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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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References

Alexopoulos, G. S. (2005). Depression in the elderly. Lancet, 365, 1961–1970.CrossRefGoogle ScholarPubMed
Belvederi Murri, M. et al. (2015). Physical exercise for late-life major depression. British Journal of Psychiatry, 207, 235–242.Google Scholar
Berardi, D., Menchetti, M., De, R. D., Rucci, P., Leggieri, G. and Ferrari, G. (2002). Late-life depression in primary care: a nationwide Italian epidemiological survey. Journal of the American Geriatrics Society, 50, 77–83.Google Scholar
Blondell, S. J., Hammersley-Mather, R. and Veerman, J. L. (2014). Does physical activity prevent cognitive decline and dementia?: a systematic review and meta-analysis of longitudinal studies. BMC Public Health, 14, 510.Google Scholar
Butters, M. A. et al. (2008). Pathways linking late-life depression to persistent cognitive impairment and dementia. Dialogues in Clinical Neuroscience, 10, 345–357.Google Scholar
Cherbuin, N., Kim, S. and Anstey, K. J. (2015). Dementia risk estimates associated with measures of depression: a systematic review and meta-analysis. BMJ Open, 5, e008853.CrossRefGoogle ScholarPubMed
Chou, C. H., Hwang, C. L. and Wu, Y. T. (2012). Effect of exercise on physical function, daily living activities, and quality of life in the frail older adults: a meta-analysis. Archives of Physical Medicine and Rehabilitation, 93, 237–244.CrossRefGoogle ScholarPubMed
Culang-Reinlieb, M. E., Sneed, J. R., Keilp, J. G. and Roose, S. P. (2012). Change in cognitive functioning in depressed older adults following treatment with sertraline or nortriptyline. International Journal of Geriatric Psychiatry, 27, 777–784.CrossRefGoogle ScholarPubMed
de Vries, N. M., van Ravensberg, C. D., Hobbelen, J. S., Olde Rikkert, M. G., Staal, J. B. and Nijhuis-van der Sanden, M. W. (2012). Effects of physical exercise therapy on mobility, physical functioning, physical activity and quality of life in community-dwelling older adults with impaired mobility, physical disability and/or multi-morbidity: a meta-analysis. Ageing Research Reviews, 11, 136–149.Google Scholar
Dombrovski, A. Y. et al. (2007). Residual symptoms and recurrence during maintenance treatment of late-life depression. Journal of Affective Disorders, 103, 77–82.CrossRefGoogle ScholarPubMed
Erickson, K. I., Leckie, R. L. and Weinstein, A. M. (2014). Physical activity, fitness, and gray matter volume. Neurobiology of Aging, 35 (Suppl. 2), S20–S28.Google Scholar
Feingold, A. (2009). Effect sizes for growth-modeling analysis for controlled clinical trials in the same metric as for classical analysis. Psychological Methods, 14, 43–53.Google Scholar
Gansler, D. A., Suvak, M., Arean, P. and Alexopoulos, G. S. (2015). Role of executive dysfunction and dysexecutive behavior in late-life depression and disability. American Journal of Geriatric Psychiatry, 23, 1038– 1045.Google Scholar
Greer, T. L., Grannemann, B. D., Chansard, M., Karim, A. I. and Trivedi, M. H. (2015). Dose-dependent changes in cognitive function with exercise augmentation for major depression: results from the TREAD study. European Neuropsychopharmacology, 25, 248–256.Google Scholar
Han, L., McCusker, J., Cole, M., Capek, R. and Abrahamowicz, M. (2011). Antidepressant use and cognitive functioning in older medical patients with major or minor depression: a prospective cohort study with database linkage. Journal of Clinical Psychopharmacology, 31, 429–435.Google Scholar
Hoffman, B. M. et al. (2008). Exercise fails to improve neurocognition in depressed middle-aged and older adults. Medicine & Science in Sports & Exercise, 40, 1344– 1352.Google Scholar
Kelly, M. E., Loughrey, D., Lawlor, B. A., Robertson, I. H., Walsh, C. and Brennan, S. (2014). The impact of exercise on the cognitive functioning of healthy older adults: a systematic review and meta-analysis. Ageing Research Reviews, 16, 12–31.Google Scholar
Krishnan, K. et al. (2016). Changes in Montreal cognitive assessment scores over time. Assessment, Epub ahead of print, Jun 18. doi: 10.1177/1073191116654217 Google Scholar
