Green Exercise for Emotional Health: Effects on Alexithymia, Depression, and Quality of Life in Older Adults—A Randomised Controlled Trial

ABSTRACT Purpose This study aimed to evaluate the effects of green exercise combined with aerobic and resistance training on alexithymia, depression, and quality of life in elderly individuals. Methods This randomised controlled trial included 64 community‐dwelling adults aged 65 and older, randomly assigned to an exercise group or a control group. Green exercises combined with aerobic and resistance exercises were applied to the exercise group once a week for 12 weeks. Alexithymia was evaluated with the Toronto Alexithymia Scale‐20 (TAS‐20), depression with the Geriatric Depression Scale (GDS), and quality of life with the World Health Organization Quality of Life Module for the Elderly (WHOQOL‐OLD). Results At week 12, the exercise group showed significant improvements compared to the control group in total scores of quality of life (F = 85.895, p < 0.001, η 2 = 0.585), alexithymia (F = 51.099, p < 0.001, η 2 = 0.456), and depression (F = 26.539, p < 0.001, η 2 = 0.303), all with large effect sizes. Conclusion The findings suggest that incorporating natural environments into structured physical activity may provide additional benefits for affect regulation and psychological well‐being in older adults. Green exercise may serve as an accessible and effective intervention to improve mental health and support healthy aging. Trial Registration: NCT05342142