Researchers examine the role of exercise on anxiety, depression and quality of life in seniors

Depression, anxiety and quality of life scores in seniors after an endurance exercise program.

Antunes HK, Stella SG, Santos RF, Bueno OF, Mello MT.Rev Bras Psiquiatr. 2005 Dec;27(4):266-271.

Writing in the medical journal Revista Brasileira de Psiquiatria, researchers sought to examine 46 sedentary seniors aged 60-75. The seniors were divided into two groups. One group began an aerobic exercise regiment, the other group (the control group) did not.

The researchers stated from the study abstract: “Mood disorders are a frequent problem in old age, and their symptoms constitute an important public health issue. These alterations affect the quality of life mainly by restricting social life. The participation in a regular exercise program is an effective way of reducing or preventing the functional decline associated with aging.”

“Comparing the groups after the study period, we found a significant decrease in depressive and anxiety scores and an improvement in the quality of life in the experimental group, but no significant changes in the control group.”

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Researchers look at what makes people age successfully

Factors associated with the successful aging of the socially-active elderly in the metropolitan region of Porto Alegre. Rev Bras Psiquiatr. 2005 Dec;27(4):302-308. Moraes JF, Souza VB.

Writing in the medical journal Revista Brasileira de Psiquiatria, researchers studied some of the inhabitants of the metropolitan region of the Brazialian city Porto Alegre. What they sought to do was “identify the factors associated with aging of the socially-active elderly in the metropolitan region of Porto Alegre.”

What they concluded was: “Independence in performing daily life activities and autonomy, as well as satisfaction with family relations and friendships, were independent predictive factors of successful aging for both men and women.

For women in particular, there were various predictive factors: material comfort; feeling physically well; body image and appearance; self-esteem; positive feelings; interpersonal relationships; social support; participation in recreational activities;… spirituality; and beliefs.

The elderly maintain a relationship with themselves, with others and with their beliefs. Family is the main social support system.”

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Subclinical Hypothyroidism and Depression

Researchers writing in the Archives of Gerontology and Geriatrics say that “subclinical hypothyroidism increases the risk for depression and emphasize the importance of thyroid screening tests in the elderly.”

Study abstract
Chueire VB, Romaldini JH, Ward LS. Subclinical hypothyroidism increases the risk for depression in the elderly. Arch Gerontol Geriatr. 2007 Jan-Feb;44(1):21-8. Epub 2006 May 5.

In order to determine if subclinical hypothyroidism is a risk factor for depression in the elderly, a total of 323 individuals over 60 years old were interviewed using the Structured Clinical Interview for Diagnosis and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) for mood disturbances.

Patients were divided into Group I: 252 patients (184 females, 68 males; median age: 67 years, range: 60-89 years) with elevated serum thyrotropin (TSH) levels and Group II: 71 patients (45 females, 26 males; median age: 67 years, range: 60-92 years) with diagnosis of depression. Serum TSH and free thyroxine (fT4) were measured by sensitive assays. Thyroid antibodies were determined by IRMA. Depression was observed in 24 (9.5%)

Group I patients and was frequent in subclinical hypothyroidism patients (14/24 = 58.3%). On the other hand, elevated TSH levels were found in 22 (30.9%) Group II patients.

Depression was observed more frequently among individuals with subclinical (74/149 = 49.7%) hypothyroidism than among individuals with overt hypothyroidism (21/125 = 16.8%) (p < 0.001). Indeed, subclinical hypothyroidism increased the risk for a patient to present depression more than four times (OR = 4.886; 95% confidence interval = 2.768-8.627).

Our results demonstrate that subclinical hypothyroidism increases the risk for depression and emphasize the importance of thyroid screening tests in the elderly.

Melatonin

Melatonin is secreted by the pea-sized pineal gland in the center of our brains to regulate our sleep patterns. Our bodies make it from the well known sleep inducing amino acid tryptophan.

As we age we seem to produce less melatonin and this has been suggested as one of the reasons why our aging population has difficult sleeping patterns.

The decline of melatonin centers around age 45. The decline is usually a steep one. By age 60, we produce half the melatonin we did during our twenties and by the late seventies nearly none.

