School of Nursing, College of Medicine, Chang Gung University, Taiwan; Healthy Aging Research Center, Chang Gung University, Taiwan.
Central Taiwan University of Science and Technology, Taiwan.
Int J Nurs Stud. 2015 Oct;52(10):1542-52. doi: 10.1016/j.ijnurstu.2015.05.013. Epub 2015 Jun 10.
Depression is a major health problem for community-dwelling elderly adults. Since limited resources are available to decrease the high prevalence of depressive symptoms among the elderly adults, improved support for them can be provided if we can determine which intervention is superior in ridding depressive symptoms.
To compare the effectiveness of the physical fitness exercise program and the cognitive behavior therapy program on primary (depressive symptoms) and secondary outcomes (6-min walk distance, quality of life, and social support) for community-dwelling elderly adults with depressive symptoms.
A prospective randomized control trial was conducted in three communities in northern Taiwan.
The elderly adults in the three communities were invited to participate by mail, phone calls, and posters. There were a total of 57 participants who had depressive symptoms and all without impaired cognition that participated in this trial. None of the participants withdrew during the 9 months of follow-up for this study.
Fifty-seven participants were randomly assigned to one of the three groups: the physical fitness exercise program group, the cognitive behavior therapy (CBT) group, or the control group. The primary (Geriatric Depression Scale-15, GDS-15), and secondary outcomes (6-min walk distance, SF-36, and Inventory of Socially Supportive Behaviors scales, ISSB) were collected immediately (T2), at 3 months (T3), and at 6 months after the interventions (T4).
After the interventions, the CBT group participants demonstrated significantly lower symptoms of depression (p=0.009) at T2 and perceived more social support from those around them (p<0.001, <0.001 and =0.004, respectively) at three time-point comparisons than the control group. Moreover, after intervention, participants in the physical fitness exercise program group had decreased GDS-15 scores at three time-point comparisons (p=0.003, 0.012 and 0.037, respectively), had a substantially greater 6-min walk distance (p=0.023), a better quality of life (p<0.001), and a better perceived social support at T2 (p<0.001).
Immediately after a 12-week intervention, there were significant decreases in depressive symptoms and more perceived social support amongst those in the CBT group. When considering the effectiveness in the decrease of depressive symptoms longer term, the increase in the 6-min walk distance and raising the patients' quality of life, physical fitness exercise program may be a better intervention for elderly adults with depressive symptoms.
抑郁症是社区老年人的主要健康问题。由于老年人中抑郁症状的高患病率，资源有限，因此，如果我们能够确定哪种干预措施更能消除抑郁症状，就可以为他们提供更好的支持。
比较健身运动方案和认知行为疗法方案对有抑郁症状的社区老年人的主要（抑郁症状）和次要结局（6 分钟步行距离、生活质量和社会支持）的效果。
在台湾北部的三个社区进行了一项前瞻性随机对照试验。
通过邮件、电话和海报邀请三个社区的老年人参加。共有 57 名患有抑郁症状且认知无障碍的老年人参加了这项试验，在 9 个月的随访期间没有一人退出。
57 名参与者被随机分配到三个组之一：健身运动方案组、认知行为疗法（CBT）组或对照组。主要（老年抑郁量表-15，GDS-15）和次要结局（6 分钟步行距离、SF-36 和社会支持行为量表，ISSB）在干预后立即（T2）、3 个月（T3）和 6 个月（T4）收集。
干预后，CBT 组参与者在 T2 时抑郁症状明显减轻（p=0.009），与对照组相比，他们在三个时间点的社会支持感更强（p<0.001、<0.001 和=0.004）。此外，干预后，健身运动方案组参与者的 GDS-15 评分在三个时间点均降低（p=0.003、0.012 和 0.037），6 分钟步行距离显著增加（p=0.023），生活质量明显提高（p<0.001），T2 时社会支持感增强（p<0.001）。
在 12 周的干预后立即，CBT 组的抑郁症状明显减轻，社会支持感增强。考虑到长期降低抑郁症状的效果，健身运动方案可增加 6 分钟步行距离和提高患者生活质量，可能是治疗抑郁症状老年人的更好干预措施。
