Physical exercise for late-life depression: Effects on symptom dimensions and time course

Murri, Martino Belvederi; Ekkekakis, P.; Menchetti, Marco; Neviani, Francesca; Trevisani, Fausto; Tedeschi, Stefano; Latessa, Pasqualino Maietta; Nerozzi, Erika; Ermini, Giuliano; Zocchi, Donato; Squatrito, Salvatore; Toni, Giulio; Cabassi, Aderville; Neri, Mirco; Zanetidou, Stamatula; Amore, Mario

doi:10.1016/j.jad.2018.01.004

Cited by 83 publications

(40 citation statements)

References 42 publications

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“…More recently, the SEEDS study showed that exercise was an effective add-on to antidepressant drugs for mild to moderate depression (132). Interestingly, adding exercise to antidepressant drugs primarily affected core symptoms of depression rather than somatic symptoms (133). Moreover, individuals receiving aerobic exercise plus antidepressants displayed greater improvements in cognition and autonomic balance compared to those only receiving antidepressants (134, 135).…”

Section: Effectiveness Of Exercise In Late Life Depressionmentioning

confidence: 99%

Physical Exercise in Major Depression: Reducing the Mortality Gap While Improving Clinical Outcomes

et al. 2019

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Major depression shortens life while the effectiveness of frontline treatments remains modest. Exercise has been shown to be effective both in reducing mortality and in treating symptoms of major depression, but it is still underutilized in clinical practice, possibly due to prevalent misperceptions. For instance, a common misperception is that exercise is beneficial for depression mostly because of its positive effects on the body (“from the neck down”), whereas its effectiveness in treating core features of depression (“from the neck up”) is underappreciated. Other long-held misperceptions are that patients suffering from depression will not engage in exercise even if physicians prescribe it, and that only vigorous exercise is effective. Lastly, a false assumption is that exercise may be more harmful than beneficial in old age, and therefore should only be recommended to younger patients. This narrative review summarizes relevant literature to address the aforementioned misperceptions and to provide practical recommendations for prescribing exercise to individuals with major depression.

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Section: Effectiveness Of Exercise In Late Life Depressionmentioning

confidence: 99%

Physical Exercise in Major Depression: Reducing the Mortality Gap While Improving Clinical Outcomes

et al. 2019

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“…Interestingly a recent study conducted by Murri et al (2018), has demonstrated that physical exercise, in combination with the SSRI sertraline, reduces affective symptoms and psychomotor retardation in MDD. Furthermore, the beneficial effects of AE as an add-on strategy in the treatment of moderate to severe depression has been shown in a study carried out by Imboden et al (2019), considering different psychological and biological variables (e.g., BDNF, HPA axis activity, cognitive symptoms) besides depression severity.…”

Section: The Pathophysiology Of Depression: the Role Of Neurotrophic mentioning

confidence: 99%

Antidepressant Drugs and Physical Activity: A Possible Synergism in the Treatment of Major Depression?

et al. 2020

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Major depressive disorder (MDD) is a severe mental illness that affects 5-20% of the general population. Current antidepressant drugs exert only a partial clinical efficacy because approximately 30% of depressed patients failed to respond to these drugs and antidepressants produce remission only in 30% of patients. This can be explained by the fact that the complex pathophysiology of depression has not been completely elucidated, and treatments have been mainly developed following the "monoaminergic hypothesis" of depression without considering the key role of other factors involved in the pathogenesis of MDD, such as the role of chronic stress and neuroinflammation. Chronic stress acts as a risk factor for the development of MDD through the impairment of neurotrophins signaling such as brain-derived neurotrophic factor (BDNF) and transforming-growth-factor-β1 (TGF-β1). Stress-induced depressive pathology contributes to altered BDNF level and function in MDD patients and, thereby, an impairment of neuroplasticity at the regional and circuit level. Recent studies demonstrate that aerobic exercise strongly increases BDNF production and it may contribute as a non-pharmacological strategy to improve the treatment of cognitive and affective symptoms in MDD. Here we will provide a general overview on the possible synergism between physical activity and antidepressants in MDD. Physical activity can synergize with antidepressant treatment by rescuing neurotrophins signaling in MDD patients, promoting neuronal health and recovery of function in MDD-related circuits, finally enhancing pharmacotherapeutic response. This synergism might be particularly relevant in elderly patients with late-life depression, a clinical subgroup with an increased risk to develop dementia.

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“…At the close of this decade, the last remaining 'baby boomers' will transition to an expanding peer demographic aged ≥ 65 years projected to constitute more than one billion older adults, worldwide 1 . Physical exercise is proposed as a low-risk adjunctive mitigant of age-associated functional deterioration in mental health, including for dementia 2 and depression 3,4 . In light of impending demographic shifts, and with the burden of age-associated depression estimated to affect ~20% of older adults [5][6][7] , 2030 may confer a burden of 200 million adults aged ≥ 65 years presenting with clinical depression.…”

Section: Introductionmentioning

confidence: 99%

Aerobic, resistance, and mind-body exercise are equivalent to mitigate symptoms of depression in older adults: A systematic review and network meta-analysis of randomised controlled trials

et al. 2020

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Background: Exercise has been identified as an allied health strategy that can support the management of depression in older adults, yet the relative effectiveness for different exercise modalities is unknown. To meet this gap in knowledge, we present a systematic review and network meta-analysis of randomised controlled trials (RCTs) to examine the head-to-head effectiveness of aerobic, resistance, and mind-body exercise to mitigate depressive symptoms in adults aged ≥ 65 years. Methods: A PRISMA-NMA compliant review was undertaken on RCTs from inception to September 12th, 2019. PubMed, Web of Science, CINAHL, Health Source: Nursing/Academic Edition, PsycARTICLES, PsycINFO, and SPORTDiscus were systematically searched for eligible RCTs enrolling adults with a mean age ≥ 65 years, comparing one or more exercise intervention arms, and which used valid measures of depressive symptomology. Comparative effectiveness was evaluated using network meta-analysis to combine direct and indirect evidence, controlling for inherent variation in trial control groups. Results: The systematic review included 81 RCTs, with 69 meeting eligibility for the network meta-analysis (n = 5,379 participants). Pooled analysis found each exercise type to be effective compared with controls (Hedges’ g = -0.27 to -0.51). Relative head-to-head comparisons were statistically comparable between exercise types: resistance versus aerobic (Hedges’ g = -0.06, PrI = -0.91, 0.79), mind-body versus aerobic (Hedges’ g = -0.12, PrI = -0.95, 0.72), mind-body versus resistance (Hedges’ g = -0.06, PrI = -0.90, 0.79). High levels of compliance were demonstrated for each exercise treatment. Conclusions: Aerobic, resistance, and mind-body exercise demonstrate equivalence to mitigate symptoms of depression in older adults aged ≥ 65 years, with comparably encouraging levels of compliance to exercise treatment. These findings coalesce with previous findings in clinically depressed older adults to encourage personal preference when prescribing exercise for depressive symptoms in older adults, irrespective of severity. Registration: PROSPERO CRD42018115866 (23/11/2018).

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Physical exercise for late-life depression: Effects on symptom dimensions and time course

Cited by 83 publications

References 42 publications

Physical Exercise in Major Depression: Reducing the Mortality Gap While Improving Clinical Outcomes

Physical Exercise in Major Depression: Reducing the Mortality Gap While Improving Clinical Outcomes

Antidepressant Drugs and Physical Activity: A Possible Synergism in the Treatment of Major Depression?

Aerobic, resistance, and mind-body exercise are equivalent to mitigate symptoms of depression in older adults: A systematic review and network meta-analysis of randomised controlled trials

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