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
- Miller, Kyle, Areerob, Pinyadapat, Hennessy, Declan, Gonçalves-Bradley, Daniela, Mesagno, Christopher, Grace, Fergal
- Authors: Miller, Kyle , Areerob, Pinyadapat , Hennessy, Declan , Gonçalves-Bradley, Daniela , Mesagno, Christopher , Grace, Fergal
- Date: 2020
- Type: Text , Journal article
- Relation: F1000Research Vol. 9, no. (2020), p. 1-51
- Full Text:
- Reviewed:
- Description: 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 12 th, 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). © 2020 Miller KJ et al.
- Authors: Miller, Kyle , Areerob, Pinyadapat , Hennessy, Declan , Gonçalves-Bradley, Daniela , Mesagno, Christopher , Grace, Fergal
- Date: 2020
- Type: Text , Journal article
- Relation: F1000Research Vol. 9, no. (2020), p. 1-51
- Full Text:
- Reviewed:
- Description: 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 12 th, 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). © 2020 Miller KJ et al.
An examination of physical exercise as an adjunct treatment for depressive symptoms in adults aged 65 years and older
- Authors: Miller, Kyle
- Date: 2020
- Type: Text , Thesis , PhD
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- Description: In light of impending demographic shifts and projected strain on healthcare systems, this thesis set out to progress our putative understanding of the benefits of physical exercise on mental health in older adults aged 65 years and over. Herein, four studies of divergent research design interrogated the current knowledge base relating to the potential benefits of exercise in older adults with depressive symptomology. Study 1 set out to establish preliminary experimental evidence that four years of unsupervised aerobic exercise can improve cardiorespiratory function (determined by VO2max) and health-related quality of life (HRQL) in lifelong sedentary ageing men compared with lifelong exercising athletes. Results demonstrated preliminary proof of concept for exercise-induced benefits on cardiorespiratory function and HRQL in ageing men. Study 2 surveyed community-dwelling older adults (n = 586) to establish a hierarchy of exercise-associated factors to predict depressive symptomology. Contrary to expectation, exercise behaviour did not confer additional antidepressant effect, but was substantially predicted by exercise-induced mood, exercise self-efficacy, and social support (f2 = 0.993). Study 3 pooled evidence from randomised controlled trials (RCTs) to quantitatively compare the treatment effectiveness from aerobic, resistance and mind-body exercise training in older adults with pre-existing clinical depression, whereas Study 4 followed the same methodology in apparently health older adults without pre-existing clinical depression. Using network meta-analytical techniques, both clinical depressed (g = -0.41 to -1.38) and apparently healthy (g = -0.27 to -0.51) older adults demonstrated equivalent effectiveness for aerobic, resistance, and mind-body exercise interventions, with encouraging levels of study compliance. Taken together, these findings encourage personal exercise preference when prescribing either aerobic, resistance, or mind-body exercise as a treatment adjunct for clinical depression and older adults with symptoms thereof. The sum of works herein provide new knowledge to guide exercise prescription for stakeholders in mental health and older adults over 65 years.
- Description: Doctor of Philosophy
- Authors: Miller, Kyle
- Date: 2020
- Type: Text , Thesis , PhD
- Full Text:
- Description: In light of impending demographic shifts and projected strain on healthcare systems, this thesis set out to progress our putative understanding of the benefits of physical exercise on mental health in older adults aged 65 years and over. Herein, four studies of divergent research design interrogated the current knowledge base relating to the potential benefits of exercise in older adults with depressive symptomology. Study 1 set out to establish preliminary experimental evidence that four years of unsupervised aerobic exercise can improve cardiorespiratory function (determined by VO2max) and health-related quality of life (HRQL) in lifelong sedentary ageing men compared with lifelong exercising athletes. Results demonstrated preliminary proof of concept for exercise-induced benefits on cardiorespiratory function and HRQL in ageing men. Study 2 surveyed community-dwelling older adults (n = 586) to establish a hierarchy of exercise-associated factors to predict depressive symptomology. Contrary to expectation, exercise behaviour did not confer additional antidepressant effect, but was substantially predicted by exercise-induced mood, exercise self-efficacy, and social support (f2 = 0.993). Study 3 pooled evidence from randomised controlled trials (RCTs) to quantitatively compare the treatment effectiveness from aerobic, resistance and mind-body exercise training in older adults with pre-existing clinical depression, whereas Study 4 followed the same methodology in apparently health older adults without pre-existing clinical depression. Using network meta-analytical techniques, both clinical depressed (g = -0.41 to -1.38) and apparently healthy (g = -0.27 to -0.51) older adults demonstrated equivalent effectiveness for aerobic, resistance, and mind-body exercise interventions, with encouraging levels of study compliance. Taken together, these findings encourage personal exercise preference when prescribing either aerobic, resistance, or mind-body exercise as a treatment adjunct for clinical depression and older adults with symptoms thereof. The sum of works herein provide new knowledge to guide exercise prescription for stakeholders in mental health and older adults over 65 years.
