The role of exercise in the treatment of depression: biological underpinnings and clinical outcomes

Systemic immune-inflammatory index mediates the association between regular walking and depression in the elderly with coronary heart disease

BACKGROUND

Depressive disorders and coronary heart disease (CHD) are significant and pervasive global public health challenges, influenced by various factors such as diet, physical activity, social circumstances, and lifestyle habits. This study aim to investigate the relationship among regular walking, the systemic immune-inflammation index (SII), and depression in CHD patients. Additionally, it seeks to explore the mediating role of SII in the effect of regular walking on depression among these patients.

METHODS

This cross-sectional study involved 464 patients aged ≥ 65 years with CHD, admitted to the cadre ward of the First Hospital of Jilin University from September 2021 to December 2022. A comprehensive geriatric assessment (CGA) inventory was prepared by compiling and screening regular walking, calculated SII, and the Geriatric Depression Scale (GDS). Binary logistic regression was employed to examine the relationship among walking, ln(SII) and depression. After adjusting for confounding factors, linear regression analysis was used to assess the correlation among exercise-related factors, ln(SII) and depression. Sensitivity analyses were performed through stratified analysis, investigating the relationship between walking and depression within the strata of each variable, as well as the P-interaction among stratified variables. Additionally, the Process package in SPSS was used to explore the mediating role of ln(SII) in the association between regular walking and depression.

RESULTS

Model 2: Elderly individuals who walk regularly are 72.2% less likely to experience depression compared to those who do not engage in regular walking (odds ratio (OR) = 0.278, 95% CI = 0.178-0.433, P < 0.001). However, one-unit increases in ln(SII) corresponds to an approximately sixfold in the likelihood of depression among elderly individuals (OR = 5.899, 95% CI = 4.183-8.318, P < 0.001). Model 3: Participants who walk regularly are 69.4% less likely to suffer from depression compared to those who do not walk regularly (OR = 0.306, 95% CI = 0.190-0.491, P < 0.001). Similarly, a one-unit increase in ln(SII) is associated with an approximately sixfold increase in the probability of depression elderly individuals (OR = 5.976, 95% CI = 4.126-8.656, P < 0.001). The stratified analysis examining the effect of regular walking on depression in patients with CHD confirms the robustness of these associations. Additionally, SII was found to mediate the relationship between regular walking and depression in CHD patients, accounting for 43.19% of the total effect.

CONCLUSIONS

An interaction exists among SII, regular walking and depression in elderly patients with coronary heart disease. Furthermore, SII partially mediates the relationship between regular walking and depression.

CLINICAL TRIAL NUMBER

Not applicable.

The efficacy, mechanisms and implementation of physical activity as an adjunctive treatment in mental disorders: a meta-review of outcomes, neurobiology and key determinants

Research examining physical activity interventions for mental disorders has grown exponentially in the past decade. At this critical juncture, there is a need to synthesize the best evidence to guide researchers, clinicians and people with lived experience. This meta-review aimed to systematically identify and comprehensively evaluate the current evidence about: a) the efficacy of physical activity interventions on mental, cognitive and physical outcomes for individuals with mental disorders; b) the potential neurobiological, psychosocial and behavioral mechanisms underlying the observed effects; and c) the barriers and facilitators for individuals to successfully engage in these interventions. Our systematic search identified 13 meta-analyses of high methodological quality (i.e., A Measurement Tool to Assess Systematic Reviews, AMSTAR score ≥8) assessing outcomes of physical activity as an adjunctive treatment, which included 256 randomized clinical trials (RCTs) and 12,233 individuals. Large effect sizes were found for adjunctive physical activity interventions in improving attention in children and adolescents with attention-deficit/hyperactivity disorder (ADHD); reducing depressive symptoms in children, adolescents and adults with depressive disorders; and reducing body mass index in adults with schizophrenia. Moderate effect sizes were found for reductions of hyperactivity, impulsivity and anxiety, and improvements of executive and social functioning in children and adolescents with ADHD; reduction of anxiety symptoms in adults with anxiety disorders; improved physical and psychological quality of life and cardiovascular fitness in adults with depressive disorders; improved daily living skills, overall quality of life and cardiorespiratory fitness in adults with schizophrenia; reduction of depressive symptoms in older people with depressive disorders; and improvements in cognition and functional mobility in older people with dementia. There is, to date, no meta-analytic evidence for physical activity as a first-line treatment for people with a mental disorder. Five meta-analyses, including 89 RCTs and 4,575 individuals, investigated potential underlying mechanisms. There is a very preliminary evidence for an effect of physical activity on circulating levels of kynurenine, growth hormone, tumor necrosis factor-alpha and brain-derived neurotrophic factor in people with major depressive disorder. No meta-analytic evidence could be found for psychosocial or behavioral mechanisms. Based on 15 umbrella or systematic reviews, covering 432 studies and 48 guidelines, six implementation strategies, along with the most evidence-based behavioral change techniques to support them, were identified. Recommendations to support implementation research in this area were finally formulated.

Correlation between physical activity levels and the risk of cognitive impairment in Chinese older adults

Objective

To analyze the correlation between the level of physical activity and the risk of cognitive impairment in Chinese older adults aged 60 years and above, and to provide correlational evidence for the development of targeted strategies to prevent cognitive impairment.

Methods

This study used five rounds of longitudinal data from the China Health and Retirement Longitudinal Study (CHARLS) conducted between 2011 and 2020, which included 3,583 older adults aged 60 years and above. Multiple regression models were employed to evaluate the association between varying intensities of physical activity (low-intensity, moderate-intensity, and high-intensity) and the risk of developing cognitive impairment (HR).

Results

In models that were not adjusted for any variables, the risk of cognitive impairment was reduced by 25.3% in the moderate-intensity physical activity group compared to the low-intensity group (HR = 0.747, 95%CI: 0.617-0.903), and by 11.0% in the high-intensity group (HR = 0.890, 95%CI: 0.798-0.992). In the model that fully controlled for all confounding variables, the risk ratio was further reduced to 30.7% (HR = 0.693, 95%CI: 0.571-0.841) in the moderate-intensity physical activity group and 9.7% (HR = 0.903, 95% CI: 0.809-1.007) in the high-intensity group. Dose-response analysis revealed an optimal strength of association between moderate-intensity physical activity (approximately 2,800 MET-minutes per week) and cognitive health.

Conclusion

Moderate-intensity physical activity can significantly reduce the risk of cognitive impairment among older adults in China. It is recommended that health management and cognitive impairment prevention strategies for this population incorporate moderate-intensity physical activity.

Socioeconomic inequality in mental health disorders: A cross-sectional study from the Tehran University of Medical Sciences employees' cohort study

Understanding socioeconomic inequalities in health helps identify vulnerable groups and guide targeted interventions. Mental health disorders significantly affect well-being and productivity. This study assessed the prevalence and socioeconomic inequalities in depression, anxiety, and stress among employees of the Tehran University of Medical Sciences. This cross-sectional study analyzed data from the Tehran University of Medical Sciences Employees' Cohort (TEC) baseline phase, comprising 4,442 individuals. The Depression, Anxiety, and Stress Scale-42 (DASS-42) was utilized to measure mental health disorders. Education level and wealth index were considered as socioeconomic indicators. The Slope Index of Inequality (SII) and the Relative Index of Inequality (RII) were employed to estimate socioeconomic inequality. The age-adjusted prevalence of depression, anxiety, and stress was 8.7%, 8.6%, and 11.5%, respectively. The relative wealth-related inequality analysis revealed that, after adjusting for age, sex, marital status, and education level, the prevalence of depression, anxiety, and stress in the lowest wealth index was 2.54, 2.89, and 1.65 times higher than in the highest wealth index, respectively. Additionally, the relative education-related inequality analysis indicated that, adjusted for age, sex, marital status, and wealth index, individuals with primary education or no formal education had 2.58, 2.99, and 2.14 times higher prevalence of depression, anxiety, and stress compared to those with a doctoral degree, respectively. Significant disparities in the prevalence of mental health disorders were found across educational and wealth index levels. Targeted interventions and policies should aim to achieve and sustain long-term benefits for vulnerable and disadvantaged groups.

