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Although antidepressants may facilitate a more rapid initial therapeutic response than exercise, after 16 weeks of treatment exercise was equally effective in reducing depression among patients with MDD.  JM Antidepressant drug. Sometimes medications taken for these physical illnesses may cause side effects that contribute to depression. American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. The clinical psychologists administering the Diagnostic Interview Schedule and HAM-D were not involved in the provision of any of the treatments or in the interim assessments. 2 Aerobic exercise is an effective therapeutic option in younger adults with MDD, but this option has not been well studied in the elderly.  JJTraven  CG Relapse after recovery from unipolar depression. Previous observational and interventional studies have suggested that regular physical exercise may be associated with reduced symptoms of depression. Effects of exercise training on older patients with major depression. The neurobiological effects of physical exercise are numerous and involve a wide range of interrelated effects on brain structure, brain function, and cognition. At 10 weeks a significantly higher proportion of the exercise group (55% v. 33%) experienced a greater than 30% decline in depression according to HRSD (OR=2.51, P =0.05, 95% Cl 1.00–6.38).  O The effects of training heart rate: a longitudinal study.  J Our study offers no definitive conclusions about what psychological processes may mediate the improved mood associated with exercise training. Blumenthal JA, Babyak MA, Moore KA, et al.  EJChambless Khatri P et al. Psychosom Med 2000;62:633-638. The ANCOVA models controlling for baseline levels of depression also did not yield any significant treatment effects with respect to the HAM-D (F2,152 = 0.61; P = .55) or BDI (F2,152 = 1.01; P = .37). Arch Inter Med. Six patients (2 from each group) dropped out of the study after randomization but before treatment was initiated owing to dissatisfaction with their group assignments, but were included in the data analysis following the intent-to-treat principle. This is thought to be due to both the physical and social side effects of depression.  JRMcPherson Arch Intern Med. 5 Aerobic exercise has been shown to be effective in geriatric depression. The groups did not differ at baseline on self-reported levels of anxiety, self-esteem, life satisfaction, or dysfunctional attitudes (Table 4). Weissman Aerobic exercise training and improved neuropsychological function of older individuals.  ASolberg Results: who met with each patient at study onset and weeks 2, 6, 10, 14, and 16. Contemp Clin Trials.  MG Psychometric properties of the Beck Depression Inventory: twenty-five years of evaluation. Secondary outcomes were seen with the Geriatric Depression Scale, Clinical Global Impression and Patient Global Impression. Effects of Exercise Training on Older Patients With Major Depression. The treatment groups did not differ with respect to age, sex, level of education, marital status, income, ethnic composition, or history of recurrent depression (Table 1).  WJ The effects of exercise training on psychosocial functioning after myocardial infarction. McMurdo The primary reasons for patient exclusion were a failure to meet the criteria for MDD, a HAM-D score of less than 13, or a history of bipolar disorder (Figure 1). Long Objective: To evaluate the short term effects of a training programme on patients with moderate to severe major depression.  et al. Course of depressive symptoms over follow-up. The results showed that exercise training was associated with a significant reduction in depressive symptoms, and its antidepressive effect was not influenced by age, duration of the exercise intervention, or exercise setting, but rather by LVEF and the exercise mode; HF patients with LVEFs of <50%, as well as aerobic exercise intervention, demonstrated consistent benefits on depressive symptoms. Expired air was collected by mouthpiece for quantification of minute ventilation, oxygen consumption, and carbon dioxide production (2900 Metabolic Cart; Sensormedics, Yorba Linda, Calif).  JLMintz McCann However, the extent to which exercise training may reduce depressive symptoms in older patients with major depressive disorder (MDD) has not been systematically evaluated. Objective: To assess the effectiveness of an aerobic exercise program compared with standard medication (ie, antidepressants) for treatment of MDD in older patients, we conducted a 16-week randomized controlled trial. A stratified randomization procedure was used to ensure that roughly proportionate numbers of mildly and moderately to severely depressed patients were assigned to each treatment condition. 2015 Dec;71:48-55. doi: 10.1016/j.jpsychires.2015.09.007. Blumenthal Other studies have reported that relapse and long-term recurrence rates for MDD range from 50% to 80%.10,61-63 Although exercise and antidepressants may be comparable in their short-term effectiveness, there may be important differences in maintenance. MDD is one of the top 10 causes of years lived with disability across the … (3) Life Satisfaction Index,41 a 20-item index that measures overall life satisfaction (eg, "As I grow older, things seem better than I thought they would be"). Pfizer Pharmaceuticals, New York, NY, provided the medications for this study and financial support (Drs Doraswaimy, Forman, and Krishnan). Accessibility Statement, Our website uses cookies to enhance your experience. As one example, a recent study done by the Harvard T.H. The treatment groups did not differ significantly on baseline levels of depression as measured by the HAM-D (F2,153 = 0.96; P = .39) or the BDI (F2,153 = 0.90; P = .40). However, the extent to which exercise training may reduce depressive symptoms in older patients with major depressive disorder (MDD) has not been systematically evaluated. Depression can make these conditions worse and vice versa.  