Resistance training and depressive symptoms in subcortical vascular cognitive impairment: secondary results of a randomised clinical trial

Vollständiger Abstract

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Objectives Cerebral small vessel disease (CSVD) is associated with depressive symptoms. Exercise may reduce depressive symptoms for people with CSVD. We examined the effects of progressive resistance training (PRT) on depressive symptoms among adults with CSVD and mild cognitive impairment (ie, subcortical vascular cognitive impairment (SVCI)). Methods A single-site, 12-month, parallel group, secondary analysis of a randomised controlled trial (ClinicalTrials.gov identifier: NCT02669394 ). Community-dwelling adults (aged 55+ years) with SVCI were randomly allocated to 12 months of twice-weekly (1) PRT using Keiser pressurised air machines and free weights or (2) a balance and tone control group (BAT), which included stretches and light exercises. Our main outcome was depressive symptoms, indexed using the 10-item Centres for Epidemiologic Studies Depression Scale (CESD-10) at baseline, 6 months (midpoint) and 12 months (end of intervention). We examined treatment effects using a linear mixed model with restricted maximum likelihood estimation and followed the intention-to-treat principle. Covariates included baseline CESD-10 score, sociodemographic and health factors. Results 91 participants were randomised (PRT=45; BAT=46). Mean age was 75 years (SD=6 years), 65.2% were female and mean CESD-10 score at baseline was 7.45 (SD=5.91). CESD-10 scores were significantly lower for PRT compared with BAT at 6 months (estimated mean difference: −3.17; 95% CI −6.12 to −0.22; p = 0.036) and 12 months (estimated mean difference: −4.25; 95% CI −7.23 to −1.27; p=0.006). Conclusions Following 12 months of PRT, adults with SVCI had fewer depressive symptoms than a BAT control group. Our results suggest PRT should be considered for adults with mild to moderate SVCI in order to mitigate depressive symptoms.