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Prospective associations between sedentary behaviour and incident depressive symptoms in older people: a 15-month longitudinal cohort study
- Authors:
- TSUTSUMIMOTO Kota, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 32(2), 2017, pp.193-200.
- Publisher:
- Wiley
Objective: This study aimed to investigate whether sitting time, as a form of sedentary behaviour, is related to incident depressive symptoms in older people. Methods: This study included 3503 participants (mean age 71.7 years, 50.1% female) from the ‘Obu Study of Health Promotion for the Elderly' cohort study. At baseline and then 15 months later, the participants reported their status of depressive symptoms using the 15-item Geriatric Depression Scale. During the baseline assessment, the participants were also asked about their sedentary behaviour on weekdays over the past 7 days and, from there, categorised into three groups (<240, 240–480, ≥480 min/day). Demographic data and the other health behaviours were also assessed at the baseline. Results: Cross-sectional analysis revealed that 437 participants (12.0%) had depressive symptoms. In a prospective analysis, the logistic regression model revealed that the odds ratio for depressive symptom incidence was higher in participants who, at baseline, spent 480 min or more per day sitting, and in those who spent 240-480 min in comparison with those who spent less than 240 min. Conclusions: Sedentary behaviour significantly affects the risk of incident depressive symptoms. Further research is needed to develop an intervention strategy to manage depressive symptoms, as the second most common cause of burden of disease among older adults. (Edited publisher abstract)
Physical exercise for late-life major depression
- Authors:
- MURRI M. Belvederi, et al
- Journal article citation:
- British Journal of Psychiatry, 207(3), 2015, pp.235-242.
- Publisher:
- Cambridge University Press
Aims: Interventions including physical exercise may help improve the outcomes of late-life major depression, but few studies are available. This study aimed to investigate whether augmenting sertraline therapy with physical exercise leads to better outcomes of late-life major depression. Method: Primary care patients (465 years) with major depression were randomised to 24 weeks of higher-intensity, progressive aerobic exercise plus sertraline (S+PAE), lower-intensity, non-progressive exercise plus sertraline (S+NPE) and sertraline alone. The primary outcome was remission (a score of ≤10 on the Hamilton Rating Scale for Depression). Results: A total of 121 patients were included. At study end, 45% of participants in the sertraline group, 73% of those in the S+NPE group and 81% of those in the S+PAE group achieved remission (P = 0.001). A shorter time to remission was observed in the S+PAE group than in the sertraline-only group. Conclusions: Physical exercise may be a safe and effective augmentation to antidepressant therapy in late-life major depression. (Publisher abstract)
Effect of exercise on depression severity in older people: systematic review and meta-analysis of randomised controlled trials
- Authors:
- BRIDLE Christopher, et al
- Journal article citation:
- British Journal of Psychiatry, 201(3), September 2012, pp.180-185.
- Publisher:
- Cambridge University Press
There is uncertainty concerning the effect of exercise on depression among older people with clinically significant symptoms of depression. The primary aim of this meta analysis was to estimate the effect of exercise on depression severity in this group of patients. A secondary objective was to examine any variation between pre-specified subgroups stratified by depression eligibility criteria. Nine randomised controlled trials, including 667 patients, met the inclusion criteria and seven were used in the analyses. Medium term, 3-12 months, of mixed exercise was associated with significantly lower depression severity (standardised mean difference –0.34), irrespective of whether participant eligibility was determined by clinical diagnosis or symptom checklist. The authors conclude that, for older people who present with clinically meaningful symptoms of depression, prescribing structured exercise tailored to individual ability will reduce depression severity.
The effects of physical exercise on depressive symptoms among the aged: a systematic review
- Authors:
- SJOSTEN Noora, KIVELA Sirkka-Liisa
- Journal article citation:
- International Journal of Geriatric Psychiatry, 21(5), May 2006, pp.410-418.
