The efficacy of exercise as a long-term antidepressant in elderly subjects: A randomized, controlled trial

Background. Pharmacological treatment of depression in geriatric patients i s often difficult. Although unsupervised exercise has been shown to benefit younger depressed patients, there is no evidence that unsupervised exercis e. can be used as a maintenance treatment for depression in elderly patient s. Our aim was to test the feasibility and efficacy of unsupervised exercis e as a long-term treatment for clinical depression in elderly patients. Methods. We studied 32 subjects (71.3 +/-1.2 years of age, mean SE) in a 20 -week, randomized, controlled trial, with follow-up at 26 months. Subjects were community-dwelling patients with major or minor depression or dysthymi a. Exercisers engaged in 10 weeks of supervised weight-lifting exercise fol lowed by 10 weeks of unsupervised exercise. Controls attended lectures for 10 weeks. No contact was made with either group after 20 weeks until final follow-up. Blinded assessment was made with the Beck Depression Inventory ( BDI), the Philadelphia Geriatric Morale Scale, and Ewart's Self Efficacy Sc ale at 20 weeks and with the BDI and physical activity questionnaire at 26 months. Results. Patients randomized to the exercise condition completed 18 +/-2 se ssions of unsupervised exercise during Weeks 10 to 20. The BDI was signific antly reduced at both 20 weeks and 26 months of follow-up in exercisers com pared with controls (p < .05-001). At the 26-month follow-up, 33% of the ex ercisers were still regularly weight lifting, versus 0% of controls (p < .0 5). Conclusions. Unsupervised weight-lifting exercise maintains its antidepress ant effectiveness at 20 weeks in depressed elderly patients. Long-term chan ges in exercise behavior are possible in some patients even without supervi sion.