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
- 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
- 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
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