Background: The complexity of health problems concerning women aged ≥60 years makes it necessary to develop effective, low-cost strategies involving biopsychosocial interventions. The aim of this study is to identify the factors associated with undertaking health-promoting activities by older women at high risk of metabolic syndrome (MetS) with or without depressive symptoms. Methods: The study group consisted of 70 older women (62–84 years old) undertaking regular physical activity. A self-developed questionnaire (used to determine the living situation, selected lifestyle components and health problems), the Perceived Stress Questionnaire (PSQ) and the Geriatric Depression Scale (GDS) were used. Results: In the study group undertaking regular physical activity, 40% had increased symptoms of depression (D group), and 60% were classified as non-depressed (ND group). The D group had a higher general stress level (t = −6.18, p = 0.001). Improving and/or maintaining physical fitness was identified as the greatest motivation in both groups. Willingness to spend time with other people significantly differed between the two groups (χ2 = 4.148, p = 0.042). The sole factor significantly differentiating between both groups was lack of time (χ2 = 8.777, p = 0.003). Conclusions: Motivations and barriers to undertaking health-promoting activities and levels of perceived stress were significantly different between the depressed and non-depressed groups. It is important to encourage primary care physicians to perform screening tests for late-life depression and to provide information on where therapeutic interventions are available for patients with symptoms of MetS and coexisting depressive symptoms.