***TASK*** the task is to summarize an input biomedical literature in six sentences 
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    Input: Background Depression is a disabling , prevalent condition . Physical activity programs may assist depression management in older people , ameliorate co-morbid conditions and reduce the need for antidepressants . The UPLIFT pilot study assessed the feasibility of older depressed people attending a community-based progressive resistance training ( PRT ) program .  The study also aim ed to determine whether PRT improves depressive status in older depressed patients . Methods A r and omised controlled trial was conducted . People aged ≥ 65 years with depressive symptoms were recruited via general practice s. Following baseline assessment , subjects were r and omly allocated to attend a local PRT program three times per week for 10 weeks or a brief advice control group . Follow-up assessment of depressive status , physical and psychological health , functional and quality of life status occurred post intervention and at six months . Results Three hundred and forty six people responded to the study invitation , of whom 22 % had depressive symptoms ( Geriatric Depression Scale , GDS-30 score ≥ 11 ) . Thirty two people entered the trial . There were no significant group differences on the GDS at follow-up . At six months there was a trend for the PRT intervention group to have lower GDS scores than the comparison group , but this finding did not reach significance ( p = 0.08 ) . More of the PRT group ( 57 % ) had a reduction in depressive symptoms post program , compared to 44 % of the control group . It was not possible to discern which specific components of the program influenced its impact , but in post hoc analyses , improvement in depressive status appeared to be associated with the number of exercise sessions completed ( r = -0.8 , p < 0.01 ) . Conclusion The UPLIFT pilot study confirmed that older people with depression can be successfully recruited to a community based PRT program . The program can be offered by existing community-based facilities , enabling its ongoing implementation for the potential benefit of other older people BACKGROUND Although exercise has been shown to relieve depression , little is known about its mechanism or dose-response characteristics . We hypothesized that high intensity progressive resistance training ( PRT ) would be more effective than either low intensity PRT or st and ard care by a general practitioner ( GP ) in depressed elderly persons , and that high intensity PRT would provide superior benefits in quality of life , sleep quality , and self-efficacy . METHODS Sixty community-dwelling adults > 60 years with major or minor depression were r and omized to supervised high intensity PRT ( 80 % maximum load ) or low intensity PRT ( 20 % maximum load ) 3 days per week for 8 weeks , or GP care . RESULTS A 50 % reduction in the Hamilton Rating Scale of Depression score was achieved in 61 % of the high intensity , 29 % of the low intensity , and 21 % of the GP care group ( p = .03 ) . Strength gain was directly associated with reduction in depressive symptoms ( r = 0.40 , p = .004 ) , as was baseline social support network type ( F = 3.52 , p = .015 ) , whereas personality type , self-efficacy , and locus of control were unrelated to the antidepressant effect . Vitality quality -of-life scale improved more in the high intensity group than in the others ( p = .04 ) . Sleep quality improved significantly in all participants ( p < .0001 ) , with the greatest relative change in high intensity PRT ( p = .05 ) . CONCLUSIONS High intensity PRT is more effective than is low intensity PRT or GP care for the treatment of older depressed patients BACKGROUND  Serum anticholinergic activity ( SAA ) , as measured by a radioreceptor assay , quantifies a person 's overall anticholinergic burden caused by all drugs and their metabolites . In several small geriatric patient groups , SAA has been associated with cognitive impairment or frank delirium . To our knowledge , there has not yet been any systematic study of the prevalence of SAA and its effect on cognition in a community-based population . METHODS  Serum anticholinergic activity  was measured in 201 subjects who were r and omly selected among the participants in an epidemiological community study , based on their age and sex .  