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Randomized Controlled Trial
. 2010 May-Jun;8(3):214-23.
doi: 10.1370/afm.1093.

Home-based activity program for older people with depressive symptoms: DeLLITE--a randomized controlled trial

Ngaire Kerse  1 , Karen J Hayman, Simon A Moyes, Kathy Peri, Elizabeth Robinson, Anthony Dowell, Gregory S Kolt, C Raina Elley, Simon Hatcher, Liz Kiata, Janine Wiles, Sally Keeling, John Parsons, Bruce Arroll
Affiliations
Randomized Controlled Trial

Home-based activity program for older people with depressive symptoms: DeLLITE--a randomized controlled trial

Ngaire Kerse et al. Ann Fam Med. 2010 May-Jun.

Abstract

Purpose: We wanted to assess the effectiveness of a home-based physical activity program, the Depression in Late Life Intervention Trial of Exercise (DeLLITE), in improving function, quality of life, and mood in older people with depressive symptoms.

Methods: We undertook a randomized controlled trial involving 193 people aged 75 years and older with depressive symptoms at enrollment who were recruited from primary health care practices in Auckland, New Zealand. Participants received either an individualized physical activity program or social visits to control for the contact time of the activity intervention delivered over 6 months. Primary outcome measures were function, a short physical performance battery comprising balance and mobility, and the Nottingham Extended Activities of Daily Living scale. Secondary outcome measures were quality of life, the Medical Outcomes Study 36-item short form, mood, Geriatric Depression Scale (GDS-15), physical activity, Auckland Heart Study Physical Activity Questionnaire, and self-report of falls. Repeated measures analyses tested the differential impact on outcomes over 12 months' follow-up.

Results: The mean age of the participants was 81 years, and 59% were women. All participants scored in the at-risk category on the depression screen, 53% had a Diagnostic and Statistical Manual of Mental Disorders or International Classification of Diseases, Tenth Revision diagnosis of major depression or scored more than 4 on the GDS-15 at baseline, indicating moderate or severe depression. Almost all participants, 187 (97%), completed the trial. Overall there were no differences in the impact of the 2 interventions on outcomes. Mood and mental health related quality of life improved for both groups.

Conclusion: The DeLLITE activity program improved mood and quality of life for older people with depressive symptoms as much as the effect of social visits. Future social and activity interventions should be tested against a true usual care control.

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Figures

Figure 1.
Figure 1.
Flow chart of participants through the DeLLITE trial. a Depression criteria: any 2 yes responses to the following: (1) During the past month have you often been bothered by feeling down, depressed or hopeless? (2) During the past month have you often been bothered by having little interest or pleasure in doing things? (3) Answer if you responded yes to 1 or 2: Is this something with which you would like help? b Completed outcome assessments, not withdrawn from the trial. c Completed all intervention visits.
Figure 2.
Figure 2.
Outcomes of a physical activity intervention compared with social control for older participants with depressive symptoms. Note: Horizontal bracket refers to the P value for the change over time, and vertical bracket refers to the P value for the differential change between the groups. GDS-15 = Geriatric Depression Scale; SF-36 MHC = Medical Outcomes Study Short Form 36-item mental health component subscale; NEADL=Nottingham Extended Activities of Daily Living Scale. a Higher score indicates greater function. b Higher score indicates better quality of life. c Lower score indicates better mood.
Figure 2.
Figure 2.
Outcomes of a physical activity intervention compared with social control for older participants with depressive symptoms. Note: Horizontal bracket refers to the P value for the change over time, and vertical bracket refers to the P value for the differential change between the groups. GDS-15 = Geriatric Depression Scale; SF-36 MHC = Medical Outcomes Study Short Form 36-item mental health component subscale; NEADL=Nottingham Extended Activities of Daily Living Scale. a Higher score indicates greater function. b Higher score indicates better quality of life. c Lower score indicates better mood.
Figure 2.
Figure 2.
Outcomes of a physical activity intervention compared with social control for older participants with depressive symptoms. Note: Horizontal bracket refers to the P value for the change over time, and vertical bracket refers to the P value for the differential change between the groups. GDS-15 = Geriatric Depression Scale; SF-36 MHC = Medical Outcomes Study Short Form 36-item mental health component subscale; NEADL=Nottingham Extended Activities of Daily Living Scale. a Higher score indicates greater function. b Higher score indicates better quality of life. c Lower score indicates better mood.
Figure 2.
Figure 2.
Outcomes of a physical activity intervention compared with social control for older participants with depressive symptoms. Note: Horizontal bracket refers to the P value for the change over time, and vertical bracket refers to the P value for the differential change between the groups. GDS-15 = Geriatric Depression Scale; SF-36 MHC = Medical Outcomes Study Short Form 36-item mental health component subscale; NEADL=Nottingham Extended Activities of Daily Living Scale. a Higher score indicates greater function. b Higher score indicates better quality of life. c Lower score indicates better mood.
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