Fasting blood glucose mediated the association between a body shape index and depression: a cross sectional study from NHANES 2017-2023

Objective

The objective was to evaluate ABSI's association with depression and explore FBG as a possible mediating factor.

Methods

Data from 8,748 NHANES participants (2017-2023) were analyzed. Logistic regression analyses assessed ABSI-depression associations, while mediation models tested FBG's intermediary role. We conducted stratified analyses and interaction test to assess the impact of gender, age, race, PIR, education, alcohol use, current smoking status, BMI, hypertension history and hypercholesterolemia history on the study outcomes.

Results

The fully adjusted logistic regression models demonstrated a significant positive association between ABSI and depression (OR = 1.20, 95%CI: 1.00, 1.44, p = 0.0497). Stratified analyses and interaction test showed that this association was significant only among participants with some college education or above (P for interaction < 0.05). No significant interactions were found across other subgroups. Mediation analyses revealed that FBG partially mediated the relationship between ABSI and depression (15.8%, p < 0.0001).

Conclusion

ABSI was associated with depression, potentially mediated through FBG.

Habits and vulnerability or resilience to stress - Impact on depressive disorders

Major depressive disorder (MDD) is prevalent worldwide and impacts the health and quality of life of millions of people. MDD is a condition influenced by a complex interplay of genetic, psychological and environmental factors. This narrative review examines the roles of stress vulnerability, resilience, and lifestyle habits in shaping the risk of depression, emphasizing holistic approaches that address both biological and environmental factors in mental health management. Vulnerability to stress, influenced by factors such as childhood adversity and personality traits such as neuroticism, increases the probability of MDD. On the other hand, resilience acts as a protective mechanism, reducing stress reactivity and supporting mental health. The main findings suggest that healthy lifestyle habits, including consistent sleep patterns, a balanced diet and regular exercise, play significant roles in increasing resilience and preventing depressive symptoms. Interventions to build resilience, such as emotional skills training and promoting a growth mindset, have been proven effective in reducing depressive symptoms. Overall, the findings suggest that lifestyle modifications combined with psychological strategies to build resilience can significantly reduce depressive disorders. This study advocates for personalized therapeutic strategies that consider the multifactorial nature of depressive disorders, integrating psychological and lifestyle interventions to enhance resilience and mental health.

Untargeted Metabolomics and Proteomics-Based Research of the Long-Term Exercise on Human Body

Regular long-term exercise can benefit the body and reduce the risk of several diseases, such as cardiovascular disease, diabetes, and obesity. However, the proteomic and metabolomic changes, as well as the physiological responses associated with long-term exercise, remain incompletely understood. To investigate the effects of long-term exercise on the human body, 14 subjects with long-term exercise habits and 10 subjects without exercise habits were selected for this study. Morning urine samples were collected and analyzed for untargeted metabolomics and proteomics using liquid chromatography-mass spectrometry. A total of 404 differential metabolites and 394 differential proteins were screened in this research, and the analysis results indicated that long-term exercise may affect energy metabolism, amino acid synthesis and metabolism, nucleotide metabolism, steroid hormone biosynthesis, and the inflammatory response. These findings offer a more comprehensive understanding of the molecular effects of long-term exercise on the human body and provide a basis for future research exploring the underlying mechanisms.

Differential behavior responses and genetic alteration underpinning exercise effectiveness in stress-susceptible mice

Stress susceptibility varies across individuals, influenced by genetic, molecular, and environmental factors. Hence, approaches for exercise treatment as an antidepressant and anxiolytic intervention must consider individual variability. Examining individual adaptation to exercise provides insights into the biology of such variations. We investigated the efficacy of voluntary wheel running (VWR) exercise as a disease-modifying treatment for stress-susceptible (SS) mice subjected to chronic restraint stress. A multidimensional behavior analysis revealed significant variability in VWR efficacy among individuals; while some mice showed substantial behavior phenotypic improvements (SES), others displayed limited/no benefits (SER). A transcriptomic profiling of the ventral hippocampus, a brain region critical to emotional regulation, revealed molecular signatures that promote adaptive changes by restoring cellular repair, energy availability, and synaptic plasticity in SS mice. SER mice exhibited limited behavior resilience and distinct transcriptomic profiles enriched in structural adaptation without functional resilience and glial cell differentiation marked by astrocyte activation or differentiation. These findings suggest that while VWR can mitigates multiple behavior symptoms in stress-susceptible mice, its effectiveness is modulated by distinct biological mechanisms. We highlight the importance of a multivariate framework for behavior assessment and genetic underpinnings, clarifying the variability in responses to stress and exercise's therapeutic efficacy in stress-related disorders.

Age-dependent mechanisms of exercise in the treatment of depression: a comprehensive review of physiological and psychological pathways

Depression has become one of the most common mental disorders in the world. The rising incidence rate and disability rate pose a serious challenge to public health and socio-economic development. Traditional medication and psychotherapy are positive, but they often come with limitations such as side effects, poor compliance, and resource constraints, which highlights the urgent need for more proactive and sustainable non pharmacological interventions. We mainly explored the physiological and psychological mechanisms of exercise in alleviating depression in different age groups. In particular, we evaluated the characteristics and influencing factors of depression in each age group and compared the pathways through which exercise works, aiming to provide scientific basis for clinical practice and public health policies, and strengthen the application of non pharmacological treatment in depression management. It is worth noting that, in the context of a comprehensive search and analysis of recent literature, we have covered the epidemiology of depression, the impact of exercise on mental health, the characteristics of depression in different age groups, and the specific ways in which exercise alleviates depression through physiological and psychological mechanisms. Exercise alleviates symptoms of depression by regulating neurotransmitters, enhancing neuroplasticity, regulating hormone levels, reducing inflammatory responses through physiological pathways, as well as enhancing cognitive function, strengthening emotional regulation, triggering social interactions, and improving self-efficacy through psychological pathways. The differences in physiological and psychological mechanisms among different age groups determine the age dependent characteristics of exercise in mitigating depression. Teenagers, middle-aged people, and elderly people can improve depressive symptoms by enhancing neural progression, regulating stress responses, and strengthening social support, respectively.

Individual patterns of activity predict the response to physical exercise as an intervention in mild to moderate depression

Physical exercise (PE) as antidepressive intervention is a promising alternative, as shown by multiple meta-analyses. However, there is no consensus regarding optimal intensity and duration of exercise, and there are no objective criteria available for personalized indication of treatment. The aims of this study were (1) to evaluate whether individual activity patterns before intervention can predict the response to treatment; and (2) to evaluate whether the patient outcome can be improved by using prior information on treatment efficacy at individual level. The study included subjects with mild to moderate depression randomized to three PE regimens as antidepressive intervention. Features extracted from actigraphy recordings were used for training linear regression ensembles to predict the response to treatment. The Bayesian analysis of coefficients yielded distinct signatures in enriched feature subsets for each PE regimen. Next, we used a counterfactual approach by virtually assigning each patient to the PE regimen predicted to yield best outcome. This procedure significantly increased the remission rates as compared to random assignment to treatment. Our data suggest that the analysis of individual patterns of activity can identify a PE regimen to yield the best results, and that assignment to PE regimen using this information would significantly increase remission rate.

Endurance Exercise Training Alleviates Hepatic Lipocalin-2 Release and Prevents Anxiety-Like Disorders in Chronically Stressed Mice

Exercise training can prevent anxiety disorders in both rodent models and human cohorts. The involvement of peripheral factors in exercise-mediated mental health is being appreciated. It is recently shown that the hepatic biosynthesis of lipocalin-2 (LCN2) can respond to chronic restraint stress (CRS) and elicit anxiety-like behaviors via inhibiting the neural activity in the medial prefrontal cortex (mPFC). Here, it is found that 14-day treadmill exercise training ameliorates anxiety-like behaviors in these CRS-treated mice. Further assays show that exercise intervention reduces the hepatic release of LCN2. Meanwhile, exercise training may also counteract the adverse effect of LCN2 via relieving the cortical microglial cell proliferation. The results collectively suggest that exercise training may modulate the liver-brain axis to reshape the cortical activity for preventing anxiety disorders.

