Depression Clinical Trial
Official title:
Exercise Training and Depression in Older Adults II
This study will evaluate the effectiveness of both center-based and home-based exercise versus the antidepressant drug sertraline in treating depression in middle-aged and older adults.
The combination of an aging population and the increased prevalence of chronic diseases
among the elderly presents a major public health concern. Depression acts as both a cause
and a consequence of disability, and with major depressive disorder (MDD) affecting up to
25% of women and 12% of men during their lifetimes, effective treatments for people of all
ages must be made available. Although antidepressant medications are available as treatments
for MDD, they sometimes either do not adequately relieve depressive symptoms, or do relieve
depressive symptoms, but cause undesirable side effects. These side effects may become more
common or more problematic as people age. Alternative approaches to treating depression,
therefore, are necessary. Research suggests that exercise positively affects the levels of
certain mood-enhancing neurotransmitters in the brain. This study will evaluate the
effectiveness of both center-based and home-based exercise versus the antidepressant drug
sertraline in treating depression in middle-aged and older adults.
Participants in this double-blind study will be randomly assigned to one of the following
four treatments for 16 weeks: supervised aerobic exercise; home-based aerobic exercise; drug
therapy; or placebo. All participants assigned to an exercise condition will report to the
study site for a baseline exercise stress test. Participants assigned to supervised aerobic
exercise will attend study visits 3 times per week for an exercise session. Each session
will entail 10 minutes of warm-up exercises, followed by 30 to 35 minutes of continuous
walking, biking, or jogging, and 10 to 15 minutes of cool-down exercises. Participants
assigned to home-based aerobic exercise will attend one introductory session with an
exercise physiologist, who will prescribe an exercise regimen and provide instruction on how
to self-monitor pulse rate. They will also receive written information about their exercise
plan, tips for maintaining progress and relapse prevention, and daily activity logs. The
exercise prescription will be adjusted on a bi-weekly basis. Participants will be expected
to exercise 3 times per week on their own, and will perform 10 minutes of warm-up exercises,
followed by 30 to 35 minutes of continuous walking, biking, or jogging, and 10 to 15 minutes
of cool-down exercises. In addition, they will mail in daily activity logs weekly for the
first 6 weeks and biweekly for the remaining 10 weeks. Brief telephone contacts will be made
to monitor progress, answer questions, and provide individualized feedback. Additionally,
the exercise physiologist will conduct home visits at Weeks 4 and 8. Participants assigned
to receive sertraline or placebo will receive their medication in pill-form at baseline and
Weeks 2, 4, 8, 12, and 16 study visits. All participants will receive several phone calls to
assess treatment response and suicide risk. These calls will take place weekly for the first
4 weeks and biweekly for the remainder of the study. Follow-up visits will occur at Months 6
and 12 post-treatment, and will include participating in psychological interviews and
filling out questionnaires.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double-Blind, Primary Purpose: Treatment
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