The Q4-Mood Framework: A Stratified Movement Intervention Model for Late-Life Depression

Late-life depression (LLD) represents a significant public health challenge within global ageing societies, substantially impacting older adults' quality of life and health status. Despite the widespread application of pharmacological and psychotherapeutic interventions, their efficacy is frequently constrained by individual variability and treatment adherence issues. In recent years, exercise behaviour intervention (MBI) has garnered increasing attention as a low-side-effect, highly accessible therapeutic approach. This study proposes an innovative exercise intervention model-the Q4-Mood framework-aimed at stratifying older adults based on their motivation (self-efficacy) and physical capacity (fitness level), providing a personalised, progressive exercise intervention pathway for each stratum. The Q4-Mood framework categorises exercise interventions into four tiers: Sedentary Behaviour Interruption (SB), Exercise Snacks (ES), Physical Activity (PA), and Regular Exercise (RE). This model not only enhances exercise adherence among older adults but also effectively alleviates depressive symptoms. Through personalised intervention strategies, it facilitates dual physical and psychological improvements. Through a systematic review of existing exercise intervention studies, this paper demonstrates the Q4-Mood framework's potential in treating geriatric depression and offers novel perspectives for future research. We contend that Q4-Mood provides a comprehensive, flexible, and actionable framework for geriatric depression interventions, paving the way for its future application in clinical practice.