1. Elderly residents living in care homes with an opt-in exercise program were no less likely to be depressed than those living in care homes without a program.
2. Among residents depressed at baseline, an exercise program produced no change in symptoms.
Evidence Rating Level: 2 (Good)
Study Rundown: Availability of a yearlong exercise program did not reduce depression in elderly care home residents, even among those reporting depression at baseline. Given that 49% of care home residents in this study were depressed at baseline, there remains a substantial unmet need exists for effective depression interventions in this population. Strengths of the study included randomization and use of a validated geriatric depression scale, though study results are limited by the sensitivity of outcome measures (depression scale) and investigators did not assess other outcomes such as health-related quality of life indicators. Future investigations could examine whether subsets of residents, such as younger or more physically fit individuals, derive mental health benefits from exercise-based interventions and whether opt-out exercise programs are more effective.
Relevant Reading: Effects of a high-intensity functional exercise programme on depressive symptoms and psychological well-being among older people living in residential care facilities: a cluster-randomized controlled trial
In-Depth [cluster randomized trial]: This study examined the effect of a yearlong, opt-in exercise program on depression symptoms among 891 British elderly care home residents (age ≥65 years). Care homes were randomized by location, size, and type of home provider to receive the program (intervention group: 35 homes, n=398) or not (control group: 43 homes, n=493). Intervention group homes held two optional 45-minute exercise sessions per week, encouraged additional physical activity in residents, and received staff depression awareness training. Control group homes received depression awareness training only. Outcomes included number of depressive symptoms on a validated geriatric depression scale, recorded at baseline, 6 months, and 12 months.
Among all participants, there were no between-group differences in depression scores at 12 months (p=0.58). Among participants depressed at baseline, the intervention had no effect on depression scores at 6 months (p=0.57).
By Caroline Huang and Leah Hawkins
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