Relationship among depression, fatigue, and sleep after traumatic brain injury: The role of physical exercise as a non-pharmacological therapy

Traumatic brain injury (TBI) is a burdensome condition frequently associated with an increased risk of psychiatric disorders. Although the exact molecular signaling pathways have not yet been fully defined, the compromised integrity of functional brain networks in regions such as the prefrontal cortex and anterior cingulate cortex has been linked to persistent symptoms, including depression, fatigue, and sleep disorders. Understanding how TBI affects neural physiology enables the development of effective interventions. One such strategy may be physical exercise, which promotes neural repair and behavioral rehabilitation after TBI. However, there are caveats to consider when interpreting the effects of physical exercise on TBI-induced mental health issues. This review will highlight the main findings from the literature investigating how different physical exercise protocols affect the progression of TBI-induced depression, fatigue, and sleep disturbances. Furthermore, we aim to explore potential neurobiological pathways that explain how physical exercise influences depression, fatigue, and sleep following TBI.

The role and therapeutic potential of mitophagy in major depressive disorder

Major depressive disorder, also known as MDD, affects more than 264 million people globally, making it a prevalent and critical health challenge. Traditional treatments show limited efficacy in many patients. Therefore, exploring new treatment methods is particularly crucial. Mitophagy, as a regulatory process, can help understand and treat MDD. This paper focuses on the molecular mechanisms of mitophagy, starting from proteins and related pathways, and its role in MDD. The study also explores the associations between mitophagy and neuroinflammation, oxidative stress, neurotransmitter synthesis, and neuroplasticity in MDD and discusses the progress of clinical research on the role of mitophagy in MDD. In addition, the article describes the current pharmaceutical and non-pharmaceutical interventions that can regulate mitophagy in MDD and unravels the potential and challenges of these therapeutic strategies in clinical settings. This article offers a deeper insight into the pathogenesis of MDD and offers a scientific basis for the development of new treatment strategies.

Curvilinear association between cardiometabolic index and depressive symptoms in individuals aged 45 and older: a cross-sectional study of CHARLS

Objective

This research is aimed at investigating the association between the cardiometabolic index (CMI) and depressive symptoms in Chinese population of middle and older age, using data derived from the CHARLS study.

Methods

Using data from 7,800 participants in the 2011-2012 wave of the CHARLS cohort, this cross-sectional analysis concentrated on examining the association between CMI and depressive symptoms, assessed through CESD-10 scores. The study utilized multivariate logistic regression, multiple linear regression, and restricted cubic spline (RCS) models to investigate the link between CMI and depression, with subgroup analyses offering further insights. Sensitivity analyses included propensity score matching and data from 8,457 participants in the 2015-2016 CHARLS wave.

Results

In fully adjusted models, higher CMI was significantly associated with an elevated risk of depression, with participants having a CMI ≥ 0.594 showing a 162% higher risk compared to those with lower CMI. The RCS analysis identified a threshold at CMI = 0.594, where participants with CMI ≥ 0.594 had a 162% elevated possibility of depression in comparison to those with CMI < 0.594 [OR = 2.62, 95% CI: 2.36-2.91]. Sensitivity analyses, including propensity score matching and data from the 2015-2016 CHARLS wave, confirmed the robustness of the findings.

Conclusion

Our analysis demonstrates that elevated CMI levels are independently correlated with a heightened likelihood of experiencing depressive symptoms, highlighting the significance of metabolic interventions in mitigating depressive tendencies in middle-aged and older individuals.

Effect of physical exercise training on neural activity during working memory in major depressive disorder

BACKGROUND

Deficits in working memory (WM) are common in patients with Major Depression Disorder (MDD). Previous research mainly in healthy adults indicated that physical exercise training may improve cognitive functions by stimulating neuronal plasticity particularly in hippocampal structures. Thus, the goal of this functional Magnetic Resonance Imaging (fMRI) study was to examine alterations in neuronal activity during a WM task and to investigate changes in brain volume and functioning following a physical exercise training in patients with MDD with a specific focus on hippocampal structures.

METHODS

86 (39 female) MDD outpatients (average age 37.3), diagnosed by clinical psychologists, were randomly assigned to one of three groups for a 12-week intervention: High intensity exercise training (HEX), low intensity exercise training (LEX) or waiting list control group (WL). An n-back task (with WM loads of 0, 1, 2, and 3) during fMRI was conducted before and after interventions/waiting period.

RESULTS

Both exercise groups showed better performance and shorter reaction times at higher WM loads after 12-weeks of physical exercise training. Specifically in the HEX, we found an improvement in physical fitness and an increase in neural activation in the left hippocampus as compared to the WL following the exercise training. Training-related structural volume changes in gray matter or hippocampus were not detected.

CONCLUSIONS

Our results partly support the hypothesis that physical exercise training positively affects WM functions by improving neuronal plasticity in hippocampal regions. Exercise training seems to be a promising intervention to improve deficient WM performance in patients with MDD.

CLINICAL TRIALS REGISTRATION NAME

Neurobiological correlates and mechanisms of the augmentation of psychotherapy with endurance exercise in mild to moderate depression - SPeED, http://apps.who.int/trialsearch/Trial2.aspx?TrialID=DRKS00008869, DRKS00008869.

Immune-inflammatory effects of the multicomponent intervention FIBROWALK in outdoor and online formats for patients with fibromyalgia

The multicomponent intervention FIBROWALK integrates pain science education (PSE), therapeutic exercise, cognitive behavioral therapy (CBT), and mindfulness training for treating fibromyalgia (FM). This study investigated the effects of the FIBROWALK in online (FIBRO-On) and outdoor (FIBRO-Out) formats compared to treatment-as-usual (TAU) on core clinical variables along with serum immune-inflammatory biomarkers and brain-derived neurotrophic factor (BDNF). Furthermore, the predictive value of these biomarkers on clinical response to FIBROWALK was also evaluated. 120 participants were randomly divided into three groups: TAU, TAU + FIBRO-On or TAU + FIBRO-Out. Clinical and blood assessments were conducted pre-post treatment. Both FIBRO-Out and FIBRO-On showed effectiveness (vs TAU) by improving functional impairment and kinesiophobia. Individuals allocated to FIBRO-Out (vs TAU) additionally showed decreases in pain, fatigue, depressive symptoms, and serum IL-6 and IL-10 levels along with IL-6/IL-4 ratio; patients allocated to FIBRO-On only showed a less stepped increase in IL-6 compared to TAU. An exaggerated pro-inflammatory profile along with higher levels of BDNF at baseline predicted greater clinical improvements in both active treatment arms. Our results suggest that FIBROWALK -in online and outdoor formats- is effective in individuals with FM and has significant immune regulatory effects in FM patients, while immune-inflammatory pathways and BDNF levels may in part predict its clinical effectiveness. Trial registration number NCT05377567 (clinicaltrials.gov).

Does multimodal exercise reduce C-reactive protein levels in major depressive disorder? Preliminary results from a randomized controlled trial

This randomized controlled trial aimed to evaluate the adjunctive effects of an affect-based, supervised, multimodal, online, and home-based exercise intervention on C-reactive protein (CRP) levels and depressive symptoms by comparing it to pharmacotherapy alone (antidepressants) over a 12-week period. The study specifically focused on CRP levels and their association with depression outcomes. Depressive symptoms and blood samples were assessed before (baseline - t0), during (Week 5 - t1), and at end of treatment (Week 12 - t2). The exercise intervention was designed to optimize positive affect during and after exercise, and considered each participant's preferred exercise intensity to enhance perceived effort, pleasure, and enjoyment. The study enrolled 59 adults and randomly allocated them into two groups: exercise group (EG; n = 26,76.9% females, mean age 28.5 years) and control group (CG, n = 33, 78.7% females, mean age 25.9 years). CRP levels reduced in the EG at t2 compared with t0 [p = .019; d = .64 (CI 95% -.04,1.24)], while the CRP did not change during treatment in the CG [p = .116; d = -.35 (CI 95% -.93,.16)]. At t2, EG showed clinically meaningful reductions in CRP compared to CG: [p = .043; d = .50 (CI 95% .14,1.30)]. For EG, the anti-inflammatory response predicted reductions in self-reported depressive symptoms (t = 2.066, β = .438, p = .030). Given the significant role inflammation plays in modulating depression symptoms, our findings indicate that structured multimodal exercise programs, which can be delivered online, are effective in the management of depression and potentially have anti-inflammatory. TRIAL REGISTRATION NUMBER: Brazilian Registry of Clinical Trials (ReBEC: RBR-4pgd3ct); Date of registration: 10/19/2023.

