Principle Investigators: Dr Jane Sims¹, A/Prof Keith Hill², Ms Sandra Davidson³, Prof Jane Gunn³and Dr Nancy Huang4
¹ Monash Institue of Health Service Research, Monash University
² National Ageing Research Institute
³ Department of General Practice, University of Melbourne
4 National Heart Foundation, Melbourne
beyondblue Victorian Centre of Excellence
Project completion year
Depression is a disabling, prevalent condition. Physical activity programs may assist depression management in older people, ameliorate co-morbid conditions and reduce the need for antidepressants.
The UPLIFT pilot study assessed the feasibility of older, depressed people attending a community-based progressive resistance training (PRT) program. The study also aimed to determine whether PRT improves depressive status in older depressed patients and whether additional benefits accrue in terms of improved physical and psychological health, functional status and quality of life.
A randomised controlled trial was conducted. People aged over 65 years with depressive symptoms were recruited via general practices. Following baseline assessment, subjects were randomly allocated to attend a local PRT program three times per week for 10 weeks or a brief advice control group. Follow-up assessment of depressive status, physical and psychological health, functional and quality of life status occurred post intervention and at six months.
Three hundred and forty six people responded to the study invitation, of whom around a fifth (22 per cent) had depressive symptoms determined using the Geriatric Depression Scale (GDS).
Thirty two people entered the trial. There were no significant group differences on the GDS at follow-up. At six months there was a trend for the PRT intervention group to have lower GDS scores than the comparison group, but this finding did not reach statistical significance. More of the PRT group (57 per cent) had a reduction in depressive symptoms post program, compared to 44 per cent of the control group. In post hoc analyses, improvement in depressive status appeared to be associated with the number of exercise sessions completed.
There was a slight improvement in functional status in both groups. At follow-up, the intervention group was more likely to be ‘sufficiently active to achieve health benefits’. Three intervention and four control group members each attended a focus group and provided positive feedback on their experiences of taking part in the study.
Implications for Policy and Practice
The UPLIFT pilot study has demonstrated that there is scope for older people with depressive symptoms to be successfully recruited and referred to a community-based PRT program.
Since the strength-training program used in this research is - and can be- offered by existing community-based facilities, such as the Living Longer, Living Stronger ™ partner sites, this should enable its broader implementation for the potential benefit of other older people, both in Victoria and elsewhere.
Several process aspects will need to be addressed in future programs, including access to exercise facilities. Two people had no ready access to transport.
Participants’ adherence to the program is a promising finding. With the exception of those who decided not to attend at all, reasons for lack of adherence were health related, rather than dissatisfaction with the program or lack of motivation to attend. Whilst some of these health problems may mean that people are unable to return to exercising, in many cases they were short term.
The findings have been presented at a number of conferences, both national and international, and to a range of relevant stakeholders.
A summary report was provided to participants, GPs, Victorian Divisions of General Practice and participating physical activity sites.
A GP-education workshop (funded by an AAG (Victoria) scholarship to Dr Sims) was held with the assistance of Professor Chiu, Academic Unit for Psychiatry of Old Age, University of Melbourne.
A similar study, funded by beyondblue in 2005: the Regenerate study assessed the use of PRT in the reduction of depressive symptoms in chronic stroke survivors.