What is the clinical evidence from this study?

Study design: Systematic Review. Population: Depression. Intervention: Physical activity / Exercise vs. Standard treatments (including antidepressants), no treatment, or placebo-control. Primary outcome: Reduction in depressive symptoms.

What does this research mean for the field?

Physical activity interventions exert beneficial clinical effects on depressive symptoms in the elderly, and combining exercise with antidepressants shows promise for treatment-resistant late-life depression. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

July 12, 2013Open Access

Physical Activity in Depressed Elderly. A Systematic Review

GMGioia MuraUniversity of Verona MCMauro Giovanni CartaUniversity of Cagliari

Key Result

Physical activity interventions appear to exert beneficial clinical effects on depressive symptoms in the elderly, with promising findings for exercise combined with antidepressants in treatment-resistant late-life depression.

Study Design

Type

Systematic Review

Structured PICO

Does physical activity reduce depressive symptoms in elderly patients with depression?

Population

Elderly patients (>60 years old) with depression (major depressive disorder or depressive symptoms)

Intervention

Physical activity/exercise interventions (often as an adjunctive treatment with antidepressants)

Comparator

Standard treatments (including antidepressants), no treatment, or active controls (e.g., health education, social visits)

Outcome

Reduction in depressive symptoms (measured by scales such as GDS, BDI, HAM-D, or CES-D)patient reported

Physical activity interventions appear to exert beneficial clinical effects on depressive symptoms in the elderly, though high-quality evidence remains limited.

Limitations

Lack of adequately concealed randomization in many included studies
Lack of intention-to-treat analysis in several studies
No study had a double-blinded assessment
Small sample sizes
Heterogeneity in samples, interventions, and control groups making direct comparison difficult

Abstract

BACKGROUND: exercise may reduce depressive symptoms both in healthy aged populations and in old patients diagnosed with MDD, but few specific analysis were conducted on the efficacy of exercise as an adjunctive treatment with antidepressants, which may be probably more useful in clinical practice, considered the high prevalence of treatment resistant depression in late life, the low cost and safety of physical activity interventions. OBJECTIVE: to establish the new findings on the effectiveness of exercise on depression in elderlies, with particular focus on the efficacy of the exercise as an adjunctive treatment with antidepressants drug therapy. METHOD: THE SEARCH OF SIGNIFICANT ARTICLES WAS CARRIED OUT IN PUBMED/MEDLINE WITH THE FOLLOWING KEY WORDS: "exercise", "physical activity", "physical fitness", "depressive disorder", "depression", "depressive symptoms", "late life", "old people", and "elderly". RESULTS: 44 papers were retrieved by the search. Among the 10 included randomized controlled trials, treatment allocation was adequately conceived in 4 studies, intention-to-treat analysis was performed in 6 studies, but no study had a double-blinded assessment. We examined and discussed the results of all these trials. CONCLUSION: in the last 20 years, few progresses were done in showing the efficacy of exercise on depression, due in part to the persistent lack of high quality research, in part to clinical issues of management of depression in late life, in part to the difficult to establish the real effectiveness of exercise on depressive symptoms in elderlies. However, there are some promising findings on physical activity combined with antidepressants in treatment resistant late life depression.

Ask AI

Helpful

Bookmark

View Full Paper