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Is Exercise an Evidence-Based Intervention for Clinical Depression in Older Adults: A Meta-Analysis of Randomized Studies 2000-2006

Promoting physical activity is consistent with many models and perspectives on social work, such as the empowerment perspective, self-efficacy theory, resilience, the strengths perspective, good health, hardiness, and self-determination, yet it has received little attention in social work literature as an effective intervention. Among older adults, exercise has been shown to reduce costs for health care, limit injury, decrease heart disease and obesity, improve diabetes, and result in a more active life style. Moreover it has been shown to elevate mood. Recent neuroimaging studies indicate that exercise expresses neural functions similar to anti-depressant medication without the side effects. Findings of this meta-analysis found a significant overall pretest-posttest mean change effect size of -0.46 (p This meta-analysis included randomized experimental studies of exercise and follow-up with clinically depressed samples of older adults conducted 2000-2006. Clinical depression was defined according to DSM-IV-TR and ICD-10 criteria. Twenty-six independent samples describing nine studies met criteria. The null hypothesis proposed exercise would have no effect upon major depression, as defined by statistically significant differences and meaningful effect sizes. A comprehensive literature search was conducted and features of each study were coded independently by two coders, with an inter-rater reliability of 0.97. Analyses looked at overall effect, group of assignment, duration, treatment studies and follow-up, outcome measures, type of exercise, age: young-old versus old-old, and standards and protocols used to determine clinical effectiveness. All effect sizes were computed as standardized pretest-posttest mean-change measures. Weighted analyses adjusted for variable sample size. In the fixed effects model analysis, each effect size was weighted by its inverse variance; the random effects model employed a method-of-moments estimator. The significant overall pretest-posttest mean change effect size was a moderate -0.46 (p Both specific and overall findings among the studies of the analyses suggest that like cardio protection, a lifestyle change of ongoing regular moderate exercise can effect remission from clinical depression in older adult clients and protect from relapse. Findings indicate that efforts by social work researchers and practitioners are worthwhile at the micro, mezzo, and macro levels to provide professional pre-education, develop exercise interventions within practice, educate clients and others about the antidepressant nature of exercise, promote accessibility, and advocate community and regulatory improvement. Other studies suggest a neural link between exercise and remission of depression, and further intervention research should include interdisciplinary teams drawing from venues of social work, neuroscience, medicine, and exercise to explain the causal mechanism, identify the populations at risk, and investigate the prophylactic effect. / A Dissertation submitted to the College of Social Work in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Fall Semester, 2007. / September 19, 2007. / Older Adults, Elderly, Physical Activity, Depression, Exercise, Randomized, Evidence-Based / Includes bibliographical references. / Bruce A. Thyer, Professor Directing Dissertation; Charles C. Ouimet, Outside Committee Member; Charles R. Figley, Committee Member.

Identiferoai:union.ndltd.org:fsu.edu/oai:fsu.digital.flvc.org:fsu_181664
ContributorsCox, Janet Gray (authoraut), Thyer, Bruce A. (professor directing dissertation), Ouimet, Charles C. (outside committee member), Figley, Charles R. (committee member), College of Social Work (degree granting department), Florida State University (degree granting institution)
PublisherFlorida State University, Florida State University
Source SetsFlorida State University
LanguageEnglish, English
Detected LanguageEnglish
TypeText, text
Format1 online resource, computer, application/pdf
RightsThis Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s). The copyright in theses and dissertations completed at Florida State University is held by the students who author them.

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