Research ArticleOriginal Research

Home-Based Activity Program for Older People With Depressive Symptoms: DeLLITE–A Randomized Controlled Trial

Ngaire Kerse, Karen J. Hayman, Simon A. Moyes, Kathy Peri, Elizabeth Robinson, Anthony Dowell, Gregory S. Kolt, C. Raina Elley, Simon Hatcher, Liz Kiata, Janine Wiles, Sally Keeling, John Parsons and Bruce Arroll
The Annals of Family Medicine May 2010, 8 (3) 214-223; DOI: https://doi.org/10.1370/afm.1093

Article Figures & Data

Figures

  • Figure 1.
    Figure 1.

    Flow chart of participants through the DeLLITE trial.

    a Depression criteria: any 2 yes responses to the following: (1) During the past month have you often been bothered by feeling down, depressed or hopeless? (2) During the past month have you often been bothered by having little interest or pleasure in doing things? (3) Answer if you responded yes to 1 or 2: Is this something with which you would like help?21
 b Completed outcome assessments, not withdrawn from the trial.
 c Completed all intervention visits.

  • Figure 2.
    Figure 2.
    Figure 2.
    Figure 2.
    Figure 2.

    Outcomes of a physical activity intervention compared with social control for older participants with depressive symptoms.

    Note: Horizontal bracket refers to the P value for the change over time, and vertical bracket refers to the P value for the differential change between the groups.
 GDS-15 = Geriatric Depression Scale; SF-36 MHC = Medical Outcomes Study Short Form 36-item mental health component subscale; NEADL=Nottingham Extended Activities of Daily Living Scale.
 a Higher score indicates greater function.
 b Higher score indicates better quality of life.
 c Lower score indicates better mood.

Tables

  • Table 1.

    Characteristics and Outcome Measures at Baseline for All Study Participants

    CharacteristicActivity n=97Social n=96Total N=193
    AMTS=Abbreviated Mental Test Score; GDS=Geriatric Depression Scale; ICD-10=International Classification of Diseases 10th edition; DSM-IV = Diagnostic and Statistical Manual 4th edition; CIDI=Composite International Diagnostic Interview; NEADL = Nottingham Extended Activities of Daily Living scale; SPPB = short physical performance battery; SF-36 PHC = Medical Outcomes Study Short Form 36-item physical health component subscale; SF-36 MHC = Medical Outcomes Study Short Form 36-item mental health component subscale.
    a Scores range from 0 to 10; higher score indicates greater cognition.
    b Scores range from 0 to 12; higher score indicates better function.
    c Scores range from 0 to 22; higher score indicates greater function.
    d Scores range from 0 to 4; higher score indicates greater function.
    e Scores range from 0 to 15; lower score indicates better mood.
    f Scores range from 0 to 100; higher score indicates better physical health-related quality of life.
    g Scores range from 0 to 100; higher score indicates better mental health-related quality of life.
    Female, No. (%)62 (63.9)51 (53.1)113 (58.5)
    Age mean (SD)81.4 (4.8)80.8 (3.9)81.1 (4.4)
    Widowed, No. (%)46 (47.4)42 (43.8)88 (45.6)
    Lives alone, No. (%)54 (55.7)46 (47.9)100 (51.8)
    Perception of enough money, No. (%)97 (100)95 (99.0)192 (99.5)
    Diagnoses, No. (%)
        Asthma12 (12.4)14 (14.6)26 (13.5)
        Diabetes12 (12.4)11 (11.5)23 (11.9)
        Arthritis/rheumatism62 (63.9)61 (63.5)123 (63.7)
        Epilepsy1 (1.0)1 (1.0)2 (1.0)
        Parkinson’s Disease4 (4.1)2 (2.1)6 (3.1)
        Heart attack/angina25 (25.8)29 (30.2)54 (28.0)
        Stroke18 (18.6)10 (10.4)28 (14.5)
        Hip fracture6 (6.2)6 (6.3)12 (6.2)
    Hospitalized in the last 12 months, No. (%)32 (33.0)33 (34.4)65 (33.7)
    Total prescription medications, mean (SD), No.6.7 (3.7)6.2 (3.8)6.5 (3.7)
    ICD-10 prior depression, No. (%)22 (22.7)30 (31.3)52 (26.9)
    ICD-10 current depression, No. (%)3 (3.1)5 (5.2)8 (4.1)
    ICD-10 severe depression, No. (%)2 (2.1)5 (5.2)7 (3.6)
    DSM- IV diagnosis, No. (%)23 (23.7)29 (30.2)52 (26.9)
        Depression symptoms, GDS >421 (22)35 (36.5)56 (29.0)
        Any depression criteria met on CIDI29 (29.9)40 (41.7)69 (35.8)
        Any depression criteria met on CIDI or GDS-15 score >442 (43.3)60 (63.2)102 (53.1)
    Antidepressants, No. (%)28 (28.9)23 (24.0)51 (26.4)
        Short-acting sedatives or benzodiazepines24 (24.7)22 (22.9)46 (23.8)
        Long-acting benzodiazepine2 (2.1)2 (2.1)4 (2.1)
    AMTS <7, No. (%)a3 (3.1)3 (3.1)6 (3.1)
    SPPB score, mean (SD)b7.5 (3.0)7.6 (2.9)7.6 (3.0)
    NEADL score, mean (SD)c18.2 (3.1)17.9 (3.7)18.0 (3.4)
    Chair stand test, mean (SD)d1.5 (1.2)1.6 (1.2)1.5 (1.2)
    GDS-15 score, mean (SD)e3.4 (2.7)4.0 (2.8)3.7 (2.7)
    SF-36 PHC score, mean (SD)f39.0 (11.7)39.3 (11.0)39.1 (11.3)
    SF-36 MHC score, mean (SD)g51.2 (9.3)48.7 (9.9)50.0 (9.7)
    Physical activity moderate/vigorous, mean (SD), min/wk315 (428)379 (500)347 (465)
    Any falls in last year, No. (%)43 (44.3)42 (43.8)85 (44.0)
  • Table 2.

