Does a physical activity program in the nursing home impact on depressive symptoms? A generalized linear mixed-model approach. (3rd June 2018)

• Record Type: Journal Article
• Authors: Diegelmann, Mona; Jansen, Carl-Philipp; Wahl, Hans-Werner; Schilling, Oliver K.; Schnabel, Eva-Luisa; Hauer, Klaus
• Is Part Of: Aging & mental health. Volume 22:Number 6(2018)
• Page Start: 784
• Page End: 793
• Publication Date: 2018-06-03
• Subjects: Nursing home -- depressive symptoms -- physical activity intervention -- multilevel models -- generalized linear mixed-models; Older people -- Mental health -- Periodicals; Geriatric psychiatry -- Periodicals; Older people -- Psychology -- Periodicals; Aging -- Psychological aspects -- Periodicals; Aged -- psychology -- periodicals; Mental Health -- periodicals; Mental Health Services -- periodicals; Aging -- psychology -- periodicals; Aged, 80 and over -- psychology -- periodicals; 618.97689
• DOI: 10.1080/13607863.2017.1310804
• Languages: English
• ISSNs: 1360-7863

Abstract

ABSTRACT: Objectives: Physical activity (PA) may counteract depressive symptoms in nursing home (NH) residents considering biological, psychological, and person-environment transactional pathways. Empirical results, however, have remained inconsistent. Addressing potential shortcomings of previous research, we examined the effect of a whole-ecology PA intervention program on NH residents' depressive symptoms using generalized linear mixed-models (GLMMs). Method: We used longitudinal data from residents of two German NHs who were included without any pre-selection regarding physical and mental functioning ( n = 163, M age = 83.1, 53–100 years; 72% female) and assessed on four occasions each three months apart. Residents willing to participate received a 12-week PA training program. Afterwards, the training was implemented in weekly activity schedules by NH staff. We ran GLMMs to account for the highly skewed depressive symptoms outcome measure (12-item Geriatric Depression Scale–Residential ) by using gamma distribution. Results: Exercising ( n = 78) and non-exercising residents ( n = 85) showed a comparable level of depressive symptoms at pretest. For exercising residents, depressive symptoms stabilized between pre-, posttest, and at follow-up, whereas an increase was observed for non-exercising residents. The intervention group's stabilization in depressive symptoms was maintained at follow-up, but increased further for non-exercising residents. Conclusion: Implementing an innovative PA intervention appears to be a promising approach to prevent the increase of NH residents' depressive symptoms. At the data-analytical level, GLMMs seem to be a promising tool for intervention research at large, because all longitudinally available data points and non-normality of outcome data can be considered.