Abstract
BackgroundDepression is a disabling, prevalent condition. Physical activity programs may assist depression management in older people, ameliorate co-morbid conditions and reduce the need for antidepressants. The UPLIFT pilot study assessed the feasibility of older depressed people attending a community-based progressive resistance training (PRT) program. The study also aimed to determine whether PRT improves depressive status in older depressed patients.MethodsA randomised controlled trial was conducted. People aged ≥ 65 years with depressive symptoms were recruited via general practices. Following baseline assessment, subjects were randomly allocated to attend a local PRT program three times per week for 10 weeks or a brief advice control group. Follow-up assessment of depressive status, physical and psychological health, functional and quality of life status occurred post intervention and at six months.ResultsThree hundred and forty six people responded to the study invitation, of whom 22% had depressive symptoms (Geriatric Depression Scale, GDS-30 score ≥ 11). Thirty two people entered the trial. There were no significant group differences on the GDS at follow-up. At six months there was a trend for the PRT intervention group to have lower GDS scores than the comparison group, but this finding did not reach significance (p = 0.08). More of the PRT group (57%) had a reduction in depressive symptoms post program, compared to 44% of the control group. It was not possible to discern which specific components of the program influenced its impact, but in post hoc analyses, improvement in depressive status appeared to be associated with the number of exercise sessions completed (r = -0.8, p < 0.01).ConclusionThe UPLIFT pilot study confirmed that older people with depression can be successfully recruited to a community based PRT program. The program can be offered by existing community-based facilities, enabling its ongoing implementation for the potential benefit of other older people.
Highlights
Recruitment results General practitioners from 38 practices agreed to assist in recruitment for the study: and we recruited older people from 13 of these practices
Recruitment via invitation letters proved more productive than opportunistic recruitment, but not all practices had the staff capacity to assist in recruitment by this mode in accordance with the privacy/data protection legislation
Eleven were unable to participate for other reasons e.g. no consent, travelling away from home, time commitments
Summary
Physical activity programs may assist depression management in older people, ameliorate co-morbid conditions and reduce the need for antidepressants. The UPLIFT pilot study assessed the feasibility of older depressed people attending a community-based progressive resistance training (PRT) program. Several reviews have assessed the use of exercise in the management of depression and reported benefits [79]. Several trials indicated that physical activity can reduce depression in older people. In a trial of people with major depression, aerobic exercise was found to be of similar benefit to sertraline [11]. Secondary analyses in an osteoarthritis trial found improvements in depressive symptoms and disability at 18 months post aerobic, but not resistance, training [13]. In a brief trial with non-clinically depressed people, both walking and social contact had similar benefit [14]. Since polypharmacy is a management challenge amongst older people, nonpharmacological treatment options are worth considering
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