41591-023-02506-1；Fancourt D, Opher S, de Oliveira C (2020). Fixed-effects analyses of time-varying associations between hobbies and depression in a longitudinal cohort study: support for social prescribing? Psychotherapy and Psychosomatics, 89(2), 111-113. https://doi.org/10.1159/000503571；Johnson JK, Stewart AL, Acree M, Nápoles AM, Flatt JD, Max WB, Gregorich SE (2020). A community choir intervention to promote well-being among diverse older adults: results from the Community of Voices trial. The Journals of Gerontology: Series B, 75(3), 549-559. https://doi.org/10.1093/geronb/gby132；Coulton S, Clift S, Skingley A, Rodriguez J (2015). Effectiveness and cost-effectiveness of community singing on mental health-related quality of life of older people: randomised controlled trial. The British Journal of Psychiatry, 207(3), 250-255. https://doi.org/10.1192/bjp.bp.113.129908

Debated. The 16-country study and the English study of 8,780 people were observational follow-ups; the authors explicitly acknowledged that observational data cannot establish causation. Within-person comparisons account for stable factors such as personality and background, but among factors changing over the same period they can adjust only for those measured in the surveys. In the two choir trials, the English study found less depression at 3 months, while the US study found no significant difference in depression at six months. All this evidence comes from people aged 50 and over; comparable data for younger people are absent here. The benefit is judged small because the most rigorous comparison found a difference of only about 0.1 standard deviations and the two trials did not agree on depression. The questionnaires asked whether people had hobbies or pastimes, without distinguishing which kind. A hobby done with others also fits Item 9 in this section (meet people regularly); an active one fits Item 6 (go walking or running). If depression or anxiety is already disrupting your life, see a doctor first. For things you can do yourself, see Item 6 (depression), Item 7 (mindfulness-based stress reduction), and Section 3, Item 18 (first steps when your mood is low).