- Description: Doctor of Philosophy
Comparative effectiveness of three exercise types to treat clinical depression in older adults : a systematic review and network meta-analysis of randomised controlled trials
- Miller, Kyle, Gonçalves-Bradley, Daniela, Areerob, Pinyadapat, Hennessy, Declan, Mesagno, Christopher, Grace, Fergal
- Authors: Miller, Kyle , Gonçalves-Bradley, Daniela , Areerob, Pinyadapat , Hennessy, Declan , Mesagno, Christopher , Grace, Fergal
- Date: 2020
- Type: Text , Journal article , Review
- Relation: Ageing Research Reviews Vol. 58 (2020).
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- Description: 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 (aerobic, resistance, and mind-body exercise) in clinically depressed older adults. Methods: We followed PRISMA-NMA guidelines and searched databases for eligible RCTs (inception – September 12th, 2019). 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 guide optimal exercise prescription for allied health professionals and stakeholders in clinical geriatrics. Notably, clinically depressed older adults may be encouraged to 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 effective treatment adjucts for older adults presenting with clinical depression. © 2019
- Authors: Miller, Kyle , Gonçalves-Bradley, Daniela , Areerob, Pinyadapat , Hennessy, Declan , Mesagno, Christopher , Grace, Fergal
- Date: 2020
- Type: Text , Journal article , Review
- Relation: Ageing Research Reviews Vol. 58 (2020).
- Full Text:
- Reviewed:
- Description: 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 (aerobic, resistance, and mind-body exercise) in clinically depressed older adults. Methods: We followed PRISMA-NMA guidelines and searched databases for eligible RCTs (inception – September 12th, 2019). 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 guide optimal exercise prescription for allied health professionals and stakeholders in clinical geriatrics. Notably, clinically depressed older adults may be encouraged to 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 effective treatment adjucts for older adults presenting with clinical depression. © 2019
Exercise, mood, self-efficacy, and social support as predictors of depressive symptoms in older adults : Direct and interaction effects
- Miller, Kyle, Mesagno, Christopher, McLaren, Suzanne, Grace, Fergal, Yates, Mark, Gomez, Rapson
- Authors: Miller, Kyle , Mesagno, Christopher , McLaren, Suzanne , Grace, Fergal , Yates, Mark , Gomez, Rapson
- Date: 2019
- Type: Text , Journal article
- Relation: Frontiers in Psychology Vol. 10, no. (2019), p. 1-11
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- Description: Background: Depression is a chronic condition that affects up to 15% of older adults. The healthogenic effects of regular exercise are well established, but it is still unclear which exercise-related variables characterise the antidepressant effects of exercise. Thus, the purpose of this study was to examine the extent to which exercise-related variables (exercise behaviour, exercise-induced mood, exercise self-efficacy, and social support) can predict depressive symptoms in a cohort of community-dwelling older adults. Methods: This study employed a cross-sectional analysis of questionnaire data from a sample of 586 community-dwelling older Australians aged 65 to 96 years old. Participants completed the Center for Epidemiologic Studies Depression Scale, modified CHAMPS Physical Activity Questionnaire for Older Adults, Four-Dimension Mood Scale, Self-Efficacy for Exercise Scale, and Social Provisions Scale - Short Form. Bivariate correlations were performed, and hierarchical multiple regression was subsequently used to test the regression model. Results: Exercise behaviour, exercise-induced mood, exercise self-efficacy, and social support were all negatively associated with depressive symptoms (r = -0.20 to -0.56). When the variables were entered as predictors into the hierarchical multiple regression model, social support was the strongest predictor of depressive symptoms (beta = -0.42), followed by exercise-induced mood (beta = -0.23), and exercise self-efficacy (beta = -0.07). Exercise behaviour did not explain any additional variance in depressive symptoms. A modest interaction effect was also observed between exercise-induced mood and social support. Conclusion: These findings indicate that social support is the strongest predictor of depressive symptomology in community-dwelling older adults, particularly when combined with positive exercise-induced mood states. When addressing the needs of older adults at risk of depression, healthcare professionals should consider the implementation of exercise programmes that are likely to benefit older adults by improving mood, enhancing self-efficacy, and building social support.
