title: Physical Exercise for Late-Life Depression: Effects on Heart Rate Variability.
abstract: Late-life major depression is associated with increased cardiovascular risk and impaired autonomic control of the heart, as evident from reduced heart rate variability (HRV). Moreover, antidepressant drug therapy also might be associated with further reductions of HRV. In the SEEDS study, we investigated whether sertraline associated with physical exercise protocols led to improvements of HRV, compared with antidepressant drug therapy alone.
  
  
  
  Single-blind randomized controlled trial.
  
  
  
  Psychiatric consultation-liaison program for primary care.
  
  
  
  Patients aged 65-85 years with major depression, recruited from primary care.
  
  
  
  Sertraline plus structured, tailored group physical exercise (S + EX) versus sertraline alone (S) for 24 weeks.
  
  
  
  HRV indices (RR, percentage of NN intervals greater than 50 msec [pNN50], square root of the mean squared differences of successive NN intervals [RMSSD], standard deviation of heart rate [SDHR], standard deviation of the NN interval [SDNN], high-frequency band [HF], low-frequency band [LF], and their ratio [LF/HF]) were measured at baseline, week 12, and week 24. Psychiatric and medical assessments.
  
  
  
  Participants displayed significant improvements of most HRV indices over time, irrespective of the group assignment (pNN50, RMSSD, SDHR, SDNN, HF, LF, and LF/HF). Moreover, patients in the S + EX group displayed greater increases of different HRV indices(RR, pNN50, RMSSD, SDHR, SDNN, HF, and LF) compared with those in the S group.
  
  
  
  The combination of structured physical exercise and sertraline might exert positive effects on the autonomic control of the heart among older patients with major depression.
authors.affiliation: Cardiology Unit, Ramazzini Hospital, Carpi, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Toni
authors.affiliation: Section of Psychiatry, Department of Neuroscience, Oftalmology, Genetics, and Infant-Maternal Science, University of Genoa, Genoa, Italy; Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology, and Neuroscience, London, UK. Electronic address: martino.belvederi@gmail.com.
authors.forename: Martino
authors.initials: M
authors.lastname: Belvederi Murri
authors.affiliation: Heart Failure Unit, Cardiac Department, G. da Saliceto Polichirurgico Hospital, Piacenza, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Piepoli
authors.affiliation: Consultation Liaison Psychiatry Service, Department of Mental Health, Bologna, Italy.
authors.forename: Stamatula
authors.initials: S
authors.lastname: Zanetidou
authors.affiliation: Cardiorenal Research Unit, Department of Clinical and Experimental Medicine, Parma University School of Medicine, Parma, Italy.
authors.forename: Aderville
authors.initials: A
authors.lastname: Cabassi
authors.affiliation: Department of Biomedical and Neuromotor Sciences, Section of Human and General Physiology, University of Bologna, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Squatrito
authors.affiliation: Primary Care Physicians in Private Practice, Bologna, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Bagnoli
authors.affiliation: Department of Biomedical and Neuromotor Sciences, Section of Human and General Physiology, University of Bologna, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Piras
authors.affiliation: Department of Geriatrics, Nuovo Ospedale Civile S. Agostino Estense, Modena, and Reggio Emilia University, Modena, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Mussi
authors.affiliation: Sport Medicine Institute, University of Bologna, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Senaldi
authors.affiliation: Department of Medical and Surgical Sciences, University of Bologna, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Menchetti
authors.affiliation: Primary Care Physicians in Private Practice, Bologna, Italy.
authors.forename: Donato
authors.initials: D
authors.lastname: Zocchi
authors.affiliation: Primary Care Physicians in Private Practice, Bologna, Italy.
authors.forename: Giuliano
authors.initials: G
authors.lastname: Ermini
authors.affiliation: Department of Clinical and Experimental Medicine, Endocrinology of Aging Unit, University of Parma, Italy.
authors.forename: Graziano
authors.initials: G
authors.lastname: Ceresini
authors.affiliation: Sports medicine Unit, Regional Hospital of Modena, Italy.
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Tripi
authors.affiliation: Department of Biomedical and Neuromotor Sciences, Section of Human and General Physiology, University of Bologna, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Rucci
authors.affiliation: Department of Psychiatry, Weill Cornell Medical College, New York, NY, USA.
authors.forename: George S
authors.initials: GS
authors.lastname: Alexopoulos
authors.affiliation: Section of Psychiatry, Department of Neuroscience, Oftalmology, Genetics, and Infant-Maternal Science, University of Genoa, Genoa, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Amore
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001341:Autonomic Nervous System; D003865:Major Depressive Disorder / Q000628:therapy*; D015444:Exercise; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006339:Heart Rate; D006801:Humans; D000067562:Late Onset Disorders / Q000628:therapy*; D008297:Male; D020280:Sertraline / Q000627:therapeutic use*; D016037:Single-Blind Method
chemical_list: D000928:Antidepressive Agents; D020280:Sertraline
keywords: antidepressants; autonomic nervous system; elderly; exercise; heart rate variability; major depression