The Association Between Low Muscle Mass and the Risk of Depressive Symptoms: A Cross-Sectional Study Based on the Chinese Longitudinal Health Longevity Survey (CLHLS)

BACKGROUND

Many studies have shown a strong link between sarcopenia and depression, and low muscle mass (LMM) is an important component in the diagnosis of sarcopenia; however, there have been no studies on the relationship between LMM and depressive symptoms in the Chinese elderly population. To estimate the potential relationship between LMM and depressive symptoms among older adults, a cross-sectional analysis was conducted utilizing data from the Chinese Longitudinal Health Longevity Survey (CLHLS).

METHOD

The study sample comprised 11,711 individuals aged 65 years or older (mean age 83.0 ± 10.9) from the CLHLS database in 2018. We used the corrected appendicular skeletal muscle mass (ASM) prediction formula to assess muscle mass and the 10-item Center for Epidemiological Studies-Depression Scale (CES-D-10) to assess depressive symptoms. A multivariate logistic regression model and restricted cubic spline (RCS) curves were employed to investigate the association between LMM and depressive symptoms.

RESULTS

The study findings revealed a 1.16-fold higher risk of depressive symptoms in the LMM group compared to the control group (adjusted odds ratio [aOR]: 1.16, 95% confidence intervals [95% CI]: 1.05-1.29, p < 0.001). Furthermore, for every one-point decrease in LMM score below 7.87, the risk of depressive symptoms increased by 8%, with statistical significance. However, when the LMM score was greater than or equal to 7.87, the decrease in the LMM score did not significantly increase the risk of depressive symptoms.

CONCLUSION

Our study suggests LMM is a risk factor for depressive symptoms in the elderly Chinese population, and within a certain range, the risk of depressive symptoms increases as the LMM score decreases. Physical exercise may be an effective strategy to maintain optimal muscle mass and help the mental health of the elderly.

Effects of exercise dose based on the ACSM recommendations on depression in hemodialysis patients: a systematic review and meta-analysis of randomized controlled trials

Objective

To explore the impact of various exercise doses on depressive symptoms among hemodialysis patients and offer valuable guidance for the selection of optimal exercise doses in clinical practice settings.

Methods

A comprehensive systematic review was conducted across four major databases, namely, PubMed, Embase, Web of Science, and Cochrane Library, covering the period from their inception until August 2024. Exercise interventions were classified based on adherence to American College of Sports Medicine (ACSM) recommendations, dividing studies into groups with high and low/uncertain ACSM adherence. A meta-analysis was performed utilising Review Manager5.4.1 to assess the effects of ACSM adherence on depression in hemodialysis patients.

Results

This meta-analysis incorporated a total of 19 randomized controlled trials, involving 1,285 patients. The mean age of the patients ranged from 33.2 to 70 years, and the average body mass index (BMI) fluctuated between 23.3 and 28.81 kg/m2. Males accounted for a relatively larger proportion of the participants. Among these trials, 14 were classified as having high ACSM adherence, while 5 were categorized as having low or uncertain adherence. Overall, exercise markedly improved depression in hemodialysis patients (SMD: -0.63, 95% CI: -0.87, -0.39; p < 0.05). The high ACSM adherence group showed greater improvement relative to the low/uncertain adherence group (SMD: -0.66 vs. -0.56). No notable disparities were noted in the effects of exercise duration or patient age on depression outcomes between the subgroups (p = 0.86, p = 0.48).

Conclusion

Exercise interventions that exhibit high adherence to the ACSM guidelines prove to be more efficacious in alleviating depression among hemodialysis patients as compared to those with low or uncertain adherence levels.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/#myprospero.

Effect of leisure-time physical activity on depression and depressive symptoms in menopausal women: a systematic review and meta-analysis of randomized controlled trials

Aims

Menopausal women often suffer from depression, which impairs their quality of life. Physical activity has been reported to exert beneficial effects on preventing and treating depression. This meta-analysis aims to explore the effect of leisure-time physical activity on determined depression or depressive symptoms in menopausal women.

Methods

Relevant studies were searched from PubMed, Embase, Cochrane Library, Web of Science, PsycINFO, CINAHL Plus, China National Knowledge Infrastructure (CNKI), VIP, and WanFang databases. Outcomes were depression or depressive symptoms. Weighted mean difference (WMD) or standard mean difference (SMD) with 95% confidence interval (CI) was used as the statistical measure. Heterogeneity tests were performed for each outcome, and all outcomes were subjected to sensitivity analysis. Subgroup analysis was performed based on depression degree, exercise intensity, exercise form, intervention duration, supervision, sample size, and geographical region.

Results

A total of 17 studies were included in this meta-analysis. The results showed that exercise alleviated the depressive symptoms of menopausal women (SMD = -1.23; 95% CI, -2.21 to -0.24). In addition, exercise was found to reduce the depression (SMD = 11.45; 95% CI, -1.75 to -1.15), and depression assessed by the Center for Epidemiologic Studies Depression Scale (CES-D) (WMD = -5.76; 95% CI, -6.63 to -4.89) or Self-Rating Depression Scale (SDS) (WMD = -6.86; 95% CI, -9.24 to -4.49). The results were similar regardless of depression degrees, exercise intensity, intervention duration, exercise form, supervision or not, sample size, and geographical region.

Conclusions

Leisure-time physical activity may help alleviate depressive symptoms or depression in menopausal women. However, further high-quality studies are needed to confirm these findings and better understand the specific effects of physical activity on depression in this population.

Systematic review registration

https://www.crd.york.ac.uk/prospero/, identifier CRD42024581087.

The immunological perspective of major depressive disorder: unveiling the interactions between central and peripheral immune mechanisms

Major depressive disorder is a prevalent mental disorder, yet its pathogenesis remains poorly understood. Accumulating evidence implicates dysregulated immune mechanisms as key contributors to depressive disorders. This review elucidates the complex interplay between peripheral and central immune components underlying depressive disorder pathology. Peripherally, systemic inflammation, gut immune dysregulation, and immune dysfunction in organs including gut, liver, spleen and adipose tissue influence brain function through neural and molecular pathways. Within the central nervous system, aberrant microglial and astrocytes activation, cytokine imbalances, and compromised blood-brain barrier integrity propagate neuroinflammation, disrupting neurotransmission, impairing neuroplasticity, and promoting neuronal injury. The crosstalk between peripheral and central immunity creates a vicious cycle exacerbating depressive neuropathology. Unraveling these multifaceted immune-mediated mechanisms provides insights into major depressive disorder's pathogenic basis and potential biomarkers and targets. Modulating both peripheral and central immune responses represent a promising multidimensional therapeutic strategy.

The effect of exercise on depression and gut microbiota: Possible mechanisms

Exercise can effectively prevent and treat depression and anxiety, with gut microbiota playing a crucial role in this process. Studies have shown that exercise can influence the diversity and composition of gut microbiota, which in turn affects depression through immune, endocrine, and neural pathways in the gut-brain axis. The effectiveness of exercise varies based on its type, intensity, and duration, largely due to the different changes in gut microbiota. This article summarizes the possible mechanisms by which exercise affects gut microbiota and how gut microbiota influences depression. Additionally, we reviewed literature on the effects of exercise on depression at different intensities, types, and durations to provide a reference for future exercise-based therapies for depression.

Therapeutic effects of exercise on depression: The role of microglia

Major depressive disorderadversely affects mental health. Traditional therapeutic approaches, including medication, psychological intervention, and physical therapy, exert beneficial effects on depression. However, these approaches are associated with some limitations, such as high cost, adverse reactions, recurrent episodes, and low patient adherence. Previous studies have demonstrated that exercise therapy can effectively mitigate depressive symptoms, although the underlying mechanism has not been elucidated. Recent studies have suggested that depression is a microglial disease. Microglia regulate the inflammatory response, synaptic plasticity, neurogenesis, kynurenine pathway and the activation of hypothalamic-pituitary-adrenal axis, all of which affect depression. Exercise therapy is reported to shift the balance of microglial M1/M2 polarization in the hippocampus, frontal lobe, and striatum, suppressing the release of pro-inflammatory factors and consequently alleviating behavioral deficits in animal models of depression. Further studies are needed to examine the specific effects of different exercise regimens on microglia to identify the exercise regimen with the best therapeutic effect.

