Exercise as a therapeutic modality for the prevention and treatment of depression

Effect of a Nurse-Led Exercise Program on Depression in Elderly Patients with Diabetes: A Retrospective Study

BACKGROUND

Patients with diabetes often face psychological challenges, particularly depression. The coexistence of these two conditions can significantly impact both the mental and physical health of individuals. This study aims to investigate the effects of nurse-led exercise training on elderly patients diagnosed with type 2 diabetes mellitus and comorbid depression through experimental research. By selecting appropriate exercise programs for patients, the study seeks to identify effective strategies for improving both their physical health and depressive symptoms. Additionally, it aims to offer tailored exercise recommendations to enhance the overall well-being of these patients.

METHOD

The observation group (n = 53) and the control group (n = 53) were selected based on the interventions documented in the patients' medical records, with eligible patients identified as research participants. The control group received standard medication, while the observation group engaged in intensive exercise training in addition to their standard treatment, dedicating 60-90 min per day to exercise. Prior to and following the intervention, blood glucose indices, levels of 5-hydroxytryptamine (5-HT) and norepinephrine (NE), self-rating depression scale (SDS), Self-Rating Anxiety Scale (SAS), Pittsburgh Sleep Quality Index (PSQI), and Generic Quality of Life Inventory (GQOLI-74) scores were assessed to evaluate the impact of the exercise training intervention.

RESULT

Following the intervention, levels of fasting blood glucose (FBG), 2-h postprandial blood glucose (PBG), and Hemoglobin A1c (HbA1c) were reduced compared to pre-intervention levels, with the exercise group exhibiting lower levels than the control group (p < 0.05). Additionally, post-intervention, patients' levels of 5-HT and NE increased, with the exercise group demonstrating higher levels than the control group (p < 0.05). Moreover, post-intervention, SDS and SAS scores decreased, with more significant improvements observed in the observation group (p < 0.05). Furthermore, the intervention improved sleep quality and quality of life among patients in the exercise group compared to those in the control group (p < 0.05).

CONCLUSION

Nurse-guided exercise training demonstrates a significant capacity to ameliorate glycemic indexes among patients with diabetes mellitus comorbid with depression. It not only diminishes depression and anxiety levels but also enhances the expression of 5-HT and NE. Furthermore, it effectively elevates patients' sleep quality and quality of life. These findings underscore the potential of nurse-led exercise interventions for clinical promotion and widespread application.

Exercise for the Prevention and Treatment of Depression

Depression is among the world's leading causes of disability and accounts for a significant loss of life. Despite large investments in research for antidepressants and psychotherapies, non-response, partial response, and small effects remain significant problems. Exercise and physical activity are two lifestyle behaviors that have been studied for well over half a century for the prevention and treatment of depression. The aim of this chapter is to summarize the current evidence base supporting the efficacy of exercise and physical activity in the prevention and treatment of depression, including evidence supporting exercise as a monotherapy and adjunct to antidepressant medication and psychotherapies. We conclude the chapter by outlining challenges to prescribing exercise for depression and general recommendations for encouraging behavioral adoption for individuals suffering from depression.

Genetically predicted mood swings increased risk of cardiovascular disease: Evidence from a Mendelian randomization analysis

BACKGROUND

Mood swings is linked to a higher risk of cardiovascular diseases (CVDs). However, the causal relationships between them remain unknown.

METHODS

We conducted this Mendelian randomization (MR) analysis to evaluate the causal associations between mood swings (n = 373,733) and 5 CVDs, including CAD, MI, HF, AF, and stroke using summary data of large-scale genome-wide association studies (GWAS). FinnGen datasets validated the results. Various MR approaches, sensitivity analyses, multivariable MR (MVMR), and two-step MR mediation analyses were applied.

RESULTS

The MR analysis revealed significant causal effects of mood swings on CAD (OR = 1.45, 95 % CI 1.24-1.71; P = 5.52e-6), MI (OR = 1.60, 95 % CI 1.32-1.95; P = 1.77e-6), HF (OR = 1.42, 95 % CI 1.18-1.71; P = 2.32e-4), and stroke (OR = 1.48, 95 % CI 1.19-1.83; P = 3.46e-4), excluding AF (P = 0.16). In the reverse MR analysis, no causal relationships were observed. The results were reproducible using FinnGen data. In the MVMR analysis, the causal effects of mood swings on CAD, MI, HF and stroke still remain significant after adjusting potential confounding factors including BMI, smoking and T2DM, but not for LDL and hypertension. Further mediation analysis indicated hypertension may mediate the causal pathways from mood swings to CAD (18.11 %, 95 % CI: 8.83 %-27.39 %), MI (16.40 %, 95 % CI: 7.93 %-24.87 %), HF (13.06 %, 95 % CI: 6.25 %-19.86 %), and stroke (18.04 %, 95 % CI: 8.73 %-27.34 %).

