title: Effect of exercise on depression severity in older people: systematic review and meta-analysis of randomised controlled trials.
abstract: BACKGROUND
  The prevalence 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.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  Systematic review and meta-analysis of randomised controlled trials of exercise for depression in older people.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Warwick Clinical Trials Unit, Division of Health Sciences, Warwick Medical School, The University of Warwick, Coventry CV4 7AL, UK. c.bridle@warwick.ac.uk
authors.forename: Christopher
authors.initials: C
authors.lastname: Bridle
authors.forename: Kathleen
authors.initials: K
authors.lastname: Spanjers
authors.forename: Shilpa
authors.initials: S
authors.lastname: Patel
authors.forename: Nicola M
authors.initials: NM
authors.lastname: Atherton
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Lamb
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015982:Bias; D003866:Depressive Disorder / Q000534:rehabilitation*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic