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BALTIMORE, MD. -- A study of 4,000 randomly selected elderly people in North Carolina found that older people who attend religious services are both less depressed and physically healthier than those who worship at home, a Duke University psychiatrist reported Sunday.

Dr. Harold Koenig said the findings suggest that certain religious behaviors may help prevent poor mental and physical health.

Koenig prepared the findings for presentation at the annual meeting of the American Association for the Advancement of Science. The study was based on data drawn from a multi- pronged survey of people 65 and older sponsored by the National Institute on Aging.

"Church-related activity may prevent illness both by a direct effect, using prayer or scripture reading as coping behaviors, as well as by an indirect effect through its influence on health behaviors," Koenig said. "For example, active religious participation may indirectly prevent health problems due to poor diet, substance abuse, smoking, self-destructive behaviors, or unsafe sexual practices, because these activities are discouraged by most religious groups."

People who pray only at home do not enjoy the same mental or physical health benefits as those who attend church, the study found, in part because they may be too ill to attend services. In turn, physical illness can contribute to depression.

But poor physical health alone does not explain why those who pray at home had higher rates of depression, since the study showed they actually had greater social support systems than the church-goers -- a phenomenon that researchers hope to explain through further research. (Social support was measured by number of friends and relatives, level of practical help and services they provided, and how supportive the respondent perceived their social support system.)

Researchers speculate that religious rituals themselves may contribute to mental well-being; that both the presence of fellow congregants and the social interaction reduces feelings of isolation; or that diverting one's focus outside the home may contribute to better mental health among church- goers.

"If your sense of identity is less focused on yourself -- in other words, if you identify with your God, community, your church, etc. -- you tend to focus less on your own problems," Koenig said.

The study also showed higher rates of depression among people whose only religious activity was viewing religious television, and higher rates of physical illness among both religious television viewers and those who prayed at home.

Koenig said these seemingly subtle distinctions between religious behaviors, and their impact on mental and physical well being, are especially relevant today because of rising health care costs and an uncertain future for Medicare.

"There's a huge population of aging baby boomers and no easy solution to the problem of health care costs, so studying the relationships between religion, social support and health has become increasingly important," Koenig said.

Although the current study found no relationship between church attendance and social support, Koenig said previous studies have shown that involvement in the religious community can reduce feelings of fear, anxiety, isolation and helplessness.

"Stress and despair arise from the feeling that you're alone, that there's nothing you can do about a situation," Koenig said. "People who believe in God feel there's someone watching out for them, someone who has divine control of their destiny. Life doesn't always have to make sense to them, as long they put their trust in an all-powerful, caring and loving God."