When the authors limited the analyses to the four high-quality trials (326 participants), the pooled SMD was -0.31 (95% CI -0.63 to 0.01) indicating a small effect in favor of exercise. Among the 32 trials identified that fulfilled the inclusion criteria, 8 studies were focused on or included adults older than 60 years.51-59 Six of the studies involved aerobic Inhibitors,research,lifescience,medical exercise and two studies progressive resistance training. Of the 6 studies that involved aerobic exercise, various exercise and comparator interventions were examined. Blumenthal and colleagues (1999) studied community volunteers

with major depressive disorder (MDD) (n=156) mean (SD) age of 57 (6.5) randomized to aerobic exercise (group walking or jogging 3 times per week), antidepressant pharmacologic treatment (sertraline), Inhibitors,research,lifescience,medical or the combination.58 They found that all treatment groups had statistically significant improvement in TG101348 ic50 depression scores, although participants receiving medication alone had the fastest initial response. After 16 weeks of treatment,

exercise was equally effective in reducing depression among older adults with MDD. A limitation to this study was the absence of a placebo or control intervention. In a follow-up study, Blumenthal and colleagues59 examined community-dwelling older adults with MDD (n=202), mean (SD) Inhibitors,research,lifescience,medical age 52 (8), randomly assigned to home-based exercise, supervised exercise in a group setting, sertraline, or placebo for 16 weeks. While there was a high placebo response rate, the efficacy of exercise was comparable to antidepressant

pharmacotherapy, and both were better than placebo. Brenes and colleagues studied 37 older adults with a mean (SD) age of 73.5 (7.8) with minor depression, randomized to exercise, antidepressant pharmacotherapy Inhibitors,research,lifescience,medical (sertraline), or usual care over 16 weeks.52 In the 32 participants who completed the study, they found trends for exercise and sertraline to be superior to usual care in improving emotional and physical functioning. Mather and colleagues examined whether exercise Inhibitors,research,lifescience,medical is effective as an adjunct to antidepressant pharmacotherapy in older adults. Eighty-six older adults with depression (mean age 65) were randomly assigned to attend exercise classes or health education talks for second 10 weeks.53 At 10 weeks, a significantly higher proportion of the exercise group (55% versus 33%) experienced a greater than 30% decline in depressive symptoms as measured with the Hamilton Rating Scale for Depression. McNeil and colleagues (1991) randomly assigned 30 community dwelling, moderately depressed older adults with a mean (SD) age of 72.5 (6.9) to 1 of 3 interventions: experimenter-accompanied exercise (walking), social contact control condition, and a wait-list control.54 They found that exercise and social contact both resulted in reductions in the Beck Depression Inventory. Lastly, Williams and Tappen examined the effects of exercise training for depressed older adults with Alzheimer’s disease.