How effective are physical activity interventions for alleviating depressive symptoms in older people? A systematic review.
BACKGROUND
The benefits of physical exercise in reducing clinically defined depression in the general population have been established, although a review of the evidence for older adults is needed.


OBJECTIVE
To assess the efficacy of physical exercise for the treatment of depressive symptoms in older adults (>60 years).


METHODS
We searched: MEDLINE (1966-May 2008); EMBASE (1980-May 2008); Cumulative Index to Nursing & Allied Health Literature (CINAHL; 1982-May 2008); PsycINFO (1966-May 2008), The Cochrane Library (Issue 2, 2008), and National Research Register (NRR; Issue 2, 2008).


METHODS
Randomized controlled trials and quasi-experimental studies of physical exercise interventions for depression were included where 80% or more of participants were >60 years. Abstracts were assessed to determine whether they met specified inclusion criteria. Primary analysis focused on the prevalence of diagnosable depressive disorder following intervention. Secondary outcome was depression or mood scores on standardized scales.


RESULTS
Eleven randomized controlled trials with a total of 641 participants were included in the review. Short-term positive outcome for depression or depressive symptoms was found in nine studies, although the mode, intensity and duration of intervention varied across studies. Medium- to long-term effects of intervention were less clear.


CONCLUSIONS
Physical exercise programmes obtain clinically relevant outcomes in the treatment of depressive symptoms in depressed older people. Exercise, though not appropriate for all in this population, may improve mood in this group. Further research is needed to establish medium- to long-term effects and cost-effectiveness.
Blake
H
H
Faculty of Medicine & Health Sciences, University of Nottingham School of Nursing, Midwifery & Physiotherapy, Nottingham, UK. Holly.Blake@nottingham.ac.uk
Mo
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P
Malik
S
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Thomas
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D000368:Aged; D000369:Aged, 80 and over; D003863:Depression / Q000628:therapy*; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D016896:Treatment Outcome