Effect of exercise on depression severity in older people: Systematic review and meta-analysis of randomised controlled trials

Warwick Clinical Trials Unit, Division of Health Sciences, Warwick Medical School, The University of Warwick, Coventry CV4 7AL, UK. .
The British journal of psychiatry: the journal of mental science (Impact Factor: 7.99). 09/2012; 201(30):180-5. DOI: 10.1192/bjp.bp.111.095174
Source: PubMed


The prevelance of depression in older people is high, treatment is inadequate, it creates a substantial burden and is a public health priority for which exercise has been proposed as a therapeutic strategy.
To estimate the effect of exercise on depressive symptoms among older people, and assess whether treatment effect varies depending on the depression criteria used to determine participant eligibility.
Systematic review and meta-analysis of randomised controlled trials of exercise for depression in older people.
Nine trials met the inclusion criteria and seven were meta-analysed. Exercise was associated with significantly lower depression severity (standardised mean difference (SMD) = -0.34, 95% CI -0.52 to -0.17), irrespective of whether participant eligibility was determined by clinical diagnosis (SMD = -0.38, 95% CI -0.67 to -0.10) or symptom checklist (SMD = -0.34, 95% CI -0.62 to -0.06). Results remained significant in sensitivity analyses.
Our findings suggest that, for older people who present with clinically meaningful symptoms of depression, prescribing structured exercise tailored to individual ability will reduce depression severity.

    • "The cutoff used to determine " older adults " was chosen in accordance with the UN and WHO agree- ment ( accessed April 7, 2015) and previous reviews (Blake et al., 2009; Bridle et al., 2012; Mura & Carta, 2013; 150 S. Heinzel et al.: Using Exercise to Fight Depression in Older Adults Sjösten & Kivelä, 2006). Furthermore, an increased level of depressive symptoms assessed by a valid measurement or a clinical diagnosis of Major Depressive Disorder (according to the Diagnostic and Statistical Manual of Mental Disorders, Text Revision [DSM-IV-TR]) had to be described clearly as eligibility criteria in the primary studies. "
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    ABSTRACT: Depression is the most prevalent psychiatric disorder in the general population. Despite a large demand for efficient treatment options, the majority of older depressed adults does not receive adequate treatment: Additional low-threshold treatments are needed for this age group. Over the past two decades, a growing number of randomized controlled trials (RCT) have been conducted, testing the efficacy of physical exercise in the alleviation of depression in older adults. This meta-analysis systematically reviews and evaluates these studies; some subanalyses testing specific effects of different types of exercise and settings are also performed. In order to be included, exercise programs of the RCTs had to fulfill the criteria of exercise according to the American College of Sports Medicine, including a sample mean age of 60 or above and an increased level of depressive symptoms. Eighteen trials with 1,063 participants fulfilled our inclusion criteria. A comparison of the posttreatment depression scores between the exercise and control groups revealed a moderate effect size in favor of the exercise groups (standardized mean difference (SMD) of –0.68, p < .001). The effect was comparable to the results achieved when only the eleven trials with low risk of bias were included (SMD = –0.63, p < .001). The subanalyses showed significant effects for all types of exercise and for supervised interventions. The results of this meta-analysis suggest that physical exercise may serve as a feasible, additional intervention to fight depression in older adults. However, because of small sample sizes of the majority of individual trials and high statistical heterogeneity, results must be interpreted carefully.
    No preview · Article · Dec 2015 · GeroPsych: The Journal of Gerontopsychology and Geriatric Psychiatry
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    • "Although depression can lead to physical inactivity, that further compound risk factors for depression (Reed, Crespo, Harvey, &amp; Andersen, 2011), studies also show that depression is less prevalent among individuals who are physically active (Almeida, Norman, &amp; Hankey, 2006). Further, the antidepressant effects of physical activity are comparable to patients receiving medication or psychotherapy as individuals who are physically active report less depression than to those receiving antidepressant therapy (Bridle, Spanjers, &amp; Patel, 2012;Pfaff et al., 2014). Thus, the positive impact of physical activity on depression warrants further investigation. "
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    ABSTRACT: This qualitative study described the lived experience of dancing as it related to depression and social isolation in 16 disadvantaged adults who completed a 12-week dance intervention. It is the first qualitative study to explore the experience of dance as an adjunct therapy, depression, and social isolation. A descriptive phenomenological framework consisted of two focus groups using semi-structured interviews. A Giorgian approach guided thematic analysis. Four themes emerged: (1) dance for myself and health, (2) social acceptance, (3) connection with others: a group, and (4) not wanting to stop: unexpected benefits from dancing. As the participants continued to dance, they developed a sense of belonging and group identity, which may have maintained group involvement and contributed to reducing depression and social isolation. Thus, dancing is a complementary therapy that should be considered when working with adults with depression and social isolation.
    Full-text · Article · Oct 2015
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    • "International Scholarly Research Notices and special tools; these approaches are not applied as routine care extensively [8]. Exercise and physical activity, as a nonpharmacological care, are suggested to treat or help to cure major depression [11] [12] [13], but there are few studies and paradoxical results related to the effect of exercise on depression in hemodialysis patients [14] [15] [16]. "
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    ABSTRACT: Background and Aim. Depression is the most common psychological disorder in hemodialysis patients which decreases their quality of life and increases the mortality. This study was conducted to assess the effect of regular exercise on depression in hemodialysis patients. Methods. In a randomized clinical trial, 51 hemodialysis patients were allocated in two groups. Beck Depression Inventory (BDI) scale was used to assessing depression rate in participants. Designed program was educated using poster and face-to-face methods for case group. Intervention was carried out three times a week for ten weeks. At the beginning and the end of the study, depression rate of the subjects was assessed. Data was analyzed by SPSS16 software and descriptive and inferential statistics. Findings. According to the results of this study, there were no differences between case and control groups in depression rate at the beginning of the study, but there was significant difference after intervention . In the beginning of the study, the mean and SD of depression in case group were and reduced to at the end . Conclusion. The regular exercise program could reduce the depression in hemodialysis patients; therefore it is suggested for training this program for hemodialysis patients. This trial is registered with Iranian Registry of Clinical Trial (IRCT) number IRCT201205159763N1.
    Full-text · Article · Jan 2015 · International Scholarly Research Notices
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