OBJECTIVE: To evaluate the efficacy of a home-based exercise programme added to usual medical care for the treatment of depression. DESIGN: Prospective, two group parallel, randomised controlled study. SETTING: Community-based. PATIENTS: 200 adults aged 50 years or older deemed to be currently suffering from a clinical depressive illness and under the care of a general practitioner. INTERVENTIONS: Participants were randomly allocated to either usual medical care alone (control) or usual medical care plus physical activity (intervention). The intervention consisted of a 12-week home-based programme to promote physical activity at a level that meets recently published guidelines for exercise in people aged 65 years or over. MAIN OUTCOME MEASUREMENTS: Severity of depression was measured with the structured interview guide for the Montgomery-Asberg Depression Rating Scale (SIGMA), and depression status was assessed with the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). RESULTS: Remission of depressive illness was similar in both the usual care (59%) and exercise groups (63%; OR 1.18, 95% CI 0.61 to 2.30) at the end of the 12-week intervention, and again at the 52-week follow-up (67% versus 68%) (OR 1.07, 95% CI 0.56 to 2.02). There was no change in objective measures of fitness over the 12-week intervention among the exercise group. CONCLUSIONS: This home-based physical activity intervention failed to enhance fitness and did not ameliorate depressive symptoms in older adults, possibly due to a lack of ongoing supervision to ensure compliance and optimal engagement.
Reproduced with permission from the BMJ Publishing Group.

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