Warwick Clinical Trials Unit, Division of Health Sciences, Warwick Medical School, The University of Warwick, Coventry CV4 7AL, UK.
Br J Psychiatry. 2012 Sep;201(3):180-5. doi: 10.1192/bjp.bp.111.095174.
The prevalence of depression in older people is high, treatment is inadequate, it creates a substantial burden and is a public health priority for which exercise has been proposed as a therapeutic strategy.
To estimate the effect of exercise on depressive symptoms among older people, and assess whether treatment effect varies depending on the depression criteria used to determine participant eligibility.
Systematic review and meta-analysis of randomised controlled trials of exercise for depression in older people.
Nine trials met the inclusion criteria and seven were meta-analysed. Exercise was associated with significantly lower depression severity (standardised mean difference (SMD) = -0.34, 95% CI -0.52 to -0.17), irrespective of whether participant eligibility was determined by clinical diagnosis (SMD = -0.38, 95% CI -0.67 to -0.10) or symptom checklist (SMD = -0.34, 95% CI -0.62 to -0.06). Results remained significant in sensitivity analyses.
Our findings suggest that, for older people who present with clinically meaningful symptoms of depression, prescribing structured exercise tailored to individual ability will reduce depression severity.
老年人的抑郁患病率较高,治疗不足,这给他们带来了沉重的负担,也是优先需要解决的公共卫生问题,运动已被提议作为一种治疗策略。
评估运动对老年人抑郁症状的影响,并评估治疗效果是否因用于确定参与者资格的抑郁标准而有所不同。
对老年人进行的运动治疗抑郁的随机对照试验进行系统评价和荟萃分析。
符合纳入标准的试验有 9 项,其中 7 项进行了荟萃分析。运动与抑郁严重程度显著降低相关(标准化均数差(SMD)=-0.34,95%CI-0.52 至-0.17),无论参与者的资格是通过临床诊断(SMD=-0.38,95%CI-0.67 至-0.10)还是症状检查表(SMD=-0.34,95%CI-0.62 至-0.06)来确定。敏感性分析结果仍然显著。
我们的研究结果表明,对于出现有临床意义的抑郁症状的老年人,开具有针对性的个体化运动处方可以降低抑郁严重程度。