    Outcomes of the DeLLITE Trial: Function, Mood, Quality of Life, Falls, and Physical Activity

    Change
    OutcomeBaseline0–6 Mo6 Mo6–12 Mo12 MoTime-Group Interaction F StatisticTime-Group Interaction P ValueaTime F StatisticTime P Valuea
    GDS-15 = Geriatric Depression Scale; MHC = SF-36 MHC = Medical Outcomes Study Short Form 36-item mental health component subscale; NEADL = Nottingham Extended Activities of Daily Living Scale; SF-36 PHC = Medical Outcomes Study Short Form 36-item physical health component subscale; SPPB = Short physical performance battery;
    a P values are for generalized linear mixed models using time as a repeated measure.
    b Scores range from 0 to 22; higher score indicates greater function.
    c Scores range from 0 to 12; higher score indicates better function.
    d Scores range from 0 to 15; lower score indicates better mood.
    e Scores range from 0 to 100; higher score indicates better physical health-related quality of life.
    f Scores range from 0 to 100; higher score indicates better mental health-related quality of life.
    Function
    NEADL score, mean (SD)b0.00.9976.19.003
        Physical activity18.2 (0.3)−0.1 (0.2)18.0 (0.3)−0.2 (0.1)17.8 (0.3)
        Social control17.9 (0.4)−0.0 (0.2)17.9 (0.4)−0.2 (0.2)17.8 (0.4)
    SPPB score, mean (SD)c1.30.2741.38.255
        Physical activity7.5 (0.3)0.3 (0.2)7.8 (0.3)−0.2 (0.2)7.5 (0.3)
        Social control7.6 (0.3)−0.0 (0.2)7.6 (0.3)−0.2 (0.2)7.5 (0.3)
    Mood
    GDS-15 score, mean (SD)d0.09.91618.49<.001
        Physical activity3.4 (0.3)−0.9 (0.2)2.4 (0.2)−0.0 (0.2)2.4 (0.2)
        Social control4.0 (0.3)−0.9 (0.3)3.1 (0.3)−0.1 (0.2)2.8 (0.3)
    GDS-15 score >4, No. (%)1.32.2694.30.015
        Physical activity21 (21.6)(−8.9)12 (12.8)(4.3)16 (17.0)
        Social control35 (36.5)(−9.3)25 (27.2)(−7.2)18 (20.7)
    Health-related quality of life
    SF-36 PHC score, mean (SD)e2.73.0680.27.761
        Physical activity39.0 (1.2)0.6 (0.9)39.5 (1.2)−1.2 (0.8)38.3 (1.2)
        Social control39.3 (1.1)−1.5 (0.9)37.9 (1.3)0.9 (0.7)39.4 (1.2)
    SF-36 MHC score, mean (SD)f1.44.24020.36<.001
        Physical activity51.2 (0.9)3.6 (0.9)54.7 (0.7)0.7 (0.7)55.4 (0.7)
        Social control48.7 (1.0)4.5 (1.0)53.7 (0.9)−1. 6 (0.9)52.7 (0.9)
    Physical activity
    Auckland Heart Study Physical Activity Questionnaire, walking, mean (SD), min/wk2.96.0541.82.165
        Physical activity121.0 (13.8)41.2 (15.8)162.3 (16.0)−33.5 (16.4)128.8 (14.0)
        Social control124.5 (16.1)−13.3 (16.1)115.3 (13.2)3.5 (13.9)119.5 (16.1)
    Auckland Heart Study Physical Activity Questionnaire, moderate to vigorous, mean (SD), min/wk0.74.4796.43.002
        Physical activity315.4 (43.5)−13.0 (41.6)302.3 (33.9)−38.8 (35.5)263.6 (38.2)
        Social control379.0 (51.0)−70.0 (43.6)309.0 (38.2)−87.9 (27.4)221.1 (31.7)

Additional Files

  • The Article in Brief

    Home-Based Activity Program for Older People With Depressive Symptoms: DeLLITE--A Randomized Controlled Trial

    Ngaire Kerse , and colleagues

    Background Both poor physical functioning and low levels of social contact can contribute to depression in older people. This study tested a home-based physical activity program that included social visits.

    What This Study Found Social visiting was just as successful as a home-based physical activity program at improving mood and quality of life. The study involved 193 people aged 75 and older with depressive symptoms recruited from primary care practices in Auckland, New Zealand. Those who received an individualized physical activity program as well as those who received social visits showed improvements in quality-of-life measures related to mood and mental health.

    Implications

    • Social contact may be as effective as physical activity in improving mood and quality of life for those with depressive symptoms.
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