CFRejeski  RMessier  MTWatkins sign up for alerts, and more, to access your subscriptions, sign up for alerts, and more, to download free article PDFs, sign up for alerts, customize your interests, and more, to make a comment, download free article PDFs, sign up for alerts and more, Archives of Neurology & Psychiatry (1919-1959), Subscribe to the JAMA Internal Medicine journal, FDA Approval and Regulation of Pharmaceuticals, 1983-2018, Global Burden of Skin Diseases, 1990-2017, Health Care Spending in the US and Other High-Income Countries, Life Expectancy and Mortality Rates in the United States, 1959-2017, Medical Marketing in the United States, 1997-2016, Practices to Foster Physician Presence and Connection With Patients in the Clinical Encounter, US Burden of Cardiovascular Disease, 1990-2016, US Burden of Neurological Disease, 1990-2017, Waste in the US Health Care System: Estimated Costs and Potential for Savings, Register for email alerts with links to free full-text articles. To date, only a single study has examined the effects of exercise as a treatment for depression in a group of 30 older adults.21 Although patients reported a significant reduction in depressive symptoms measured by the Beck Depression Inventory (BDI) compared with wait-list controls (subjects on a waiting list for treatment who served as controls), the study had important limitations, including a small sample size, imprecise diagnosis of depression, brief (ie, 6-week) treatment period, lack of a standardized exercise regimen, and failure to document exercise training. 2004;4(7):1-98. All analyses were conducted using the intent-to-treat principle.  RORussell  HISadock  LW Aerobic exercise and cognitive therapy in the treatment of dysphoric moods. Background  © 2021 American Medical Association.  LE Aerobic exercise as a treatment for depression.  K Prevalence of depression and its correlates in older adults. to download free article PDFs, doi:10.1001/archinte.159.19.2349. Murrell older patients with depression (8). Higher scores indicate higher levels of anxiety. However, the extent to which exercise training may reduce depressive symptoms in older patients with major depressive disorder (MDD) has not been systematically evaluated.  CFMadden A modified Balke protocol was used43 in which workloads were increased at a rate of 1 metabolic equivalent per minute. Rovner  et al. The median peak dose of sertraline hydrochloride was 100 mg for the medication and combined treatment groups. Double-blind, multicenter comparison of sertraline and amitriptyline in elderly depressed patients. After 16 weeks of treatment, the groups did not differ statistically on HAM-D or BDI scores (P = .67); adjustment for baseline levels of depression yielded an essentially identical result. Background: Previous observational and interventional studies have suggested that regular physical exercise may be associated with reduced symptoms of depression.  SD This medication was selected because of its documented efficacy and favorable side effect profile for the elderly.45 Medication management was provided by a staff psychiatrist (L.M.F., P.M.D., or K.R.K.)  et al. Bethesda, MD 20894, Copyright Physical activity and exercise have a wide range of beneficial effects that involve both “body” and “mind.”Bearing in mind this is an artifactual and anachronistic convention, here we provide an overview of exercise effects on the body “from the neck down” that could be relevant to individuals with depression. Patients in this group received concurrently the same medication and exercise regimens described above. Effects of exercise training on older patients with major depression.  DJ ) In middle-aged and older adults, depression becomes less prevalent, but a greater likelihood exists that it will become a chronic condition accompanied by other chronic health issues. Burckhardt One hundred fifty-six men and women with MDD (age, ≥50 years) were assigned randomly to a program of aerobic exercise, antidepressants (sertraline hydrochloride), or combined exercise and medication.  JWalsh-Riddle  RT Pharmacoendocrinology of major depression. Error bars represent SEs.  IShea  JMYudofsky Effects of Exercise Training on Older Patients With Major Depression By James A. Blumenthal, Michael A. Babyak, Kathleen A. Moore, W. Edward Craighead, Steve Herman, Parinda Khatri, Robert Waugh, Melissa A. Napolitano, Leslie M. Forman, Mark Appelbaum, P. Murali Doraiswamy and K. Ranga Krishnan  et al. Patients also were sufficiently motivated to volunteer for a study of exercise training, tended to be highly educated, and were healthy enough to participate in an exercise program.  WHBurns However, the extent to which exercise training may reduce depressive symptoms in older patients with major depressive disorder (MDD) has not been systematically evaluated. Freemont Twelve patients in the exercise group were unable to complete the program because of logistical difficulties in attending the classes (8 patients) or dissatisfaction with the exercise program (4 patients). Studies show that exercise can treat mild to moderate depression as effectively as antidepressant medication—but without the side-effects, of course. Resistance training also has been shown to produce positive effects in post coronary patients.  