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F.M. Tsaleza1, A. Sideris2,1, G. Georgoudis3,2, A. Politis4
1Physio Science Clinic, Athens, Greece, 2Hellenic Physiotherapy Society of Algology, Athens, Greece, 3University of West Attica, Physiotherapy Department, Musculoskeletal Physiotherapy Research Laboratory, Athens, Greece, 4National Kapodistrian University of Athens, School of Medicine, 1st Department of Psychiatry ('AIGINITEIO' Hospital), Psychogeriatrics Unit, Athens, Greece
Background: Depression is a common pathology affecting the elderly population. Most common interventions for treating depression include medication and cognitive behavioral therapy. However, non-pharmacological means like exercise are exhibiting promising results in bettering quality of life in the population in question, while being cost effective, approachable and easy to include in a multidisciplinary setting. However, there is a lack of up-to-date systematic reviews (SR) in the literature for the age group of the elderly. A possible contemporary SR with positive results would strengthen the case of endorsing Exercise Therapy in this field.
Purpose: The purpose of this SR is to investigate whether physical activity intervention is effective in reducing depressive symptoms, as evaluated by relevant indices/questionnaires, in an elderly population (65+) with depression, compared to any control intervention.
Methods: The PubMed, Cinhal and Index Medicus databases were searched only for RCT studies, implementing a Search strategy that included a combined search of terms “mood disorders” AND “physical activity” AND “aged” (1604 articles). The inclusion criteria for this SR required a physical activity intervention to be applied in a 65+ years and over population with a diagnosis of depression, against any control intervention such as no intervention or pharmacological psychiatric intervention. Exclusion criteria included the diagnosis of other psychiatric disorders, medication usage for other pathology that can alter the patient’s mood, active neoplasm disease. A total of 9 RCT studies were finally included and were appraised through the PEDro and the Cochrane RCT grading scales. No ethical approval was required for this SR.
Results: Pedro appraisal revealed three studies which scored 10/11, four 9/11 and one each with 7/11 and 8/11. Cochrane score was 8/10 for two studies, 7/10 for four, one 6/10 and one 5/10. In all studies a different index/questionnaire was used to evaluate the depressive state. All 9 studies showed that Exercise Therapy decreased depression, improved mood, prolonged remission and increased quality of life, as compared with control interventions. In 2 RCTs, Exercise Therapy combined with pharmacotherapy yielded better results for depression compared to pharmacotherapy alone.
Conclusion(s): This review suggests that although pharmacotherapy is the main route to treat elderly depression, exercise therapy programs may assist in improving treatment efficacy either as monotherapy or as a combination therapy, while simultaneously may reduce the cost and enhance the overall life quality of elderly patients with depression.
Implications: The results of this SR may strengthen the endorsement of Exercise Therapy in the care of elderly depression, nowadays. The benefits of exercising can be an added value to usual pharmacotherapy with enhanced results for the clinician.
Funding, acknowledgements: No funding was necessary for the current study
Keywords: Elderly, Exercise Therapy, Depression
Topic: Mental health
Did this work require ethics approval? No
Institution: N/A
Committee: N/A
Reason: It is a systematic review of scientific literature
All authors, affiliations and abstracts have been published as submitted.
