Depressive symptoms and physical performance in the lifestyle interventions and independence for elders pilot study

Abstract

Objectives: To determine whether the presence of high depressive symptoms (Center for Epidemiologic Studies Depression Scale (CES-D) score ≥ 14) diminished physical performance benefits after a comprehensive physical activity intervention in older adults.

Design: A post hoc analysis of data from the Lifestyle Interventions and Independence for Elders Pilot (LIFE-P) study, a single-blind randomized controlled trial comparing a moderate-intensity physical activity intervention (PA) with a successful aging control (SA).

Setting: Multicenter U.S. institutions participating in the LIFE-P trial.

Participants: Four hundred twenty-four sedentary, noninstitutionalized adults aged 70 to 89.

Measurements: Depressive symptoms were assessed using the CES-D. Physical performance tests included the Short Physical Performance Battery (SPPB) and 400-m walk time (400 mw) at baseline and 6 and 12 months.

Results: Of the participants, 15.8% had high depressive symptom scores (CES-D ≥ 14). For participants with low depressive symptoms, SPPB scores improved more in the PA than the SA group over 12 months (adjusted score difference +0.70; P < .001 at 6 months and +0.58; P = .004 at 12 months), and 400 mw times improved in the PA group at 6 months (adjusted score difference -0.41 minutes; P = .02). For participants with high depressive symptoms, the difference in improvement fell short of statistical significance on the SPPB between the PA and SA groups (adjusted score difference +0.76 (P = .18) at 6 months and +0.94 (P = .12) at 12 months).

Conclusion: The presence of high depressive symptoms did not substantially diminish physical performance benefits realized after a PA intervention in sedentary older adults.

Figure 1

Figure 1A: SPPB score over time, by intervention group and depressive symptoms group* Figure 1A. The Short Physical Performance Battery (SPPB) score (adjusted differences) is shown over time, by intervention group and depressive symptoms group. Adjusted differences for low Centers for Epidemiological Studies Depression Scale (CES-D) groups were at 6 months −0.44, p=0.014, and 12 months −0.16, p=0.433; p-value for average effect across all the follow-up visits is 0.063. For high CES-D groups at 6 months: −0.07, p=0.864, and 12 months −0.12, p=0.813; p-value for average effect across all the follow-up visits is 0.820. Figure 1B: 400 Meter Walk-Time over time by intervention group and depression group* Figure 1B. The 400 meter walk (400 mw) time (adjusted differences) is shown over time, by intervention and depressive symptoms group. Adjusted differences for low CES-D groups were at 6 months −0.44, p=0.014, and 12 months −0.16, p=0.433; p-value for average effect across all the follow-up visits is 0.063. For high CES-D groups at 6 months: −0.07, p=0.864, and 12 months −0.12, p=0.813; p-value for average effect across all the follow-up visits is 0.820.

Figure 1

Figure 1A: SPPB score over time, by intervention group and depressive symptoms group* Figure 1A. The Short Physical Performance Battery (SPPB) score (adjusted differences) is shown over time, by intervention group and depressive symptoms group. Adjusted differences for low Centers for Epidemiological Studies Depression Scale (CES-D) groups were at 6 months −0.44, p=0.014, and 12 months −0.16, p=0.433; p-value for average effect across all the follow-up visits is 0.063. For high CES-D groups at 6 months: −0.07, p=0.864, and 12 months −0.12, p=0.813; p-value for average effect across all the follow-up visits is 0.820. Figure 1B: 400 Meter Walk-Time over time by intervention group and depression group* Figure 1B. The 400 meter walk (400 mw) time (adjusted differences) is shown over time, by intervention and depressive symptoms group. Adjusted differences for low CES-D groups were at 6 months −0.44, p=0.014, and 12 months −0.16, p=0.433; p-value for average effect across all the follow-up visits is 0.063. For high CES-D groups at 6 months: −0.07, p=0.864, and 12 months −0.12, p=0.813; p-value for average effect across all the follow-up visits is 0.820.