Francesca Neviani1, Martino Belvederi Murri2, Chiara Mussi1, Federico Triolo1, Giulio Toni3, Elisabetta Simoncini4, Ferdinando Tripi5, Marco Menchetti6, Silvia Ferrari7, Graziano Ceresini8, Alessandro Cremonini9, Marco Bertolotti1, Giovanni Neri10, Salvatore Squatrito11, Mario Amore2, Stamatula Zanetidou9, Mirco Neri1. 1. Department of Geriatrics,Nuovo Ospedale Civile S. Agostino Estense,Modena and Reggio Emilia University,Modena,Italy. 2. Section of Psychiatry,Department of Neuroscience,Oftalmology,Genetics and Infant-Maternal Science,University of Genoa,Genoa,Italy. 3. Cardiology Unit,Hospital S. Sebastiano,Correggio,Italy. 4. Primary Care Physician,Bologna,Italy. 5. Sports Medicine Unit,Regional Hospital of Modena,Italy. 6. Department of Medical and Surgical Sciences,University of Bologna,Italy. 7. Department of Diagnostic-Clinical Medicine and Public Health,Section of Psychiatry,University of Modena and Reggio Emilia,Modena,Italy. 8. Department of Clinical and Experimental Medicine,Endocrinology of Aging Unit,University of Parma,Italy. 9. Consultation Liaison Psychiatry Service,Department of Mental Health,Bologna,Italy. 10. Villa Igea Psychiatric Clinic, andUniversity of Modena and Reggio Emilia,Modena,Italy. 11. Department of Biomedical and Neuromotor Sciences,Section of Human and General Physiology,University of Bologna,Italy.
Abstract
BACKGROUND: Late-life depression is often associated with cognitive impairments and disability, which may persist even after adequate antidepressant drug treatment. Physical exercise is increasingly recognized as an effective antidepressant agent, and may exert positive effects on these features too. However, few studies examined this issue, especially by comparing different types of exercises. METHODS: We performed secondary analyses on data from the Safety and Efficacy of Exercise for Depression in Seniors study, a trial comparing the antidepressant effectiveness of sertraline (S), sertraline plus thrice-weekly non-progressive exercise (S+NPE), and sertraline plus thrice-weekly progressive aerobic exercise (S+PAE). Exercise was conducted in small groups and monitored by heart rate meters. Patients with late-life depression without severe cognitive impairment were recruited from primary care and assessed at baseline and 24 weeks, using the Montreal Cognitive Assessment (MOCA, total and subdomain scores) and Brief Disability Questionnaire. Analyses were based on Generalized Linear Models. RESULTS: In total, 121 patients (mean age 75, 71% females) were randomized to the study interventions. Compared with the S group, patients in the S+PAE group displayed greater improvements of MOCA total scores (p=0.006, effect size=0.37), visuospatial/executive functions (p=0.001, effect size=0.13), and disability (p=0.02, effect size=-0.31). Participants in the S+NPE group did not display significant differences with the control group. CONCLUSIONS: Adding aerobic, progressive exercise to antidepressant drug treatment may offer significant advantages over standard treatment for cognitive abilities and disability. These findings suggest that even among older patients exercise may constitute a valid therapeutic measure to improve patients' outcomes.
RCT Entities:
BACKGROUND:Late-life depression is often associated with cognitive impairments and disability, which may persist even after adequate antidepressant drug treatment. Physical exercise is increasingly recognized as an effective antidepressant agent, and may exert positive effects on these features too. However, few studies examined this issue, especially by comparing different types of exercises. METHODS: We performed secondary analyses on data from the Safety and Efficacy of Exercise for Depression in Seniors study, a trial comparing the antidepressant effectiveness of sertraline (S), sertraline plus thrice-weekly non-progressive exercise (S+NPE), and sertraline plus thrice-weekly progressive aerobic exercise (S+PAE). Exercise was conducted in small groups and monitored by heart rate meters. Patients with late-life depression without severe cognitive impairment were recruited from primary care and assessed at baseline and 24 weeks, using the Montreal Cognitive Assessment (MOCA, total and subdomain scores) and Brief Disability Questionnaire. Analyses were based on Generalized Linear Models. RESULTS: In total, 121 patients (mean age 75, 71% females) were randomized to the study interventions. Compared with the S group, patients in the S+PAE group displayed greater improvements of MOCA total scores (p=0.006, effect size=0.37), visuospatial/executive functions (p=0.001, effect size=0.13), and disability (p=0.02, effect size=-0.31). Participants in the S+NPE group did not display significant differences with the control group. CONCLUSIONS: Adding aerobic, progressive exercise to antidepressant drug treatment may offer significant advantages over standard treatment for cognitive abilities and disability. These findings suggest that even among older patients exercise may constitute a valid therapeutic measure to improve patients' outcomes.
Authors: Terry D Ellis; Cristina Colón-Semenza; Tamara R DeAngelis; Cathi A Thomas; Marie-Hélène Saint Hilaire; Gammon M Earhart; Leland E Dibble Journal: Semin Neurol Date: 2021-03-19 Impact factor: 3.420
Authors: Silvia Ferrari; Giorgio Mattei; Mattia Marchi; Gian Maria Galeazzi; Luca Pingani Journal: Int J Environ Res Public Health Date: 2020-10-10 Impact factor: 3.390