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Exercise Training as an Alternative Treatment for Depression among Older Adults

Kathleen A Moore, PhD, and James A Blumenthal, PhD

Abstract
The detection and treatment of depression among the elderly is an important clinical and public health concern. In fact, depression is one of the primary health problems currently faced by the elderly. According to the Epidemiologic Catchment Area Study, depressive symptoms occur in approximately 15% of the elderly population, and rates are even higher for elderly in nursing homes.1 Depressive illness among the elderly is responsible for more hospitalizations than is any other disorder except cardiovascular disease, and leads to decreased functioning, increased morbidity and mortality, increased use of healthcare resources, and institutionalization.2-4 Given the impact of depression on quality of life, health outcomes, and society as a whole, the identification of effective strategies for the prevention and treatment of depression among the elderly is needed.

Depression is characterized by a core group of signs and symptoms including despondent mood, loss of interest in usual activities, weight loss or gain, difficulty sleeping, low energy, a state of worthlessness, a diminished ability to think or concentrate, and suicidal ideation.5 Older people are especially vulnerable to depressive grief reactions, because they tend to suffer more frequent losses than do individuals at other periods of life.6 In fact, aging is associated with numerous losses: diminished physical health; loss of spouse and friends; and reduced financial, social, and employment status. Failure to recognize and treat depression in later life may lead to decreased quality of life, social isolation, and increased mortality among those affected.

Depression also may increase vulnerability to other diseases. For example, Frasure-Smith et al7 reported that major depression occurred in 18% of postmyocardial infarction survivors, which was associated with a three- to fourfold increase in risk for mortality compared with nondepressed individuals. This finding suggests that interventions directed toward postmyocardial infarction patients who show signs of major depression during hospitalization could significantly reduce mortality.

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