Comparative Effectiveness of Three Exercise Types to Treat Clinical Depression in Older Adults: A Systematic Review and Network Meta-Analysis of Randomised Controlled Trials.

Author: Miller KJ1, Gonçalves-Bradley DC2, Areerob P3, Hennessy D3, Mesagno C3, Grace F3
Affiliation:
1School of Health and Life Sciences, Federation University, Ballarat, Victoria, Australia. Electronic address: kylemiller@students.federation.edu.au.
2Nuffield Department of Population Health, University of Oxford, UK.
3School of Health and Life Sciences, Federation University, Ballarat, Victoria, Australia.
Conference/Journal: Ageing Res Rev.
Date published: 2019 Dec 11
Other: Volume ID: 100999 , Special Notes: doi: 10.1016/j.arr.2019.100999. [Epub ahead of print] , Word Count: 286


BACKGROUND: Few studies have directly compared the effects of different exercise therapies on clinical depression in older adults. Thus, we conducted a systematic review and network meta-analysis of current evidence from randomised controlled trials (RCTs) to compare the effectiveness of three major exercise types (resistance, aerobic, and mind-body exercise) in clinically depressed older adults.

METHODS: We followed PRISMA-NMA guidelines and searched databases for eligible RCTs (inception - June 30th, 2018). RCTs were eligible if they included clinically depressed adults aged >65 years, implemented one or more exercise therapy arms using aerobic, resistance, or mind-body exercise, and assessed depressive symptoms at baseline and follow-up using a validated clinical questionnaire.

RESULTS: A network meta-analysis was performed on 15 eligible RCTs comprising 596 participants (321 treatment and 275 controls), including aerobic (n = 6), resistance (n = 5), and mind-body (n = 4) exercise trials. Compared with controls, mind-body exercise showed the largest improvement on depressive symptoms (g = -0.87 to -1.38), followed by aerobic exercise (g = -0.51 to -1.02), and resistance exercise (g = -0.41 to -0.92). Notably, there were no statistically significant differences between exercise types: aerobic versus resistance (g = -0.10, PrI = -2.23, 2.03), mind-body versus aerobic (g = -0.36, PrI = -2.69, 1.97), or mind-body versus resistance (g = -0.46, PrI = -2.75, 1.83).

CONCLUSIONS: These findings should be used to advise allied health professionals and stakeholders in clinical geriatrics that clinically depressed older adults can self-select their preferred exercise type in order to achieve therapeutic benefit on symptoms of depression. In coalition with high levels of compliance, these data provide encouraging evidence for the antidepressant effect of either aerobic, resistance, or mind-body exercise as an adjunct to prescribed therapy for clinical depression in older populations.

Copyright © 2019. Published by Elsevier B.V.

KEYWORDS: Elderly; aerobic; major depressive disorder; mind-body; physical activity; resistance

PMID: 31837462 DOI: 10.1016/j.arr.2019.100999

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