Middle-Aged and Young People's Perspectives on Healthy Aging Through Exercise: Environmental, Psychosocial, and Individual Factors With the Photovoice Method

The aim of this study is to examine the individual's perspective on healthy aging through exercise. Individuals aged 18-60 years who have been physically active for at least one year were included in this study. The study focused on the exercise behaviors of young and middle-aged individuals through photographs. The photovoice method was used to discover how healthy aging affects exercise behaviors in physically active individuals. Content analysis was used to analyze photographs and the photovoice of the participants. Environmental, psychosocial, and individual themes emerged with the interpretation of the data. According to the results of this study, environmental, psychosocial, and individual factors have been found to be effective for healthy aging. The contribution of exercise to personal development was beneficial in strengthening the network of interpersonal relationships and improving physical and mental health in young and middle-aged adults. Exercise programs should not be monotonous, and individuals should not depend on a single location for exercise.

The effects of exercise on anxiety and depression in adults with cancer: A meta-review of meta-analyses

BACKGROUND

This meta-review aimed to synthesize the evidence of the effects of exercise on anxiety and depression symptoms amongst adults with cancer, and cancer-survivors, comparing effects sizes between meta-analysis.

METHODS

Major databases were searched up to February 9, 2024 for meta-analyses evaluating the effects of exercise, using anxiety and/or depression scales. Effect size (ES) values were calculated as standardized differences in the means and expressed as the Standardized Mean Difference (SMD) with the 95% confidence interval (95%CI). A total of eight unique meta-analyses were included.

RESULTS

Among meta-analyses examining both anxiety and depression symptoms overall, a small beneficial effect of exercise was shown [SMD = 0.41 (0.25-0.57); p < 0.0001]. Subgroup analyses revealed that exercise has a small effect on decreasing anxiety [SMD = 0.42 (0.04-0.79); p = 0.027], and depressive symptoms [SMD = 0.38 (0.21-0.56); p < 0.0001]. In addition, aerobic exercise has a moderate effect on reducing depressive symptoms [SMD = 0.54 (0.16-0.93); p = 0.005], whereas resistance exercise has no effect. Subgroup analyses by type of cancer observed a moderate effect on decreasing depressive symptoms in patients with breast cancer [SMD = 0.51 (0.27-0.74); p < 0.0001].

CONCLUSIONS

Exercise (specifically aerobic) should be considered by healthcare professionals as a strategy to treat/manage symptoms of anxiety and depression amongst adults with cancer and cancer-survivors.

Optimizing antidepressant benefits: Effect of theta burst stimulation treatment in physically active people with treatment-resistant depression

Theta burst stimulation (TBS) is a promising therapy for treatment-resistant major depressive disorder (MDD), but a significant proportion of individuals do not respond adequately, necessitating alternative approaches. This study explores whether individuals meeting minimum recommended physical activity levels demonstrate better responses to TBS compared to physically inactive individuals. Using data from a randomized controlled trial (n = 43), participants were categorized as physically active or inactive based on baseline International Physical Activity Questionnaire (IPAQ) scores. Depression scores (Hamilton Rating Scale for Depression, 17-item; HRSD-17) were assessed at baseline, 4, and 6 weeks of TBS treatment. A significant Time X Group effect adjusted for age and baseline depression was observed. Physically active individuals consistently exhibited lower depression scores across time points. At 4 and 6 weeks, there was a significant increase in between-group differences, indicating that the physically active group derived greater benefits from treatment. At 6 weeks, a significantly higher proportion of responders (≥50 % HRSD-17 reduction) were observed in the physically active compared to inactive group. Physical activity significantly contributed to regression and logistic models predicting treatment response. These findings support the potential role of baseline physical activity in enhancing TBS therapy for MDD.

Research progress on the mechanism of exercise against depression

The substantial global health burden of depression encourages the development of innovative and broadly effective interventions. This paper aimed to examine recent advancements by which exercise works as an antidepressant and recommends optimal types and quantity of exercise as supplemental therapies in treating depression. Sedentary behavior and low physical activity significantly influence the onset of depression. Being an effective treatment option, exercise can significantly reduce depression risk. Exercise exerts antidepressant effects as it modulates neurotransmitters, neuroplasticity, the immune system, and hormone levels. Effective exercise forms include yoga, strength training, and walking/jogging. Tailored exercise regimens that consider individual preferences and tolerability can improve outcomes. Regular exercise enhances general well-being and reduces depressive symptoms. Additional research is needed to understand the complex basis of exercise's effects on depression. Exercise is a cost-effective and accessible intervention for depression management that needs additional exploration. Thus, customized exercise programs, as per each patient's needs, are essential for their successful implementation clinically.

Changes in Exercise Performance in Patients During a 6-Week Inpatient Psychiatric Rehabilitation Program and Associated Effects on Depressive Symptoms

Background/Objectives: The impact of exercise on affective disorders has been demonstrated in various studies. However, almost no data are available on performance effects. Therefore, this study investigated exercise performance related to the severity of depression symptoms in a pre-post within-subjects design in a 6-week standard inpatient psychiatric rehabilitation program. Methods: A total of 53 individuals (20 female; mean age, 40.98 ± 11.33) with a primary diagnosis of depression performed a cardiopulmonary exercise test (CPX) to obtain maximal oxygen uptake (VO2max), maximal power output (Pmax), and the first and second ventilatory threshold (VT1, VT2) at the start and the end of the rehabilitation. Degree of depression was assessed by Becks Depression Inventory (BDI) and the Brief Symptom Inventory test (BSI). Overall activity was measured by accelerometer step-counts. Results: Mean total step-count per day during rehabilitation was high (12,586 ± 2819 steps/day). Patients' BDI and BSI at entry were 21.6 ± 8.83 and 65.1 ± 6.8, respectively, and decreased significantly (p < 0.001) following rehabilitation, to 10.1 ± 9.5 and 54.5 ± 11.3, respectively. Pmax and VO2max increased significantly (p < 0.001) from entry values (182.6 ± 58.7 W, 29.74 ± 5.92 mL·kg-1·min-1) following rehabilitation: by 11.91 ± 12.09 W and 1.35 ± 2.78 mL·kg-1·min-1, respectively. VT1 and VT2 showed a similar behavior. An increase in physical performance could predict improvement in BDI (R2 = 0.104, F(1,48) = 5.582, p = 0.022) but not in BSI. Conclusions: The program was associated with improved mental health status in all patients and increased performance in the majority of patients, although increases were small. Since improvements in exercise performance may be positively related to depression symptoms and comorbidities, it is recommended to individualize and tailor exercise programs, which could yield larger effects.

Association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) with depressive symptoms: recent findings from NHANES 2005-2018

Background

The ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol (NHHR) index is a relatively new composite lipid index, the relationship between NHHR and depression is unclear from the current study. The primary aim of our study was to examine the association between the prevalence of depression and NHHR in a US population.

Methods

The National Health and Nutrition Examination Survey (NHANES) provided the data for our investigation from 2005 to 2018. and primarily included participants who contained complete data on NHHR and depression in U.S. adults (age ≥20 years). Associations between NHHR and depression were assessed using multifactorial logistic regression analysis, subgroup analysis, and smoothed curve fitting.

Results

In our study, 29,561 subjects in total showed a mean NHHR index of 3.12± 1.58,A noteworthy positive correlation was observed between NHHR and depression in multifactorial logistic regression analysis. Subgroup analyses and tests of interaction showed that gender, age, ethnicity, PIR, smoking, alcohol consumption, coronary heart disease, diabetes mellitus, hypertension, and stroke did not influence the NHHR and the association between depression (P for interaction > 0.05), whereas two stratification factors, BMI and sleep disturbance, may be potential factors in the association between NHHR and depression (P for interaction < 0.05).

Conclusion

According to our present study, if the level of NHHR rises in American adults, their likelihood of developing depression also increases.

