Can physical exercise modulate cortisol level in subjects with depression? A systematic review and meta-analysis.

INTRODUCTION: Major depressive disorder (MDD) is a prevalent medical illness that is associated with chronic stress. Patients with MDD can show an imbalance in cortisol levels, which can be restored with the remission of symptoms. Physical exercise training has been used as a tool to promote changes in cortisol levels in healthy individuals. However, it is unknown if exercise can produce the same results in individuals with MDD. OBJECTIVE: To review evidence of cortisol changes after exercise training in individuals with MDD. METHODS: We conducted a search on PubMed, SciELO, LILACS, ISI Web of Knowledge, Scopus, and PsycInfo databases. Random effects meta-analysis was performed and standardized mean difference (SMD) effect size was calculated. Analyses of forest and funnel plots was conducted using Stata v.11.0 software. RESULTS: At first, 463 studies were obtained in the search. After completion of the selection procedure, five articles with seven analyses were included. Type of exercise, frequency of training, cortisol measurement, and type of control group were analyzed. There was a reduction of cortisol levels in the exercise group (SMD = -0.65, 95%CI 1.30-0.01). Moreover, sensitivity analysis and subgroup analyses revealed an effect of type (aerobic exercise) and frequency (five times per week) of exercise on reduction of cortisol levels. However, these results should be interpreted cautiously due to the small number of studies and a substantial heterogeneity among them. CONCLUSION: Physical exercise promotes a reduction in cortisol levels in individuals with MDD. However, this finding can be influenced by type of exercise, weekly frequency, and type of cortisol measurement.

Can physical exercise modulate cortisol level in subjects with depression? A systematic review and meta-analysis / O exercício físico pode modular os níveis de cortisol em indivíduos com depressão? Uma revisão sistemática e metanálise

Abstract Introduction: Major depressive disorder (MDD) is a prevalent medical illness that is associated with chronic stress. Patients with MDD can show an imbalance in cortisol levels, which can be restored with the remission of symptoms. Physical exercise training has been used as a tool to promote changes in cortisol levels in healthy individuals. However, it is unknown if exercise can produce the same results in individuals with MDD. Objective: To review evidence of cortisol changes after exercise training in individuals with MDD. Methods: We conducted a search on PubMed, SciELO, LILACS, ISI Web of Knowledge, Scopus, and PsycInfo databases. Random effects meta-analysis was performed and standardized mean difference (SMD) effect size was calculated. Analyses of forest and funnel plots was conducted using Stata v.11.0 software. Results: At first, 463 studies were obtained in the search. After completion of the selection procedure, five articles with seven analyses were included. Type of exercise, frequency of training, cortisol measurement, and type of control group were analyzed. There was a reduction of cortisol levels in the exercise group (SMD = −0.65, 95%CI 1.30-0.01). Moreover, sensitivity analysis and subgroup analyses revealed an effect of type (aerobic exercise) and frequency (five times per week) of exercise on reduction of cortisol levels. However, these results should be interpreted cautiously due to the small number of studies and a substantial heterogeneity among them. Conclusion: Physical exercise promotes a reduction in cortisol levels in individuals with MDD. However, this finding can be influenced by type of exercise, weekly frequency, and type of cortisol measurement.

Resumo Introdução: A depressão maior (DM) é uma doença associada ao estresse crônico que pode apresentar um desequilíbrio nos níveis de cortisol, podendo ser recuperado com a remissão dos sintomas. O exercício tem sido utilizado como uma ferramenta para promover mudanças nos níveis de cortisol em indivíduos saudáveis. No entanto, não se sabe se o exercício produz os mesmos resultados em indivíduos com DM. Objetivo: Revisar evidências de alterações dos níveis de cortisol após o exercício em indivíduos com DM. Métodos: Foi realizada busca nas bases de dados PubMed, SciELO, LILACS, ISI Web of Knowledge, Scopus e PsycInfo. Procedeu-se a metanálise com o cálculo do tamanho do efeito da diferença de média padronizada. Foi utilizado o software Stata v.11.0. Resultados: Foram obtidos na busca 463 estudos. Após o procedimento de seleção, cinco artigos com sete análises foram incluídos. O tipo de exercício, frequência de treinamento, tipo de medida do cortisol e tipo de grupo controle foram analisados como subgrupos. Houve uma redução dos níveis de cortisol no grupo de exercício. Além disso, a análise de sensibilidade e análises de subgrupos revelaram um efeito do tipo (exercício aeróbico) e da frequência (cinco vezes por semana) de exercício na redução dos níveis de cortisol. No entanto, esses resultados devem ser interpretados com cautela, devido ao pequeno número de estudos e uma heterogeneidade substancial entre eles. Conclusão: O exercício promove redução dos níveis de cortisol em indivíduos com DM. No entanto, esse achado pode ser influenciado pelo tipo de exercício, medida do cortisol e frequência semanal.

Impaired cognition in depression and Alzheimer (AD): a gradient from depression to depression in AD.