What is so important about sleep?
You probably do not need a long litany of medical articles to know that it is probably a pretty good idea to get a good night’s sleep.

The researchers of sleep have broken sleep up into five different stages, Stages I and II are the “light” sleep phases, Stage III and IV are the deep sleep cycles. Dreaming occurs during Rapid Eye Movement sleep (REM). It is during level IV sleep that our body re-energizes and most importantly that the immune system is stimulated. In treating patients with chronic pain, one of the very first things we do is take a history from the patient of their sleep patterns. Melatonin helps restore good sleep architecture. Without deep Stage IV sleep, healing becomes more difficult, there is a decrease in hormones and neurotransmitters produced that can give us a great quality of life.

If regulating sleep was all that melatonin did, that would be important enough to include it in an age management program.

But research has also suggested that melatonin may contribute to the following:
– Enhances the immune system as an anti-oxidant
– Positive effect on the aging process
– Reduce blood pressure
– Improves bowel symptoms
– Decrease cholesterol
– Increase the natural killer cell activity of the immune system
– Helps reset the circadian rhythm in jet lag

Will melatonin make you live longer?
Much has been made of the possibility of melatonin being a life extender. This is based on animal studies in rats and mice that showed a 20% increase in life span. Speculation centers on melatonin’s anti-oxidant properties. No human longevity studies have been reported to date.

The negatives of melatonin
No serious side effects have been reported in the short-term, and long-term effects are unknown. Melatonin is a hormone, and as such, it should be taken under a physician’s guidance.

Other Side Effects
Headaches
Stomach upset
Insomnia
Restlessness
Depression
Strange dreams

Selected Research

Intimacy, Urinary, and Depressive Problems In Women Who Have Partners With E.D.

Researchers writing in the medical journal World Journal of Urology say that FSD disorders, urinary symptoms and depressive symptoms are common in partners of men with ED.

From the study abstract
Shabsigh R, Anastasiades A, Cooper KL, Rutman MP. Female sexual dysfunction, voiding symptoms and depression: common findings in partners of men with erectile dysfunction. World J Urol. 2006 Nov 3

The researchers sought to “investigate the prevalence of female sexual dysfunction (FSD), urinary symptoms, and depressive symptoms in female partners of men presenting with erectile dysfunction (ED).”

Through a survey 73 women with male patients presenting with ED were surveyed using a questionnaire at their counterpart’s visit. Fifty of the women filled out the questionnaire sufficiently to be studied.

Of the 50 women, the average age was 44.8 years and 38 of the women reported being sexually active

The women reported the following sexual dysfunctions:

• anxiety/inhibition (26%)
• hypoactive desire (20%)
• arousal/lubrication difficulty (30%)
• orgasmic difficulty (24%)
• dyspareunia* (18%)
• incontinence during intercourse (8%)
• sexual dissatisfaction (34%)



In other questions the women reported:
Forty-one women (82%) rated sexual activity as an important part of their lives.
Urinary symptoms of frequency and urgency were reported by 18/50 (36%).
Depressive symptoms were present in 22/50 (44%).

The researchers noted that: “FSD disorders, urinary symptoms and depressive symptoms are common in partners of men with erectile dysfunction.”

*Note added: Painful intercourse

Older Men and Testosterone

This study is sponsored by University Hospital of North Norway
From the study abstract: “Male hypogonadism is a clinical situation characterized by a low serum testosterone level in combination with a diversity of symptoms and signs such as reduced libido and vitality, decreased muscle mass, increased fat mass and depression. Similar symptoms in combination with subnormal testosterone levels are seen in some elderly men. Similar symptoms in combination with subnormal testosterone levels are seen in some elderly men. Low testosterone levels are associated with known cardiovascular risk factors, and men with diabetes and stroke have lower testosterone levels than healthy men. Even though several publications have suggested that testosterone treatment in hypogonadal men may have beneficial effects, it is still uncertain if testosterone substitution in the aging man is indicated. Despite this uncertainty the sale of testosterone has increased enormously the last few years.

We hypothesize that older men with subnormal testosterone levels have a varying degree of dysfunction/symptoms both physically and mentally, and that these dysfunction/symptoms can be improved with testosterone treatment.

Read more about this study at clinicaltrial.gov