CONCLUSION

Mood swings has a significant causal impact on the development of CAD, MI, HF, and stroke, partly mediated by hypertension.

Physical activity and prevention of mental health complications: An umbrella review

The potential of physical activity in preventing mental health issues has garnered interest among health professionals. We conducted a systematic umbrella review of evidence supporting the relationship between physical activity and the prevention of mental health complications. Our findings revealed a significant association between higher physical activity levels and reduced risk of depression (OR = 0.77, 95% CI 0.72 - 0.82). This association was consistent across various age groups, sex, and geographical regions. Interestingly, low and moderate-intensity physical activity showed the most significant protective effects against depression (low-intensity: OR = 0.81, 95% CI: 0.75-0.56; moderate-intensity: OR = 0.79, 95% CI: 0.72-0.87). Our analysis also showed significant associations between higher physical activity levels and prevention of anxiety disorders (OR = 0.71, 95% CI: 0.61-0.82). However, the evidence regarding the association between physical activity and psychosis/schizophrenia risk was less clear. These findings underscore the physical activity's potential as a preventative measure against mental health complications, highlighting the importance of promoting physical activity in mental health interventions.

Relationship between physical activity and risk of depression in a married group

BACKGROUND

Currently, there are many different findings on the relationship between physical activity and depression, and there may be differences between genders. This study therefore focused on gender differences to understand the relationship between physical activity behaviour and the risk of depression in married individuals.

METHODS

15607 married people in the China Family Panel Studies 2020 (CFPS 2020) were used to understand the relationship between physical activity and depression risk in different populations, and the chi-square test, Mann-Whitney U-test, and binary logistic regression were used to explore the relationship between physical activity and depression risk in the married population.

RESULTS

527 (6.64%) women were at high risk of depression and 365 (4.76%) men were at high risk of depression; physical activity was associated with the risk of depression in the married population, but after incorporating demographic and relevant cognitive variables, physical activity was negatively associated with the risk of depression in women (OR = 0.94, P < 0.01) but not statistically significant with the risk of depression in men (OR = 0.96, P > 0.05).

CONCLUSION

Physical activity was directly related to the risk of depression in married women, but not in married men.

Major depressive disorder: hypothesis, mechanism, prevention and treatment

Worldwide, the incidence of major depressive disorder (MDD) is increasing annually, resulting in greater economic and social burdens. Moreover, the pathological mechanisms of MDD and the mechanisms underlying the effects of pharmacological treatments for MDD are complex and unclear, and additional diagnostic and therapeutic strategies for MDD still are needed. The currently widely accepted theories of MDD pathogenesis include the neurotransmitter and receptor hypothesis, hypothalamic-pituitary-adrenal (HPA) axis hypothesis, cytokine hypothesis, neuroplasticity hypothesis and systemic influence hypothesis, but these hypothesis cannot completely explain the pathological mechanism of MDD. Even it is still hard to adopt only one hypothesis to completely reveal the pathogenesis of MDD, thus in recent years, great progress has been made in elucidating the roles of multiple organ interactions in the pathogenesis MDD and identifying novel therapeutic approaches and multitarget modulatory strategies, further revealing the disease features of MDD. Furthermore, some newly discovered potential pharmacological targets and newly studied antidepressants have attracted widespread attention, some reagents have even been approved for clinical treatment and some novel therapeutic methods such as phototherapy and acupuncture have been discovered to have effective improvement for the depressive symptoms. In this work, we comprehensively summarize the latest research on the pathogenesis and diagnosis of MDD, preventive approaches and therapeutic medicines, as well as the related clinical trials.

Resistance Training in Depression

BACKGROUND

More than 320 million people around the world suffer from depression. Physical activity and sports are effective treatment strategies. Endurance training has already been intensively studied, but any potential antidepressant effect of resistance training is unknown at present, nor is it clear whether this could yield any relevant benefit in clinical use.