- Publisher:
- Wiley
A literature search covering various medical databases was conducted to identify randomised controlled trials (RCT's) about the effects of exercise treatments on depression or depressive symptoms among the aged. The studies were classified according to the baseline depression status of participants and assessed in relation to allocation concealment, blinding at outcome assessment, follow-up and whether intention to treat analysis was used. Studies meeting the inclusion criteria were accepted. A total of 26 randomised controlled trials on the impact of physical exercise on depression among the elderly were identified. Of these, 13 were included in the full review. While some studies had methodological limitations, including lack of follow-up, they indicate that physical exercise can reduce clinical depression or depressive symptoms among the elderly in the short term. Exercise was effective in treating depression among those suffering from minor or major depression and in reducing depressive symptoms among those with a high amount of depressive symptoms at baseline. However, both the allocation concealment and the blinding method were adequately described in only four studies. Furthermore, intention-to-treat analysis was conducted in half of the studies and some follow-up information after the intervention has been published for five studies. Physical exercise may be efficient in reducing clinical depression and depressive symptoms in the short-term among the aged suffering from depression or a high amount of depressive symptoms. More well controlled studies are needed.
Does a physical activity program in the nursing home impact on depressive symptoms? A generalized linear mixed-model approach
- Authors:
- DIEGELMANN Mona, et al
- Journal article citation:
- Aging and Mental Health, 22(6), 2018, pp.784-793.
- Publisher:
- Taylor and Francis
Objectives: Physical activity (PA) may counteract depressive symptoms in nursing home (NH) residents considering biological, psychological, and person-environment transactional pathways. Empirical results, however, have remained inconsistent. This studyexamined the effect of a whole-ecology PA intervention program on NH residents’ depressive symptoms using generalized linear mixed-models (GLMMs). Method: The study used longitudinal data from residents of two German NHs who were included without any pre-selection regarding physical and mental functioning (n = 163, Mage = 83.1, 53–100 years; 72% female) and assessed on four occasions each three months apart. Residents willing to participate received a 12-week PA training program. Afterwards, the training was implemented in weekly activity schedules by NH staff. We ran GLMMs to account for the highly skewed depressive symptoms outcome measure (12-item Geriatric Depression Scale–Residential) by using gamma distribution. Results: Exercising (n = 78) and non-exercising residents (n = 85) showed a comparable level of depressive symptoms at pretest. For exercising residents, depressive symptoms stabilized between pre-, posttest, and at follow-up, whereas an increase was observed for non-exercising residents. The intervention group's stabilisation in depressive symptoms was maintained at follow-up, but increased further for non-exercising residents. Conclusion: Implementing an innovative PA intervention appears to be a promising approach to prevent the increase of NH residents’ depressive symptoms. At the data-analytical level, GLMMs seem to be a promising tool for intervention research at large, because all longitudinally available data points and non-normality of outcome data can be considered. (Edited publisher abstract)
Volunteering and depressive symptoms among residents in a continuing care retirement community
- Authors:
- KLINEDINST N. Jennifer, RESNICK Barbara
- Journal article citation:
- Journal of Gerontological Social Work, 57(1), 2014, pp.52-71.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This descriptive study examined the relationship between volunteer activities, depressive symptoms, and feelings of usefulness among older adults using path analysis. Survey data was collected via interview from residents of a continuing care retirement community. Neither feelings of usefulness nor volunteering were directly associated with depressive symptoms. Volunteering was directly associated with feelings of usefulness and indirectly associated with depressive symptoms through total physical activity. Age, fear of falling, pain, physical activity, and physical resilience explained 31% of the variance in depressive symptoms. Engaging in volunteer work may be beneficial for increasing feelings of usefulness and indirectly improving depressive symptoms among older adults. (Publisher abstract)
Clinical and sociodemographic factors in a sample of older subjects experiencing depressive symptoms
- Authors:
- BARCELOS-FERREIRA Ricardo, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 27(9), September 2012, pp.923-930.