OBJECTIVE: To assess cognition in major depressed (MD), Alzheimer's disease (AD), and depression in AD elderly. METHOD: Subjects were evaluated by Mini Mental, Rey Auditory Verbal Learning Test, Rey Complex Figure, Digit Span, Similarities, Trail Making A/B, Verbal Fluency and Stroop. One-way ANOVA and multivariate models were used to compare the performance of each group on neuropsychological tests. RESULTS: We evaluated 212 subjects. Compared to MD, attention, working memory, processing speed and recall showed significantly better in controls. Controls showed significantly higher performance in all cognitive measures, except in attention compared to AD. Verbal fluency, memory, processing speed and abstract reasoning in MD was significantly higher compared to AD. AD was significantly better in general cognitive state than depression in AD. All other cognitive domains were similar. CONCLUSION: A decreasing gradient in cognition appeared from the control to depression in AD, with MD and AD in an intermediate position.

Impaired cognition in depression and Alzheimer (AD): a gradient from depression to depression in AD / Alterações cognitivas na depressão e na doença de Alzheimer: um gradiente da depressão até a doença de Alzheimer

Objective To assess cognition in major depressed (MD), Alzheimer's disease (AD), and depression in AD elderly. Method Subjects were evaluated by Mini Mental, Rey Auditory Verbal Learning Test, Rey Complex Figure, Digit Span, Similarities, Trail Making A/B, Verbal Fluency and Stroop. One-way ANOVA and multivariate models were used to compare the performance of each group on neuropsychological tests. Results We evaluated 212 subjects. Compared to MD, attention, working memory, processing speed and recall showed significantly better in controls. Controls showed significantly higher performance in all cognitive measures, except in attention compared to AD. Verbal fluency, memory, processing speed and abstract reasoning in MD was significantly higher compared to AD. AD was significantly better in general cognitive state than depression in AD. All other cognitive domains were similar. Conclusion A decreasing gradient in cognition appeared from the control to depression in AD, with MD and AD in an intermediate position. .

Objetivo Avaliar a cognição em idosos com depressão Maior (DM), doença de Alzheimer (DA) e Depressão na DA. Método Utilizou-se o Mini Mental, Rey Auditory Verbal Learning Test, Figura de Rey, Dígitos, Semelhanças, Trail Making A/B, Fluência Verbal e Stroop. ANOVA one-way e modelos multivariados foram utilizados para comparar o desempenho dos grupos. Resultados Foram avaliados 212 sujeitos. Comparado com DM, controles apresentaram desempenho significativamente melhor na atenção, memória de trabalho, velocidade de processamento e evocação. Os controles apresentaram desempenho significativamente superior em todas as avaliações, exceto na atenção comparado com DA. Fluência verbal, memória, velocidade de processamento e raciocínio abstrato na DM foi significativamente maior comparado com DA. DA foi significativamente melhor no estado cognitivo geral comparado a depressão na DA, os outros domínios foram semelhantes. Conclusão Observou-se um gradiente decrescente na cognição dos controles até a Depressão na DA, com os grupos DM e DA com desempenhos intermediários. .

Relação entre esporte, resiliência, qualidade de vida e ansiedade / Relationship between sport, resilience, quality of life, and anxiety

CONTEXTO: A prática de esportes apresenta efeitos benéficos para o sistema cardiorrespiratório e muscular, para a função comportamental e para a saúde mental. Entretanto, não se sabe o papel do esporte de alto nível na construção de perfis resilientes. OBJETIVOS: O objetivo do presente estudo foi comparar resiliência, qualidade de vida e ansiedade de ex-atletas de alto rendimento de ginástica artística, de outros esportes e indivíduos não atletas. MÉTODOS: Participaram do estudo ex-atletas de ginástica artística (n = 17), de outras modalidades (n = 15) e indivíduos não atletas (n = 30). Foram utilizadas as seguintes escalas e questionários: Inventário de Depressão de Beck, Inventário de Ansiedade Traço e Estado (IDATE T e E), Escala de Resiliência e Questionário de Qualidade de Vida SF-36®. RESULTADOS: Foi observada diferença significativa entre os grupos na resiliência (p = 0,001), IDATE T (p = 0,049), estado geral de saúde (p = 0,044) e aspectos emocionais da qualidade de vida (p = 0,002), indicando que o grupo de ex-atletas apresentou maior resiliência e melhor aspecto emocional que não atletas. CONCLUSÃO: O esporte parece favorecer a construção de um perfil mais resiliente, além de contribuir para melhor qualidade de vida.

BACKGROUND: The practice of sports has beneficial effects on cardiorespiratory and muscle systems, behavioral function, and mental health. However, the influence of elite sports on the development of resilience is not known. OBJECTIVES: The objective of the present study was to compare resilience, quality of life, and anxiety in ex-athletes of artistic gymnastic and other sports with non-athletic individuals. METHODS: Ex-artistic gymnastics athletes (n = 17), ex-athletes of other sports (n = 15), and non-athletic individuals (n = 30) were recruited. Structured anamneses as well as depression, anxiety, resilience and quality of life scales were applied in all groups. RESULTS: Significant difference between groups were found in resilience (p = 0.001), anxiety (p = 0.049), general health status (p = 0.044), and emotional aspects of quality of life (p = 0.002). Ex-athletes showed greater resilience and better quality of life regarding to emotional aspects than non-athletes. DISCUSSION: Sport seems to contribute to the development of a more resilient profile and better quality of life.