- Authors: Miller, Kyle , Mesagno, Christopher , McLaren, Suzanne , Grace, Fergal , Yates, Mark , Gomez, Rapson
- Date: 2019
- Type: Text , Journal article
- Relation: Frontiers in Psychology Vol. 10, no. (2019), p. 1-11
- Full Text:
- Reviewed:
- Description: Background: Depression is a chronic condition that affects up to 15% of older adults. The healthogenic effects of regular exercise are well established, but it is still unclear which exercise-related variables characterise the antidepressant effects of exercise. Thus, the purpose of this study was to examine the extent to which exercise-related variables (exercise behaviour, exercise-induced mood, exercise self-efficacy, and social support) can predict depressive symptoms in a cohort of community-dwelling older adults. Methods: This study employed a cross-sectional analysis of questionnaire data from a sample of 586 community-dwelling older Australians aged 65 to 96 years old. Participants completed the Center for Epidemiologic Studies Depression Scale, modified CHAMPS Physical Activity Questionnaire for Older Adults, Four-Dimension Mood Scale, Self-Efficacy for Exercise Scale, and Social Provisions Scale - Short Form. Bivariate correlations were performed, and hierarchical multiple regression was subsequently used to test the regression model. Results: Exercise behaviour, exercise-induced mood, exercise self-efficacy, and social support were all negatively associated with depressive symptoms (r = -0.20 to -0.56). When the variables were entered as predictors into the hierarchical multiple regression model, social support was the strongest predictor of depressive symptoms (beta = -0.42), followed by exercise-induced mood (beta = -0.23), and exercise self-efficacy (beta = -0.07). Exercise behaviour did not explain any additional variance in depressive symptoms. A modest interaction effect was also observed between exercise-induced mood and social support. Conclusion: These findings indicate that social support is the strongest predictor of depressive symptomology in community-dwelling older adults, particularly when combined with positive exercise-induced mood states. When addressing the needs of older adults at risk of depression, healthcare professionals should consider the implementation of exercise programmes that are likely to benefit older adults by improving mood, enhancing self-efficacy, and building social support.
Personality traits and exercise dependence: Exploring the role of narcissism and perfectionism
- Miller, Kyle, Mesagno, Christopher
- Authors: Miller, Kyle , Mesagno, Christopher
- Date: 2014
- Type: Text , Journal article
- Relation: International Journal of Sport and Exercise Psychology Vol. 12, no. 4 (2014), p. 368-381
- Full Text: false
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- Description: There are currently limited investigations that have examined the relationship between personality traits and exercise dependence. The purpose of the present study was to explore the relationship between exercise dependence, narcissism and perfectionism. Ninety regular exercisers were recruited from various gyms, fitness centres and sporting events to complete the Narcissistic Personality Inventory [Raskin, R. N., & Terry, H. (1988). A principal-components analysis of the Narcissistic Personality Inventory and further evidence of its construct validity. Journal of Personality and Social Psychology, 54(5), 890–902], Multidimensional Perfectionism Scale [Hewitt, P. L., & Flett, G. L. (1991). Perfectionism in the self and social contexts: Conceptualization, assessment, and association with psychopathology. Journal of Personality and Social Psychology, 60(3), 456–470] and Exercise Dependence Scale-Revised [Symons Down, D., Hausenblas, H. A., & Nigg, C. R. (2004). Factorial validity and psychometric examination of the Exercise Dependence Scale-Revised. Measurement in Physical Education and Exercise Science, 8(4), 183–201] either online or in person. Exercise dependence was positively related to narcissism, self-orientated perfectionism and socially prescribed perfectionism. Gender differences between these relationships were also found. Hierarchical regression analysis indicated that a combination of narcissism and self-orientated perfectionism uniquely predicted a greater degree of exercise dependence. These findings indicate that both narcissism and perfectionism may be important antecedents of exercise dependence, and that a combination of these personality traits is associated with exercise dependence. Future research should continue to determine which personality traits contribute to the personality profile of individuals with exercise dependence. © 2014 International Society of Sport Psychology.
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