METHODS

The PubMed database was selectively searched for recent studies and review articles concerning the use, efficacy, and safety of resistance training in persons with depressive symptoms and diagnosed depression.

RESULTS

Two meta-analyses revealed that resistance training alleviated depressive symptoms with a low to moderate effect size (0.39-0.66). Resistance training in patients with diagnosed depression was studied in seven randomized controlled trials, in which the duration of the intervention ranged from eight weeks to eight months. In six of these trials, the depressive symptoms were reduced. In one trial, a persistent benefit was seen in the resistance-training group at 26 months of follow-up (adherence, 33%). Moreover, resistance training improved strength, quality of life, and quality of sleep. No serious adverse events occurred; this indicates that resistance training in depression is safe.

CONCLUSION

Resistance training seems to have an antidepressant effect. Open questions remain concerning its effects in different age groups, as well as the optimal training parameters. Further high-quality trials will be needed to document the effect of resistance training more conclusively and to enable the formulation of treatment recommendations.

Adult hippocampal neurogenesis (AHN) controls central nervous system and promotes peripheral nervous system regeneration via physical exercise

Physical exercise has beneficial effects on adult hippocampal neurogenesis (AHN) and cognitive processes, including learning. Although it is not known if anaerobic resistance training and high-intensity interval training, which involve alternating brief bouts of highly intense anaerobic activity with rest periods, have comparable effects on AHN. Also, while less thoroughly investigated, individual genetic diversity in the overall response to physical activity is likely to play a key role in the effects of exercise on AHN. Physical exercise has been shown to improve health on average, although the benefits may vary from person to person, perhaps due to genetic differences. Maximal aerobic capacity and metabolic health may improve significantly with aerobic exercise for some people, while the same amount of training may have little effect on others. This review discusses the AHN's capability for peripheral nervous system (PNS) regeneration and central nervous system (CNS) control via physical exercise. Exercise neurogenicity, effective genes, growth factors, and the neurotrophic factors involved in PNS regeneration and CNS control were discussed. Also, some disorders that could be affected by AHN and physical exercise are summarized.

Association of Depression and Cardiovascular Disease

BACKGROUND

Cardiovascular disease remains the leading worldwide cause of mortality. There has been increased awareness of the impact of psychological health on cardiovascular disease. In particular, major depression has been linked to increased all-cause mortality, development of cardiovascular disease, and worse outcomes in those with existing cardiovascular disease.

METHODS

We conducted a meta-analysis assessing the incidence of cardiovascular disease and cardiovascular disease outcomes among those with major depressive disorder.

RESULTS

Among 26 studies of 1,957,621 individuals, depression was associated with increased risk of incident stroke (hazard ratio [HR] 1.13; 95% confidence interval [CI], 1.00-1.28), myocardial infarction (HR 1.28; 95% CI, 1.14-1.45), congestive heart failure (HR 1.04; 95% CI, 1.00-1.09), or any cardiovascular disease (HR 1.16; 95% CI, 1.04-1.30). Depression was associated with increased risk of all-cause mortality (HR 1.43; 95% CI, 1.27-1.60), cardiovascular disease mortality (HR 1.44; 95% CI, 1.27-1.63), and congestive heart failure mortality (HR 3.20; 95% CI, 1.29-7.94).

CONCLUSION

Depression has a significant negative impact on development of cardiovascular disease and on cardiovascular disease outcomes. Further efforts to understand and mitigate these impacts are prudent.

Evaluation & Treatment of Psychological Effects of Stroke

Strokes are a common medical condition in the United States, including in Delaware. An under-recognized effect of stroke is the impact on mood that often occurs. Many individuals develop depression, anxiety, PTSD, and other psychological sequelae. These disorders can significantly affect their lives and their relationships. The emotional effects of stroke pose a public health problem for our residents, leading to devastating decreases in the quality of life for the patient and the family. These challenges negatively impact the community due to the associated healthcare and economic burdens. The population of the State of Delaware is growing, and the proportion of senior residents, who are also at greater risk for strokes, is also increasing. Strokes will remain an ongoing important clinical concern for our healthcare providers. Emotional changes after a stroke will occur in many Delaware residents who suffer a stroke. The emotional sequelae of stroke are under-treated. It is critical for healthcare professionals to be trained to recognize, assess, and treat the psychological disorders that can result from having a stroke. This article provides an overview of the major psychological effects of stroke, recommended assessment tools, promising treatment trends, and directions for further research. Improving our ability to detect and treat these difficult emotional challenges can facilitate effective treatment and prevention strategies and increase quality of life for stroke survivors, their loved ones, and their communities.

