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Physical exercise for late life depression: effects on cognition and disability

Published online by Cambridge University Press:  17 April 2017

Francesca Neviani ,
Martino Belvederi Murri ,
Chiara Mussi ,
Federico Triolo ,
Giulio Toni ,
Elisabetta Simoncini ,
Ferdinando Tripi ,
Marco Menchetti ,
Silvia Ferrari Open the ORCID record for Silvia Ferrari [Opens in a new window]  and
Graziano Ceresini
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Francesca Neviani
Affiliation:
Department of Geriatrics, Nuovo Ospedale Civile S. Agostino Estense, Modena and Reggio Emilia University, Modena, Italy
Martino Belvederi Murri*
Affiliation:
Section of Psychiatry, Department of Neuroscience, Oftalmology, Genetics and Infant-Maternal Science, University of Genoa, Genoa, Italy Department of Mental Health, Modena, Italy Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
Chiara Mussi
Affiliation:
Department of Geriatrics, Nuovo Ospedale Civile S. Agostino Estense, Modena and Reggio Emilia University, Modena, Italy
Federico Triolo
Affiliation:
Department of Geriatrics, Nuovo Ospedale Civile S. Agostino Estense, Modena and Reggio Emilia University, Modena, Italy
Giulio Toni
Affiliation:
Cardiology Unit, Hospital S. Sebastiano, Correggio, Italy
Elisabetta Simoncini
Affiliation:
Primary Care Physician, Bologna, Italy
Ferdinando Tripi
Affiliation:
Sports Medicine Unit, Regional Hospital of Modena, Italy
Marco Menchetti
Affiliation:
Department of Medical and Surgical Sciences, University of Bologna, Italy
Silvia Ferrari
Affiliation:
Department of Diagnostic-Clinical Medicine and Public Health, Section of Psychiatry, University of Modena and Reggio Emilia, Modena, Italy
Graziano Ceresini
Affiliation:
Department of Clinical and Experimental Medicine, Endocrinology of Aging Unit, University of Parma, Italy
Alessandro Cremonini
Affiliation:
Consultation Liaison Psychiatry Service, Department of Mental Health, Bologna, Italy
Marco Bertolotti
Affiliation:
Department of Geriatrics, Nuovo Ospedale Civile S. Agostino Estense, Modena and Reggio Emilia University, Modena, Italy
Giovanni Neri
Affiliation:
Villa Igea Psychiatric Clinic, and University of Modena and Reggio Emilia, Modena, Italy
Salvatore Squatrito
Affiliation:
Department of Biomedical and Neuromotor Sciences, Section of Human and General Physiology, University of Bologna, Italy
Mario Amore
Affiliation:
Section of Psychiatry, Department of Neuroscience, Oftalmology, Genetics and Infant-Maternal Science, University of Genoa, Genoa, Italy
Stamatula Zanetidou
Affiliation:
Consultation Liaison Psychiatry Service, Department of Mental Health, Bologna, Italy
Mirco Neri
Affiliation:
Department of Geriatrics, Nuovo Ospedale Civile S. Agostino Estense, Modena and Reggio Emilia University, Modena, Italy
*
Correspondence should be addressed to: Martino Belvederi Murri, MD, Clinica Psichiatrica, Ospedale San Martino IRCCS, Largo Rosanna Benzi, 10, Genova, 16132, Italy. Phone: +39333-5248720; Fax: +39103537669. Email: martino.belvederi@gmail.com.
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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.

Keywords

depressionantidepressantscognitiondisabilityexerciseaerobicexecutive functions
Type
Research Article
Information
International Psychogeriatrics , Volume 29 , Issue 7 , July 2017 , pp. 1105 - 1112
Copyright
Copyright © International Psychogeriatric Association 2017 

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