Pathogenesis, diagnostics, and therapeutics for Alzheimer's disease: Breaking the memory barrier

Alzheimer's disease (AD) is the most common cause of dementia and accounts for 60-70 % of all cases. It affects millions of people worldwide. AD poses a substantial economic burden on societies and healthcare systems. AD is a progressive neurodegenerative disorder characterized by cognitive decline, memory loss, and impaired daily functioning. As the prevalence of AD continues to increase, understanding its pathogenesis, improving diagnostic methods, and developing effective therapeutics have become paramount. This comprehensive review delves into the intricate mechanisms underlying AD, explores the current state of diagnostic techniques, and examines emerging therapeutic strategies. By revealing the complexities of AD, this review aims to contribute to the growing body of knowledge surrounding this devastating disease.

The effect of multi-component exercise intervention in older people with Parkinson's disease and mild cognitive impairment: A randomized controlled study

A multimodal exercise training program might be the best way to improve motor and cognitive function in patients with Parkinson's disease (PD), but this has yet to be fully proven in PD patients with mild cognitive impairment (MCI). This study aims to examine the feasibility and effectiveness of a theory-based, multi-component exercise intervention in older people with PD-MCI. Participants were randomized into an intervention group (n=23) and an active control group (n=23), receiving the theory-based multi-component exercise intervention and Parkinson's health exercises, respectively. All participants performed 60-minute exercise training sessions three times a week over a 12-week period. The retention rate at post-intervention was 95.7% (42/46) for the entire cohort. The attendance rates were 99.6% in the intervention group and 99.5% in the control group. No adverse events occurred. The intervention group showed significantly greater improvements than the control group in global cognitive function, executive function, physical motor function, balance and gait, depression, and quality of life. This study indicates that the theory-based multi-component exercise intervention demonstrates high feasibility in promoting exercise adherence and is an effective treatment option for older adults with PD-MCI.

The effect of repetitive transcranial magnetic stimulation on the Hamilton Depression Rating Scale-17 criterion in patients with major depressive disorder without psychotic features: a systematic review and meta-analysis of intervention studies

AIM

In line with the publication of clinical information related to the therapeutic process of repetitive transcranial magnetic stimulation (rTMS) and the updating of relevant treatment guidelines, the present meta-analysis study was designed and conducted to determine the effect of repetitive transcranial magnetic stimulation (rTMS) on the Hamilton Depression Rating Scale-17 (HDRS-17) criterion in patients with major depressive disorder (MDD) without psychotic features.

METHODS

In this study, a systematic search was conducted in electronic databases such as PubMed [Medline], Scopus, Web of Science, Embase, Ovid, Cochrane Library, and ClinicalTrials. gov using relevant keywords. The search period in this study was from January 2000 to January 2022, which was updated until May 2023. Randomized controlled trials (RCTs) that determined the effect of repetitive transcranial magnetic stimulation (rTMS) on the Hamilton Depression Rating Scale-17 (HDRS-17) criterion in patients with major depressive disorder (MDD) without psychotic features were included in the analysis. The quality of the included RCTs was assessed using the Cochrane Risk of Bias checklist. Statistical analyses were performed using STATA (Version 16) and RevMan (Version 5).

RESULTS

Following the combination of results from 16 clinical trial studies in the present meta-analysis, it was found that the mean Hamilton Depression Rating Scale-17 (HDRS-17) in patients with major depressive disorder (MDD) decreases by an average of 1.46 units (SMD: -1.46; % 95 CI: -1.65, -1.27, I square: 45.74%; P heterogeneity: 0.56). Subgroup analysis results indicated that the standardized mean difference of Hamilton Depression Rating Scale-17 (HDRS-17) varied based on the number of treatment sessions: patients receiving 10 or fewer repetitive transcranial magnetic stimulation (rTMS) sessions showed a mean Hamilton Depression Rating Scale-17 (HDRS-17) reduction of 2.60 units (SMD: -2.60; % 95 CI: -2.86, -2.33, I square: 55.12%; P heterogeneity: 0.55), while those receiving 11 to 20 sessions showed a mean Hamilton Depression Rating Scale-17 (HDRS-17) reduction of 0.28 units (SMD: -0.28; % 95 CI: -0.65, -0.09, I square: 39.91%; P heterogeneity: 0.89).

CONCLUSION

In conclusion, our meta-analysis demonstrates the efficacy of repetitive transcranial magnetic stimulation (rTMS) in reducing depressive symptoms in major depressive disorder (MDD) patients. The complex results of subgroup analysis revealed insight on the possible benefits of a more focused strategy with fewer sessions, as well as the impact of treatment session frequency. These findings add to our understanding of repetitive transcranial magnetic stimulation (rTMS) as a therapeutic intervention for the treatment of major depressive illnesses.

Modulation of Brain-derived Neurotrophic Factor Expression by Physical Exercise in Reserpine-induced Pain-depression Dyad in Mice

Pain accompanied by depressive symptoms is a common reason for seeking medical assistance, and many chronic pain patients experience comorbid depression. The brain-derived neurotrophic factor (BDNF) is a well-known neurotrophin expressed throughout the nervous system, playing a crucial role in neuronal growth and neuroplasticity. This study aimed to examine the effects of exercise on BDNF expression in the nervous system and reserpine (RSP)-induced pain-depression dyad. RSP (1 mg/kg) was subcutaneously administered once daily for three days in mice. The exercise was performed using a rota-rod tester for seven consecutive days following RSP administration. Pain responses were evaluated using von Frey filaments, and depression-like behaviors were assessed through forced swimming and open field tests. Immunofluorescence staining was performed to examine the changes in BDNF expression in the dorsal root ganglion (DRG), spinal cord, and hippocampus. Administration of RSP reduced mechanical paw withdrawal threshold, increased immobility time in the forced swimming test, and decreased movement in the open field test. The immunoreactivity of BDNF was increased in the DRG and spinal dorsal regions, and decreased in the hippocampus after RSP administration. Physical exercise significantly reduced the RSP-induced mechanical hypersensitivity and depression-like behaviors. In addition, exercise suppressed not only the increased expression of BDNF in the DRG and spinal dorsal regions but also the decreased expression of BDNF in the hippocampus induced by RSP administration. These findings suggest that repetitive exercise could serve as an effective and non-invasive treatment option for individuals experiencing both pain and depression by modulating BDNF expression.

The Absence of Items Addressing Increased Appetite or Weight in Depressive-Symptom Questionnaires: Implications for Understanding the Link between Major Depressive Disorder, Antidepressants, and Obesity

Major depressive disorder (MDD) and obesity have a complex bidirectional relationship. However, most studies do not assess increased appetite or weight as a depressive symptom due to limitations in rating scales. Here we aimed to analyze frequently employed depressive-symptom scales and discuss the relevance of weight and appetite assessment items. To elaborate this perspective, we searched for validated questionnaires and scales evaluating depressive symptoms in English. We analyzed appetite and weight items from 20 depressive-symptoms rating scales. Only 8 of 20 rating scales assessed for increased weight or appetite. The scales reported in the literature as the most employed in antidepressants efficacy trials do not assess increased appetite or weight. The current use of rating scales limits our understanding of the relationship between MDD, antidepressants, and obesity. It is necessary to improve our weight and appetite measurements in MDD to clarify the respective impact of depressive symptoms and antidepressants on weight change.

Associations between sugar-sweetened beverages consumption, duration of physical exercise, and depressive symptoms among Tibetan university students at high altitude

Background

Depressive symptoms have become a public health issue of common concern in countries all over the world, and have many negative impacts on university students' study and life. Depressive symptoms are influenced by many factors, including sugar-sweetened beverages (SSBs) consumption and duration of physical activity. However, no study has been conducted on the association between sugar-sweetened beverage consumption, duration of physical exercise, and depressive symptoms among Tibetan university students at high altitudes.

Methods

In this study, a self-assessment survey of SSBs consumption, duration of physical exercise, and depressive symptoms was conducted on 6,259 (2,745 boys, 43.86%) Tibetan university students aged 19-22 years in Lhasa and Ganzi areas, China, using stratified whole population sampling. The associations were also analyzed using one-way analysis of variance, binary logistic regression analysis, and ordered logistic regression analysis in the generalised linear model.