Leventhal, A. M. (2012). Relations between anhedonia and physical activity. American Journal of Health Behavior, 36, 860–872.Google Scholar
Miller, M. D. et al. (1992). Rating chronic medical illness burden in geropsychiatric practice and research: application of the cumulative illness rating scale. Psychiatry Research, 41, 237–248.CrossRefGoogle ScholarPubMed
Morimoto, S. S. and Alexopoulos, G. S. (2013). Cognitive deficits in geriatric depression: clinical correlates and implications for current and future treatment. Psychiatric Clinics of North America, 36, 517–531.CrossRefGoogle ScholarPubMed
Muscari, A. et al. (2010). Chronic endurance exercise training prevents aging-related cognitive decline in healthy older adults: a randomized controlled trial. International Journal of Geriatric Psychiatry, 25, 1055–1064.Google Scholar
Nishiguchi, S. et al. (2015). A 12-week physical and cognitive exercise program can improve cognitive function and neural efficiency in community-dwelling older adults: a randomized controlled trial. Journal of the American Geriatrics Society, 63, 1355–1363.Google Scholar
Pimontel, M. A., Rindskopf, D., Rutherford, B. R., Brown, P. J., Roose, S. P. and Sneed, J. R. (2016). A meta-analysis of executive dysfunction and antidepressant treatment response in late-life depression. American Journal of Geriatric Psychiatry, 24, 31–41.Google Scholar
Rosenblat, J. D., Kakar, R. and McIntyre, R. S. (2015). The cognitive effects of antidepressants in major depressive disorder: a systematic review and meta-analysis of randomized clinical trials. International Journal of Neuropsychopharmacology, 19, 1–13. doi: https://doi.org/10.1093/ijnp/pyv082 Google ScholarPubMed
Royall, D. R. et al. (2009). Sertraline improves executive function in patients with vascular cognitive impairment. The Journal of Neuropsychiatry & Clinical Neurosciences, 21, 445–454.Google Scholar
Santangelo, G. et al. (2014). Normative data for the montreal cognitive assessment in an Italian population sample. Neurological Sciences, 36, 585–591.Google Scholar
Schuch, F. B., Deslandes, A. C., Stubbs, B., Gosmann, N. P., Silva, C. T. and Fleck, M. P. (2016). Neurobiological effects of exercise on major depressive disorder: a systematic review. Neuroscience & Biobehavioral Reviews, 61, 1–11.CrossRefGoogle ScholarPubMed
Shankar, A., Hamer, M., McMunn, A. and Steptoe, A. (2013). Social isolation and loneliness: relationships with cognitive function during 4 years of follow-up in the english longitudinal study of ageing. Psychosomatic Medicine, 75, 161–170.CrossRefGoogle ScholarPubMed
Sheehan, D. V. et al. (1998). The mini-international neuropsychiatric interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. The Journal of Clinical Psychiatry, 59 (Suppl. 20), 22–33.Google Scholar
Toni, G. et al. (2016). Physical exercise for late-life depression: effects on heart rate variability. The American Journal of Geriatric Psychiatry, 24, 989–997.Google Scholar
Vaughan, L., Corbin, A. L. and Goveas, J. S. (2015). Depression and frailty in later life: a systematic review. Clinical Interventions in Aging, 10, 1947–1958.CrossRefGoogle ScholarPubMed
Windle, G., Hughes, D., Linck, P., Russell, I. and Woods, B. (2010). Is exercise effective in promoting mental well-being in older age? a systematic review. Aging Ment Health, 14, 652–669.Google Scholar
Yuen, G. S. et al. (2015). Apathy in late-life depression: common, persistent, and disabling. American Journal of Geriatric Psychiatry, 23, 488–494.CrossRefGoogle ScholarPubMed
Zanetidou, S. et al. (2017). Physical exercise for late-life depression: customizing an intervention for primary care. Journal of the American Geriatrics Society, 65, 348–355. doi: 10.1111/jgs.14525 CrossRefGoogle ScholarPubMed
Zheng, G., Xia, R., Zhou, W., Tao, J. and Chen, L. (2016). Aerobic exercise ameliorates cognitive function in older adults with mild cognitive impairment: a systematic review and meta-analysis of randomised controlled trials. British Journal of Sports Medicine, Epub ahead of print. doi: 10.1136/bjsports-2015-095699 CrossRefGoogle ScholarPubMed