Impacts of Depressive Symptoms on the Effectiveness of a Theory-Driven Exercise Intervention Among Community-Dwelling (Pre)frail Older Adults.

Objectives: To investigate whether baseline depressive symptoms impacted the effectiveness of an exercise intervention among (pre)frail older adults.

Methods: This is a subanalysis of a stepped-wedge cluster randomized trial implementing an exercise intervention, with an application of the integration of the Health Belief Model, Theory of Planned Behavior, and Health Action Process Approach, among 149 community-dwelling (pre)frail older adults. The intervention effectiveness was examined by baseline depressive symptoms (depressive symptoms (n = 40) and non-depressive symptoms (n = 109).

Results: Intervention effects were observed among (pre)frail older adults regardless of baseline depressive symptoms on frailty, social function, as well as physical and mental quality of life (QoL). (Pre)frail people with depressive symptoms, compared to those without depressive symptoms, were likely to benefit more in muscle mass, muscle strength, lower extremity function, activities of daily living (ADLs), cognitive function, depressive symptoms, and physical QoL, but less in dynamic balance, instrumental ADLs (IADLs), and mental QoL.

Conclusions: These findings implicate that cognitive and psychological strategies should be integrated into exercise interventions among (pre)frail people with depressive symptoms to improve their functional independence and well-being.

Clinical implications: Interventions that accommodate depressive symptoms may result in improved outcomes for (pre)frail people with depressive symptoms.