Effect of Latin dance on physical and mental health: a systematic review

BACKGROUND

Latin dance is a well-liked physical activity. It has gained increasing attention as an exercise intervention for improving physical and mental health outcomes. This systematic review examines the effects of Latin dance on physical and mental health.

METHODS

Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) were used to report the data for this review. To gather research from the literature, we used recognized academic and scientific databases such SportsDiscus with Full Text, PsycINFO, Cochrane, Scopus, PubMed, and Web of Science. The systematic review only included 22 studies out of the 1,463 that matched all inclusion criteria. The PEDro scale was used to rate each study's quality. 22 research received scores between 3 and 7.

RESULTS

Latin dance has been demonstrated to promote physical health by helping people lose weight, improve cardiovascular health, increase muscle strength and tone, and improve flexibility and balance. Furthermore, Latin dance can benefit mental health by reducing stress, improving mood, social connection, and cognitive function.

CONCLUSIONS

Finding from this systematic review provide substantial evidence that Latin dance has effect on physical and mental health. Latin dance has the potential to be a powerful and pleasurable public health intervention.

SYSTEMATIC REVIEW REGISTRATION

CRD42023387851, https://www.crd.york.ac.uk/prospero .

The pursuit of health: A vitality based perspective

The larger number of adults who enter their senior years with a high burden of chronic diseases has led to new metrics designed to promote health pro-activity, such as the calculation of one's "healthspan". These efforts call for re-evaluation as to what is meant by "health". A large body of epidemiologic and clinical investigation identifies that good health is shaped by specific health behaviors (aerobic exercise, resistance training, sleep, and good diet quality) and four psychological determinants (positive emotions, positive mindsets, purposeful living, and social connectivity). In common, each of these determinants produce "vitality", which can be defined as having the pleasing sensation of feeling energetic. Having a strong sense of vitality produces a sense of agency, provides resilience, and serves as a leading indicator of good health. Importantly, vitality can be assessed as a single item "vital sign" in clinical practice and can be promoted by recommending simple steps to patients, such as suggesting that they initiate walking or other aerobic activities. Because health habits and psychological determinants of health are inter-related, such simple steps can initiate a "virtuous cycle" of health improvement. An emphasis on vitality can also encourage patients to become more cognizant of their level of energy and manage it through health-promoting behaviors rather than quick fix behaviors. Finally, vitality assessment and prescription can promote more successful aging. In sum, an updated and more clinically useful definition of health recognizes that it is a dynamic entity that is influenced at any time by one's engagement in physical and psychological practices that promote health. Accordingly, an updated definition of health is proposed: good health is characterized by physical and psychological well-being and is associated with vitality.

New principles, the benefits, and practices for fostering a physically active lifestyle

The modern environment has led to an increased risk and incidence of sedentary lifestyles. When physical activity (PA) becomes insufficient, pathophysiological pathways are invoked and the future risk for chronic diseases and premature mortality increases. As a consequence, since the 1970s governmental agencies and medical societies have published guidelines to promote PA. The 2018 Guidelines for Physical Activity for Americans contain important updated guidelines, but many of these guidelines are not yet sufficiently known by the public or health providers. In addition, to make use of these guidelines, they need to be integrated with optimal behavioral interventions. Accordingly, this narrative review critically assesses five tenets that stem from the 2018 Guidelines and illustrates how these tenets can be integrated with tools and techniques for motivating individuals to initiate and maintain a more physically active lifestyle. The first tenet indicates that there is no lower threshold of PA that must be obtained before health benefits begin to accrue. Second, it is no longer required that PA be obtained in bouts of 10 min or more to "count". Bouts of lesser duration also count. Pending further study, new accelerometry data suggest that vigorous intermittent PA of just 1-2 min may also benefit health, such as that acquired by stair climbing or carrying heavy groceries. This has led to a new concept of promoting "lifestyle physical activity". Third, excessive sitting is health damaging if it is not accompanied by sufficient daily life PA or accrues over long uninterrupted bouts. Fourth, it is essential to incorporate resistance exercises for optimal health and to promote successful aging. Fifth, a wealth of new evidence indicates that PA strongly protects and promotes all aspects of brain health and may improve cognition even after a single bout of exercise.