CP A role for amines in the antidepressant effects of exercise: a review. Greer TL, et al.  WWWolfinger The effects of depression cause an overall increase in mortality, where those with depression may die 25 years sooner than the average person. Depression in Primary Care: Treatment of Major Depression: Clinical Practice Guideline. Exercise has been found to increase hormone activities in the body associated with an improved mood and increases the body’s sensitivity to serotonin.  AKillam Similarly, the mean percentage of time in target heart rate training range was virtually identical for the exercise (82.4%) and combined (82.4%) groups. Objective:To assess the effectiveness of an aerobic ex-ercise program compared with standard medication (ie, antidepressants) for treatment of MDD in older patients, we conducted a 16-week randomized controlled trial. Cohn A double-blind, placebo-controlled treatment trial of citalopram for major depressive disorder in older patients with heart failure: the relevance of the placebo effect and psychological symptoms. Moreover, exercising subjects achieved small but clinically and statistically significant improvements in aerobic capacity, which were comparable to changes observed in nonclinical populations of older adults.28. Comparison of high- and low-intensity exercise training early after acute myocardial infarction. Privacy, Help  JT BACKGROUND: Major depressive disorder (MDD) occurs in up to 18% of older adults 1 and is a major cause of morbidity, decreased quality of life, and mortality in this age group. Agreement with each statement was rated on a 7-point scale, so that higher scores reflect less presence of dysfunctional beliefs. To assess the effectiveness of an aerobic exercise program compared with standard medication (ie, antidepressants) for treatment of MDD in older patients, we conducted a 16-week randomized controlled trial.  M The effect of exercise on depressive symptoms in the moderately depressed elderly.  JK Affective disorders in a US urban community. Symptomatic depression in elderly medical outpatients.  RMendels Based on our results, it appears that exercise is associated with clinically significant improvements in depression that are comparable to those of antidepressants for the clinically depressed older adult when performed in a structured and supervised setting. Physical Inactivity Is Associated With Increased Levels of Anxiety, Depression, and Stress in Brazilians During the COVID-19 Pandemic: A Cross-Sectional Study. After 16 weeks of treatment, the groups did not differ statistically on HAM-D or BDI scores (P = .67); adjustment for baseline levels of depression yielded an essentially identical result. Although exercise significantly decreased depression across all age categories, the older people were (the ages ranged from eleven to fifty-five), the greater the decrease in depression with exercise. Subjects attended 3 supervised exercise sessions per week for 16 consecutive weeks. After four months of treatment, Blumenthal found, patients in the exercise and antidepressant groups had higher rates of remission than did the patients on the placebo. Participants were assigned individual training ranges equivalent to 70% to 85% of heart rate reserve44 calculated from the maximum heart rate achieved during the treadmill test.  AJHales  SC Psychopharmacology and electroconvulsive therapy. 24. When considering the prevalence of people with subsyndromal/subthreshold depression, or those that have significant depressive symptoms but do not meet the criteria for a formal diagnosis of MDD, the prevalence rate is approximately 15% to 20% (2). By continuing to use our site, or clicking "Continue," you are agreeing to our, Patient Characteristics for Treatment Groups, Solution for Growth Curve Model of HAM-D*, Mean Pretreatment and Adjusted Last Observation Scores for Ancillary Psychometric Measures*. Arch Intern Med 1999; 159:2349.  BLHavighurst Of the patients who met final entry criteria, 48 were randomly assigned to the medication condition, 53 to the exercise condition, and 55 to the combined condition.  EM Prevention and treatment information (HHS). That exercise was equally effective as medication after 16 weeks of treatment is consistent with findings of other studies of exercise training in younger depressed adults.14,15,17,18 The magnitude of reductions in depression scores is also comparable to the levels achieved using sertraline in other clinical trials of depression.45,48 Moreover, the changes in depressive symptoms found for all treatments in our study are consistent with the extent of improvements reported in more than a dozen studies of psychosocial interventions for MDD.12,49-53 For example, in the National Institute of Mental Health Collaborative Depression Study,53 36% of patients undergoing cognitive behavior therapy, 43% of patients undergoing interpersonal therapy, and 42% of patients receiving medication (imipramine hydrochloride) were considered "recovered," compared with 47.2% undergoing exercise, 56.2% receiving medication (sertraline), and 47.3% receiving a combination of exercise and medication in our study.

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