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

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.