Results

The proportions of mild depression symptoms, moderate depression symptoms, and major depressive symptoms among Tibetan boys university students in high-altitude areas of China were 18.0, 22.9, and 1.5%, respectively; the proportions of girls students were 20.1, 21.9, and 1.5%, respectively, 1.5%, and the differences in the detection rates of depressive symptoms between sex were statistically significant (χ 2 value = 14.253, p < 0.01). Ordered logistic regression analyses showed that using duration of physical exercise >60 min/d and SSBs ≤1 times/week as the reference group, the duration of physical exercise <30 min/d and SSBs ≥5 times/week groups had the highest risk of developing depressive symptoms was the highest risk (OR = 6.98, 95% CI: 5.05-9.65; p < 0.001).

Conclusion

This study confirmed that there was a positive association between SSBs consumption and depressive symptoms and a negative association between the duration of physical exercise and depressive symptoms among Tibetan university students at high altitudes in China. In the future, SSBs consumption should be effectively controlled and the duration of physical exercise should be increased to reduce the occurrence of depressive symptoms and promote the physical and mental health of Tibetan university students in high-altitude areas.

Acute effects of aerobic exercise on corticomotor plasticity in individuals with and without depression

BACKGROUND

Although complex in nature, the pathophysiology of depression involves reduced or impaired neuroplastic capabilities. Restoring or enhancing neuroplasticity may serve as a treatment target for developing therapies for depression. Aerobic exercise (AEx) has antidepressant benefits and may enhance neuroplasticity in depression although the latter has yet to be substantiated. Therefore, we sought to examine the acute effect of AEx on neuroplasticity in depression.

METHODS

Sixteen individuals with (DEP; 13 female; age = 28.5 ± 7.3; Montgomery-Äsberg Depression Rating Scale [MADRS] = 21.3 ± 5.2) and without depression (HC; 13 female; age 27.2 ± 7.5; MADRS = 0.8 ± 1.2) completed three experimental visits consisting of 15 min of low intensity AEx (LO) at 35% heart rate reserve (HRR), high intensity AEx (HI) at 70% HRR, or sitting (CON). Following AEx, excitatory paired associative stimulation (PAS25ms) was employed to probe neuroplasticity. Motor evoked potentials (MEP) were assessed via transcranial magnetic stimulation before and after PAS25ms to indicate acute changes in neuroplasticity.

RESULTS

PAS25ms primed with HI AEx led to significant increases in MEP amplitude compared to LO and CON. HI AEx elicited enhanced PAS25ms-induced neuroplasticity for up to 1-h post-PAS. There were no significant between-group differences.

CONCLUSION

HI AEx enhances PAS measured neuroplasticity in individuals with and without depression. HI AEx may have a potent influence on the brain and serve as an effective primer, or adjunct, to therapies that seek to harness neuroplasticity.

Psychotomimetic compensation versus sensitization

It is a paradox that psychotomimetic drugs can relieve symptoms that increase risk of and cooccur with psychosis, such as attention and motivational deficits (e.g., amphetamines), pain (e.g., cannabis) and symptoms of depression (e.g., psychedelics, dissociatives). We introduce the ideas of psychotomimetic compensation and psychotomimetic sensitization to explain this paradox. Psychotomimetic compensation refers to a short-term stressor or drug-induced compensation against stress that is facilitated by engagement of neurotransmitter/modulator systems (endocannabinoid, serotonergic, glutamatergic and dopaminergic) that mediate the effects of common psychotomimetic drugs. Psychotomimetic sensitization occurs after repeated exposure to stress and/or drugs and is evidenced by the gradual intensification and increase of psychotic-like experiences over time. Theoretical and practical implications of this model are discussed.

Elevated Specific Pro-Inflammatory Cytokines in Peripheral Circulation Indicate an Increased Risk of Anxiety and Depression in Rosacea

Objective

Pro-inflammatory cytokines mediate the course of rosacea, anxiety, and depression through various means such as immunity and inflammation. This study aims to further explore the relationship between rosacea, anxiety, and depression through changes in the levels of pro-inflammatory cytokines.

Methods

280 rosacea patients were included in the rosacea group, divided into: rosacea without mental disorders, rosacea with anxiety, rosacea with depression, and rosacea with combined anxiety and depression. The mental control group included 210 anxiety and depression patients, divided into: anxiety, depression, and combined anxiety and depression. The healthy control group consisted of 70 healthy individuals. Serum specimens were collected and ELISA was used to detect major pro-inflammatory cytokines. CEA, IGA, GFSS, RosaQoL, HAMA, and HAMD-24 were used for the diagnosis and severity assessment of rosacea and anxiety and depression.

Results

This study primarily used the Chi-Square test, Kruskal-Wallis H-test, generalized linear model, and binary logistic regression to evaluate the data. IL-1β, IL-17, and IL-8 levels in rosacea patients and anxiety/depression patients were higher than those in the healthy population (P<0.001), and TNF-α levels in rosacea patients were higher than those in the healthy population (P<0.001). There was an interaction between rosacea, anxiety, and depression in terms of IL-1β, IL-17, and IL-8 levels (P<0.001). Elevated levels of IL-1β, IL-17, and IL-8 are positively correlated with anxiety and depression in rosacea (all P<=0.05).

Conclusion

It was confirmed that the elevated levels of IL-1β, IL-17, and IL-8 are positively correlated with the onset of anxiety and depression in rosacea. The interaction of the above inflammatory factors suggests a possible common inflammatory mechanism in the coexistence of rosacea and mental disorders. TNF-α only increased in patients with rosacea, combined with the skin-to-mental irreversible phenomenon, indicating that this cytokine may be a key and potential therapeutic target for the onset of rosacea.

From movement to motivation: a proposed framework to understand the antidepressant effect of exercise

Depression is the leading cause of disability worldwide, exerting a profound negative impact on quality of life in those who experience it. Depression is associated with disruptions to several closely related neural and cognitive processes, including dopamine transmission, fronto-striatal brain activity and connectivity, reward processing and motivation. Physical activity, especially aerobic exercise, reduces depressive symptoms, but the mechanisms driving its antidepressant effects are poorly understood. Here we propose a novel hypothesis for understanding the antidepressant effects of exercise, centred on motivation, across different levels of explanation. There is robust evidence that aerobic exercise decreases systemic inflammation. Inflammation is known to reduce dopamine transmission, which in turn is strongly implicated in effort-based decision making for reward. Drawing on a broad range of research in humans and animals, we propose that by reducing inflammation and boosting dopamine transmission, with consequent effects on effort-based decision making for reward, exercise initially specifically improves 'interest-activity' symptoms of depression-namely anhedonia, fatigue and subjective cognitive impairment - by increasing propensity to exert effort. Extending this framework to the topic of cognitive control, we explain how cognitive impairment in depression may also be conceptualised through an effort-based decision-making framework, which may help to explain the impact of exercise on cognitive impairment. Understanding the mechanisms underlying the antidepressant effects of exercise could inform the development of novel intervention strategies, in particular personalised interventions and boost social prescribing.

The relationship between depression and relative fat mass (RFM): A population-based study

BACKGROUND

Relative fat mass (RFM) is a novel indicator for measuring body fat. The relationship between RFM and depression was explored using National Health and Nutrition Examination Survey (NHANES) data from 2005 to 2018.

METHODS

A general statistical description of the population included in the study was performed, and logistic analyses were used to explore the association between body mass index (BMI), waist circumference (WC), RFM and depression. Sensitivity analyses and restricted cubic spline (RCS) were also conducted to investigate the association between RFM and depression.

RESULTS

A total of 28,836 participants were included in the study. In multivariate models, all obesity indices were associated with depression (P < 0.001). An increase of 1 SD in BMI, WC, and RFM was associated with a respective increased risk of depression of 2.3 %, 1.0 %, and 3.3 %. Excluding those taking antidepressants, the risk of depression was OR 1.88 (95 % CI: 1.26-2.79) for those with RFM in the highest quartile compared with those in the lowest quartile. After Inverse probability of weighting (IPW), the risk of depression in individuals with RFM in the highest quartile compared with individuals in the lowest quartile was 2.62 (95 % CI: 2.21-3.09). The RCS showed a possible nonlinear relationship between RFM and depression.

