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Late Life Depression, Postural Instability and Dyspnea: The He.s.i.o.d. Study (Hexameter Study in Older Depressed)

Published online by Cambridge University Press:  23 March 2020

M. Belvederi Murr ,
E. Nerozzi ,
N. Padula ,
C. Tacconi ,
A. Coni ,
L. Chiari ,
B. Assirelli ,
G. Toni ,
R. Chattat  and
T. Ferdinando
...Show all authors
M. Belvederi Murr
Affiliation:
Clinica Psichiatrica, Dinogmi, Genoa, Italy
E. Nerozzi
Affiliation:
School of Pharmacy, Biotechnology and Sport Science, Bologna, Italy
N. Padula
Affiliation:
Sport Science Professional, Private sector, Bologna, Italy
C. Tacconi
Affiliation:
University of Bologna, Health Sciences and Technologies-Interdepartmental Center for Industrial Research HST-ICIR, Bologna, Italy
A. Coni
Affiliation:
University of Bologna, Department of Electronics, Computer Science and Systems, Bologna, Italy
L. Chiari
Affiliation:
University of Bologna, Department of Electronics, Computer Science and Systems, Bologna, Italy
B. Assirelli
Affiliation:
Primary Care Physician, Private practice, Bologna, Italy
G. Toni
Affiliation:
Correggio Hospital, Unit of Cardiology, Correggio, Italy
R. Chattat
Affiliation:
University of Bologna, Department of Psychology, Bologna, Italy
T. Ferdinando
Affiliation:
Unit of Sports Medicine, Department of Public Health, Modena, Italy
F. Neviani
Affiliation:
University of Modena and Reggio Emilia, Geriatrics Department, Modena, Italy
A. Cremonini
Affiliation:
Psychiatric Consultation Service for Primary Care, Department of Mental Health, Bologna, Italy
M. Amore
Affiliation:
Clinica Psichiatrica, Dinogmi, Genoa, Italy
S. Zanetidou
Affiliation:
Psychiatric Consultation Service for Primary Care, Department of Mental Health, Bologna, Italy
K.D. Bertakis
Affiliation:
U.C. Davis, Department of Family and Community Medicine, Sacramento, CA, USA

Abstract

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Introduction

Late life major depression (LLMD) is usually treated within primary care, but still with unsatisfactory outcomes and significant residual symptoms. Moreover, LLMD increases symptoms of anxiety, dyspnea, fear of falling (FOF), and risk of falls. Evidence from non-depressed patients suggests the efficacy of breathing and postural exercises; in particular, rhythmic breathing during poetry recitation was shown to improve cardio-respiratory synchronization. Thus, the aim of the HESIOD study was to test the efficacy of antidepressants plus breathing and postural exercises to improve patients’ anxiety mood, dyspnea, FOF, and postural stability.

Methods

Two non-randomised groups were compared: (1) antidepressant drugs plus weekly sessions of breathing/postural exercises based on the rhythmic recitation of hexameter poetry (intervention); (2) antidepressant drugs plus weekly sessions of group reading (comparator). Patients aged 65 +, with non-psychotic recurrent LLMD were recruited from a psychiatric consultation-liaison program for primary care. The main outcome measure was remission from depression (MADRS score ≤ 10) at 24 weeks. Secondary outcomes will include accelerometer-based measures of postural stability; patient-rated dyspnea, and FOF.

Results

Preliminary data on 34 patients show that patients receiving breathing and postural exercises displayed greater remission rates than those in the reading group (47.1% vs. 11.8%, P = 0.02). Further analyses will examine the effects on postural stability, dyspnea and FOF.

Conclusions

Breathing and postural exercises may exert significant clinical advantage when added to the standard antidepressant drug therapy for LLMD. This study might prompt further research on innovative treatment strategies to improve the outcomes of late life depression in primary care.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
e-Poster viewing: Old age psychiatry
Information
European Psychiatry , Volume 41 , Issue S1: Abstract of the 25th European Congress of Psychiatry , April 2017 , pp. S646
Copyright
Copyright © European Psychiatric Association 2017
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