Facultad de Medicina, Universidad de Zaragoza & Instituto Aragonés de Ciencias de la Salud (IACS), Zaragoza, Spain; Department of Obstetrics and Gynecology, Lozano-Blesa University Hospital, Zaragoza, Spain.
Facultad de Medicina, Universidad de Zaragoza & Instituto Aragonés de Ciencias de la Salud (IACS), Zaragoza, Spain.
Maturitas. 2017 Dec;106:38-47. doi: 10.1016/j.maturitas.2017.09.001. Epub 2017 Sep 4.
To perform a systematic review and meta-analysis to clarify the effect of programmed exercise on depressive symptoms (DSs) in midlife and older women.
We carried out a structured search of PubMed-Medline, Web of Science, Scopus, Embase, Cochrane Library and Scielo, from database inception through June 29, 2017, without language restriction. The search included the following terms: "depression", "depressive symptoms", "exercise", "physical activity", "menopause", and "randomized controlled trial" (RCTs) in midlife and older women. The US, UK and Australian Clinical Trials databases were also searched. We assessed randomized controlled trials (RCTs) that compared the effect of exercise for at least 6 weeks versus no intervention on DSs as the outcome (as defined by trial authors). Exercise was classified according to duration as "mid-term exercise intervention" (MTEI; lasting for 12 weeks to 4 months), and "long-term exercise intervention" (LTEI; lasting for 6-12 months). Mean changes (±standard deviations) in DSs, as assessed with different questionnaires, were extracted to calculate Hedges' g and then used as the effect size for meta-analysis. Standardized mean differences (SMDs) of DSs after intervention were pooled using a random-effects model.
Eleven publications were included for analysis related to 1943 midlife and older women (age range 44-55 years minimum to 65.5±4.0 maximum), none of whom was using a hormone therapy. Seven MTEIs were associated with a significant reduction in DSs (SMD=-0.44; 95% CI -0.69, -0.18; p=0.0008) compared with controls. The reduction in DSs was also significant in six LTEIs (SMD=- 0.29; 95% CI -0.49; -0.09; p=0.005). Heterogeneity of effects among studies was moderate to high. Less perceived stress and insomnia (after exercise) were also found as secondary outcomes.
Exercise of low to moderate intensity reduces depressive symptoms in midlife and older women.
系统回顾和荟萃分析，以阐明中年和老年女性有计划运动对抑郁症状（DSs）的影响。
我们对 PubMed-Medline、Web of Science、Scopus、Embase、Cochrane 图书馆和 Scielo 进行了结构化搜索，搜索时间从数据库成立到 2017 年 6 月 29 日，无语言限制。搜索包括以下术语：“抑郁”、“抑郁症状”、“运动”、“体育活动”、“绝经期”和“随机对照试验”（RCTs）在中年和老年女性中。还搜索了美国、英国和澳大利亚临床试验数据库。我们评估了比较至少 6 周运动与无干预对 DSs 作为结局（由试验作者定义）的影响的随机对照试验（RCTs）。运动根据持续时间分为“中期运动干预”（MTEI；持续 12 周至 4 个月）和“长期运动干预”（LTEI；持续 6-12 个月）。从中提取不同问卷评估的 DSs 的平均变化（±标准差），以计算 Hedges'g，然后用作荟萃分析的效应量。采用随机效应模型汇总干预后 DSs 的标准化均数差值（SMDs）。
共有 11 项研究与 1943 名中年和老年女性（年龄范围为 44-55 岁最低至 65.5±4.0 岁最高）相关，其中均未使用激素治疗。与对照组相比，7 项 MTEI 与 DSs 的显著降低相关（SMD=-0.44；95%CI-0.69，-0.18；p=0.0008）。六项 LTEI 也降低了 DSs（SMD=-0.29；95%CI-0.49；-0.09；p=0.005）。研究之间的效果异质性为中度至高度。还发现运动后压力和失眠的感知也有所减少（作为次要结果）。
低至中度强度的运动可减轻中年和老年女性的抑郁症状。
