Reading Week 3

Question 1

Mather, AS - what was the aim of the study?

Answer 1

To determine whether exercise is effective as an adjunct to antidepressant therapy in reducing depressive symptoms in older people.

Question 2

Mather, AS - summarise the methods

Answer 2

Patients randomised to exercise class or health talk for 10wks

Assessments at baseline, 10wk, 34wk (blind)

Rivalry outcome seen with the 17 item Hamilton rating scale for depression (HRSD)

Secondary outcome seen with the geriatric depression scale, clinical global impression, and patient global impression.

Question 3

Mather, AS - what were the results?

Answer 3

At 10wks a significantly higher proportion of the exercise group (55% vs 33%) experience coed a greater than 30% decline in depression according to the HRSD (P = 0.05)

Question 4

Mather, AS - summarise the conclusions

Answer 4

Exercise associated with a modest improvement in depressive symptoms at 10wks so older people with poorly responsive depressive disorder should be encouraged to attend group exercise activities.

Question 5

Mather, AS - what are the clinical implications?

Answer 5

Exercise superior to social intervention in the extent of response in symptoms at 10 weeks

Future studies of depression should include a structured social control group

Older people with poorly responsive depressive disorder should be encouraged to attend group exercise activities

Question 6

Mather, AS - what are the limitations of the study?

Answer 6

Physical comorbities were not considered

The addition of a non intervention control group would have been of interest

A total of 1885 patients were considered for entry to the study yet fewer than 5% were randomised