- Publisher:
- Wiley
Clinically significant depressive symptoms (CSDS) decrease quality of life and are associated with excess morbidity and mortality in older adults. The aim of this study was to determine the frequency of CSDS in a community sample of older Brazilians and to examine their relationship with sociodemographic factors, cognitive and functional impairment (CFI), and medical illness. The participants were 1145 individuals aged 60 years or older living in the City of Ribeirao Preto, Brazil. The participants completed the following instruments: a 10-item scale for screening of depressive symptoms in older people, the mini mental state examination, the Fuld Object Memory Evaluation, the Informant Questionnaire on Cognitive Decline in the Elderly, the Bayer Activities of Daily Living Scale, and a sociodemographic and clinical questionnaire. The findings showed that the prevalence of CSDS in this community-based sample was 15.7%. Logistic regression analysis indicated that being previously depressed, having CFI, having lower level of education, using psychotropics, and not engaging in physical exercise were related to CSDS. On the other hand, being a woman, older, medically ill, employed, or married was not associated with CSDS.
The relationship between depressive symptoms and walking among Hispanic older adults: a longitudinal, cross-lagged panel analysis
- Authors:
- PERRINO Tatiana, et al
- Journal article citation:
- Aging and Mental Health, 14(2), March 2010, pp.211-219.
- Publisher:
- Taylor and Francis
Studies of older adults have shown a significant association between physical inactivity and depressive symptoms. This study examined the relationship between depressive symptoms and walking behaviour across 30 months in 217 community-dwelling, Hispanic adults aged 70-100 years in Miami, Florida. In particular, the analyses examined the direction of the relationship between depressive symptoms and walking over time, as well as testing for a potential bi-directional or reciprocal relationship between these two variables. The results revealed that walking was unrelated to subsequent depressive symptoms. However, depressive symptoms were related to subsequent walking behaviour at every time-point, such that higher levels of depressive symptoms were predictive of less walking in the future. Older adults who had clinically-relevant depressive symptoms at the initial assessment had 1.34 times the risk of not walking 30 months later, compared to older adults without clinically-relevant depressive symptoms. The results support the need for primary care providers to evaluate and address depressive symptoms among older adults, as a means of reducing sedentary behaviour and potentially improving health.
Promoting physical activity in the management of depression. The perspective of older people
- Authors:
- WRIGHT Alan, CATTAN Mima
- Journal article citation:
- Mental Health and Learning Disabilities Research and Practice, 6(1), April 2009, pp.53-67.
- Publisher:
- South West Yorkshire Mental Health NHS Trust and University of Huddersfield
While exercise has been widely proposed in the management of depression in older people, the subjective experiences of individuals participating in this intervention have been neglected. Similarly, little is known about the manner in which unsupervised physical activity is adopted by older people as they recover from an episode of depression. This qualitative study sought the views of 11 older people who had recently been admitted to hospital with depression and attended regular in-patient exercise groups. It was found that participants valued opportunities to exercise when in hospital and reported a range of benefits. Following discharge unsupervised physical activity played a crucial part in the recovery process and three typologies were defined which categorised participants’ motivation to be physically active. It was concluded that opportunities for older people to join exercise groups when hospitalised with depression are likely to be valued and that individual factors should be acknowledged when promoting post discharge physical activity.
What older people tell us about the role of physical activity in the management of depression
- Authors:
- WRIGHT Alan, CATTAN Mima
- Journal article citation:
- Generations Review, 18(3), July 2008, Online only
- Publisher:
- British Society of Gerontology
Reports on a study which set out to explore the way in which older people admitted to hospital with depression experience exercise groups and the manner in which they engage in physical activity once discharged. Eleven participants aged 69 to 86 years were purposively selected using exercise group attendance records. The findings from this study support the use of exercise groups for older people admitted to hospital with depression. Community based interventions designed to promote physical activity in older people recovering from mental illness are most likely to be effective if they address individually identified functional goals and take into account the social needs of the older service users.