Fredy Alonso Patiño Villada

Ejercicio físico y depresión en adultos mayores: una revisión sistemática

BACKGROUND The literature supports the benefits of exercise in people with depressive disorders, but there is controversy over these benefits in depressed elderly. OBJECTIVE To determine the effect of different types of exercise on depression in older adults using a systematic review of clinical trials. DATA SOURCES The Cochrane Library; PubMed-MEDLINE (1966-dic 2010); EMBASE (1980-dic 2010); LILACS (1986-dic 2010); SCIELO (1998-dic 2010); Register of Controlled Trials; manual search in other sources. METHODS Clinical trials with people >60 years with diagnosis of depression were included, without restriction by year of publication, language and sex, with exercise intervention structures, controlled with usual care (medication, psychotherapy, electric shock therapy), placebo or non-intervention. Three independent reviewers conducted the search, applied inclusion and exclusion criteria, assessed methodological quality and extracted data; discrepancies were resolved by consensus. The primary outcome was the score for depressive symptoms. RESULTS A total of 11 studies (n=7195) were identified. In general, exercise produces an improvement in depression in older adults with more evidence in the short-term (3 months) and strength training at high intensity. CONCLUSIONS Exercise is beneficial for older persons with depression, but studies that support this are of low methodological quality and heterogeneous, which makes it necessary to develop clinical trials to clarify the magnitude of the effect and the levels at which it is beneficial.

Sarcopenia in community-dwelling persons over 60 years of age from a northern Spanish city: relationship between diagnostic criteria and association with the functional performance

INTRODUCTION Sarcopenia is a recognized problem in older people. Currently, its diagnosis goes beyond a simple loss of muscle mass. The aim of this study was to determine the frequency of sarcopenia, defined by the European Working Group on Sarcopenia in Older People (EWGSOP), in independent persons over 60 years of age from a northern Spanish city. In addition, this study compared the diagnostic criteria for sarcopenia and assessed the differences in functional performance according to them. METHODS A cross-sectional study was carried out on 258 members of community centers of both genders. Body composition was assessed with dual-energy X-ray absorptiometry. Appendicular lean mass index (App LMI), hand grip strength (HGS), and 8 foot up-and-go test (8f-UG) were used to diagnose sarcopenia. RESULTS The frequency of sarcopenia was 2.4% (n=6). In women, the App LMI was correlated with HGS (r= 0.164, p<0.05) and 8f–UG (r= -0.167, p<0.05), while in men, the App LMI was correlated with HGS (r=0.241, p<0.05) but not with 8f–UG (r= -0.173, p=0.117). The subjects with low HGS and low performance in the 8f–UG presented lower values in other functional outcomes than people with low App LMI (p<0.05). CONCLUSIONS Using the EWGSOP definition, the frequency of sarcopenia was low in a group of individuals over 60 years of age from a northern Spanish city. In clinical practice, greater emphasis should be placed on the decrease in muscle strength and functional performance rather than on low muscle mass alone.

Ejercicio físico y depresión en adultos mayores: una revisión sistemáticaPhysical Exercise and Depression in the Elderly : A Systematic Review

BACKGROUND The literature supports the benefits of exercise in people with depressive disorders, but there is controversy over these benefits in depressed elderly. OBJECTIVE To determine the effect of different types of exercise on depression in older adults using a systematic review of clinical trials. DATA SOURCES The Cochrane Library; PubMed-MEDLINE (1966-dic 2010); EMBASE (1980-dic 2010); LILACS (1986-dic 2010); SCIELO (1998-dic 2010); Register of Controlled Trials; manual search in other sources. METHODS Clinical trials with people >60 years with diagnosis of depression were included, without restriction by year of publication, language and sex, with exercise intervention structures, controlled with usual care (medication, psychotherapy, electric shock therapy), placebo or non-intervention. Three independent reviewers conducted the search, applied inclusion and exclusion criteria, assessed methodological quality and extracted data; discrepancies were resolved by consensus. The primary outcome was the score for depressive symptoms. RESULTS A total of 11 studies (n=7195) were identified. In general, exercise produces an improvement in depression in older adults with more evidence in the short-term (3 months) and strength training at high intensity. CONCLUSIONS Exercise is beneficial for older persons with depression, but studies that support this are of low methodological quality and heterogeneous, which makes it necessary to develop clinical trials to clarify the magnitude of the effect and the levels at which it is beneficial.