CONCLUSIONS

RFM is associated with depression, suggesting that attention to RFM may be helpful for depression research.

[Correlation between physical activity and the symptoms of depression in senior centers in Lima, Peru]

BACKGROUND AND OBJECTIVE

Depression in the elderly is a growing problem, and exercise is a strategy to prevent it. We aim to identify the correlation between scores obtained in the Geriatric Depression Scale - 15 items (GDS-15) for depressive symptomatology and Metabolic equivalent of task (MET) obtained in the International Physical Activity Questionnaire - Short Form (IPAQ-S) for physical activity in aged attending senior centers in a district of Lima, Peru.

METHODS

We conducted a cross-sectional study in three senior centers in Miraflores, Lima, Peru. Participants (n=158) completed a three-part questionnaire, including a sociodemographic survey to collect general participant data, the GDS-15 to assess the level of depressive symptomatology, and the IPAQ-S to evaluate the amount of physical activity performed in the last week.

RESULTS

A mild but significant inverse linear correlation was identified between the GDS-15 score and METs obtained in the IPAQ-S (rho=-0.213, p=0.007). Moderate to severe depressive symptomatology decreased with a higher level of physical activity: 4.3% low level, 3.3% moderate level, and no cases in those with vigorous activity; however, these differences were not significant (p=0.541, Kendall's Tau B test). CONCLUSIóN: The results showed that individuals with moderate to severe depressive symptoms show a lower level of depressive symptoms in relation to the degree of physical activity carried out in the last week.

Mixed reality technology for older adults: Evaluating the impact of a novel virtual humanoid coach in a community-based physical exercise program in the Philippines

Physical inactivity among older adults remains a global burden, leading to a variety of health challenges and even mortality. This study evaluated the impact of a novel virtual humanoid coach-driven physical exercise program among older adults. A non-randomized (quasi) experimental research was conducted in two community senior centers. The recruited participants (n = 130) were primarily female older adults with a mean age of 66.40 and agreed to be purposively assigned either experimental or control groups. Trained healthcare providers performed health assessments in three time points using valid and reliable tools. Descriptive statistics, t-tests, and RM-ANOVA were used to quantitatively analyze the data using SPSS version 22. There are significant mean differences between the groups across all functional capacity assessments and Time 2-3 assessment of sleep quality. RM-ANOVA revealed significant differences in physical assessment over time between the two groups. The analyses of time and group interaction revealed significant improvement in health assessments among the members of the mixed reality group compared to the traditional groups. The impact of virtual coaches in community-based enhancing physical activity programs is comparable to the traditional mode and introduces a novel approach to promoting physical activity among older adults.

Influence of Metabolic Dysregulation in the Management of Depressive Disorder-Narrative Review

Depressive disorders are heterogeneous in nature, and their global reach makes them the cause of suffering for a million individuals worldwide. Standard treatment does not work for one in three people, and side effects can significantly reduce the quality of life. A multidisciplinary approach allows for a broader insight into the nature of the disease, given its complex etiology. One of its elements is the hypothesis of inflammation, which also accompanies obesity-related disease. Obesity and depression interact, causing many researchers to develop new non-pharmacological treatment methods for both diseases. One suggestion is physical exercises that have great potential to be used in clinical practice. They can exert changes on the central nervous system and thus modulate mood. Another is diet, which concentrates on active molecules that also affect the central nervous system (CNS). There is an urgent need to create appropriate criteria and recommendations that systematize existing knowledge and allow it to be used in practice. There is an urgent need to create appropriate criteria and recommendations that systematize existing knowledge and allow it to be used in practice.

Pro-inflammatory cytokines in stress-induced depression: Novel insights into mechanisms and promising therapeutic strategies

Stress-mediated depression is one of the common psychiatric disorders with a high prevalence and suicide rate, there is a lack of effective treatment. Accordingly, effective treatments with few adverse effects are urgently needed. Pro-inflammatory cytokines (PICs) may play a key role in stress-mediated depression. Thereupon, both preclinical and clinical studies have found higher levels of IL-1β, TNF-α and IL-6 in peripheral blood and brain tissue of patients with depression. Recent studies have found PICs cause depression by affecting neuroinflammation, monoamine neurotransmitters, hypothalamic pituitary adrenal axis and neuroplasticity. Moreover, they play an important role in the symptom, development and progression of depression, maybe a potential diagnostic and therapeutic marker of depression. In addition, well-established antidepressant therapies have some relief on high levels of PICs. Importantly, anti-inflammatory drugs relieve depressive symptoms by reducing levels of PICs. Collectively, reducing PICs may represent a promising therapeutic strategy for depression.

Healthy lifestyle and the risk of depression recurrence requiring hospitalisation and mortality among adults with pre-existing depression: a prospective cohort study

BACKGROUND

Although lifestyle-based treatment approaches are recommended as important aspects of depression care, the quantitative influence of aggregated healthy lifestyles on depression recurrence and mortality remains unknown.

OBJECTIVE

To investigate the association between healthy lifestyle and the risks of first-time hospitalisation for recurrent depression and mortality.

METHODS

26 164 adults with depression (mean (SD) age, 56.0 (7.9) years) were included from UK Biobank between 2006 and 2010 and followed up until 2022. Depression was defined as a physician's diagnosis in hospital admissions or the use of prescribed antidepressant medication. A weighted healthy lifestyle score (HLS) was calculated based on smoking, alcohol consumption, diet, sleep pattern, physical activity, social health, employment status and greenspace interaction.

FINDINGS

Over a 13.3-year follow-up, 9740 cases of first-time hospitalisation due to depression recurrence and 1527 deaths were documented. Compared with the lowest HLS tertile, the highest tertile was associated with a 27% lower risk (HR=0.73, 95% CI 0.69 to 0.77) of first-time hospitalisation for depression recurrence and a 22% (HR=0.78, 95% CI 0.68 to 0.91) lower risk of mortality among adults with depression. Lower risks of first-time hospitalisation for depression recurrence were observed among those who smoked less, drank more alcohol, followed healthier diets and sleep patterns, spent more time employed in current job or had greater exposure to greenspace.

CONCLUSION AND IMPLICATIONS

Greater adherence to healthy lifestyle was associated with a lower risk of hospitalisation and mortality among adults with pre-existing depression. Incorporating behaviour modification as an essential part of clinical practice for depressed patients could complement medication-based therapies.

Influencing Factors on the Efficacy of Aerobic Exercise Therapy in Depression: A Single-Centre Cross-Sectional Study

BACKGROUND

Aerobic exercise therapy can improve brain function and promote positive emotions in patients with depression. This study aims to improve the efficacy of aerobic exercise therapy in depression by investigating the influencing factors therein.

METHODS

This study conducted a single-centre cross-sectional analysis of clinical data from 211 depression patients who received aerobic exercise therapy at Heze Mudan People's Hospital from May 2021 to May 2023. After excluding 10 patients who did not meet the inclusion criteria, the final cohort included 201 patients. The clinical data of patients with effective treatment and patients with ineffective treatment were collected, such as socio-demographic characteristics, disease status, depression degree, treatment compliance, and social support. Binary Logistic regression was used to analyze the factors affecting the clinical efficacy of aerobic exercise therapy in patients.

RESULTS

Among the 201 patients, the effective and ineffective rates of aerobic exercise therapy were 80.10% (161/201) and 19.90% (40/201), respectively. When analysed as groups, no significant differences were observed between the effective group (EG) and ineffective group (IG) regarding gender, body mass index, course of depression, age of first onset, mental symptoms, years of education, personal income, or marital status (p > 0.05). However, the EG exhibited a reduced probability of family history of mental illness, smoking history, and severity of depression (p < 0.05), along with higher treatment compliance and Social Support Rating Scale (SSRS) scores compared to the IG (p < 0.05). Binary logistic regression analysis revealed that smoking history, family history of mental illness, treatment compliance, depression, and SSRS score were the primary influencing factors on the efficacy of aerobic exercise therapy (p < 0.05).

CONCLUSION

Smoking history, family history of mental illness, treatment compliance, severity of depression, and social support are the primary influencing factors on the efficacy of aerobic exercise therapy in patients with depression. These factors should be emphasized during follow-up treatment to optimize the clinical treatment effect.

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.