Effectiveness of Physical Exercise in Older Adults With Mild to Moderate Depression

Abstract

Purpose: We sought to compare the effectiveness of physical exercise with that of treatment with antidepressant drugs routinely used in clinical practice, in terms of decreasing depressive symptomatology in patients aged ≥65 years who present with clinical criteria of a depressive episode.

Methods: We conducted a randomized clinical trial in a primary care setting. A total of 347 patients aged ≥65 years with a clinically significant depressive episode were randomized to participation in a supervised physical exercise program or to receive antidepressant treatment by their general practitioners.

Results: Intention-to-treat analysis showed that the cumulative incidence of improvement in depressive symptomatology (Montgomery-Åsberg Depression Rating Scale score <10) in the physical activity (PA) group after 1 month was not significantly different from that in the antidepressant treatment (AT) group. However, the proportion of those who showed improvement was significantly greater (P <.01) in the AT group (60.6% and 49.7%) compared to the PA group (45.6% and 32.9%) at the end of 3 and 6 months, respectively. The number of withdrawals was greater in the PA group (39.2% and 58.2%) compared to the AT group (22.6% and 40.0%) at 3 and 6 months, respectively, yet the proportion of participants with adverse side effects was greater in the AT group (8.9% vs 22.5%; P = .007).

Conclusion: Although improvement was initially similar in both treatment groups, AT was superior in the medium term, despite giving rise to a greater number of adverse effects.

Trial registration: ClinicalTrials.gov NCT03358433.

Keywords: antidepressant agents; depression; elderly; exercise; primary health care.

© 2021 Annals of Family Medicine, Inc.

Figures

Figure 1.

General study flow chart. AT = antidepressant treatment; PA = physical activity.

Figure 2.

Self-perceived health status over time. AT = antidepressant treatment; PA = physical activity.