Cognitive performance was assessed with use of the Mini-Mental State Examination . The association between SAA and cognitive performance was examined using a univariate analysis and a multiple logistic regression model , adjusting for age , sex , educational level , and number of medications . RESULTS Serum anticholinergic activity  was detectable in 180 ( 89.6 % ) participants ( range , 0.50 - 5.70 pmol/mL ) . Univariate testing showed a significant association between SAA and Mini-Mental State Examination scores . Logistic regression analysis indicated that subjects with SAA at or above the sample 's 90th percentile ( ie , SAA > /=2.80 pmol/mL ) were 13 times ( odds ratio , 1.08 - 152.39 ) more likely than subjects with undetectable SAA to have a Mini-Mental State Examination score of 24 ( the sample 's 10th percentile ) or below . CONCLUSIONS To our knowledge , this is the largest analysis of SAA and the first to examine its extent and relationship with cognitive performance in a community sample . Its results suggest that SAA can be detected in most older persons in the community and confirm that even low SAA is associated with cognitive impairment BACKGROUND Depression is a major health problem for community-dwelling elderly adults . Since limited re sources are available to decrease the high prevalence of depressive symptoms among the elderly adults , improved support for them can be provided if we can determine which intervention is superior in ridding depressive symptoms . OBJECTIVE To compare the effectiveness of the physical fitness exercise program and the cognitive behavior therapy program on primary ( depressive symptoms ) and secondary outcomes ( 6-min walk distance , quality of life , and social support ) for community-dwelling elderly adults with depressive symptoms . DESIGN AND SETTING S A prospect i ve r and omized control trial was conducted in three communities in northern Taiwan . PARTICIPANTS The elderly adults in the three communities were invited to participate by mail , phone calls , and posters . There were a total of 57 participants who had depressive symptoms and all without impaired cognition that participated in this trial . None of the participants withdrew during the 9 months of follow-up for this study . METHODS Fifty-seven participants were r and omly assigned to one of the three groups : the physical fitness exercise program group , the cognitive behavior therapy ( CBT ) group , or the control group . The primary ( Geriatric Depression Scale-15 , GDS-15 ) , and secondary outcomes ( 6-min walk distance , SF-36 , and Inventory of Socially Supportive Behaviors scales , ISSB ) were collected immediately ( T2 ) , at 3 months ( T3 ) , and at 6 months after the interventions ( T4 ) . RESULTS After the interventions , the CBT group participants demonstrated significantly lower symptoms of depression ( p=0.009 ) at T2 and perceived more social support from those around them ( p<0.001 , < 0.001 and = 0.004 , respectively ) at three time-point comparisons than the control group . Moreover , after intervention , participants in the physical fitness exercise program group had decreased GDS-15 scores at three time-point comparisons ( p=0.003 , 0.012 and 0.037 , respectively ) , had a substantially greater 6-min walk distance ( p=0.023 ) , a better quality of life ( p<0.001 ) , and a better perceived social support at T2 ( p<0.001 ) . CONCLUSIONS Immediately after a 12-week intervention , there were significant decreases in depressive symptoms and more perceived social support amongst those in the CBT group . When considering the effectiveness in the decrease of depressive symptoms longer term , the increase in the 6-min walk distance and raising the patients ' quality of life , physical fitness exercise program may be a better intervention for elderly adults with depressive symptoms Objectives We pilot tested a one-visit behavioral intervention with telephone follow-up for older primary care patients with mild to moderate depressive symptoms . Methods A total of 16 English-speaking primary care patients aged 60 years and older who scored 5 to 14 on the Patient Health Question naire-9 ( PHQ-9 ) engaged in the intervention visit . Outcomes were assessed at baseline and 4 weeks : activity goals , readiness to change ( University of Rhode Isl and Change Assessment ) , PHQ-9 , Generalized Anxiety Disorder-7 , World Health Organization Disability Assessment Schedule 2.0 , and satisfaction . Results The 14 participants who completed the study met or exceeded 73 % of activity goals on average . They also improved on all outcomes ( P < 0.05 ) with medium ( University of Rhode Isl and Change Assessment , GAD-7 ) to large effect sizes ( PHQ-9 , World Health Organization Disability Assessment Schedule 2.0 ) , and they were satisfied . Conclusions This pilot study provided preliminary evidence that a one-visit behavioral activation intervention is acceptable and feasible and improves outcomes . If findings are confirmed , then this intervention could be integrated into existing collaborative care programs OBJECTIVES This study provides an empirical evaluation of Cognitive Behaviour Therapy ( CBT ) alone vs Treatment as usual ( TAU ) alone ( generally pharmacotherapy ) for late life depression in a UK primary care setting . METHOD General Practitioners in Fife and Glasgow referred 114 Participants to the study with 44 meeting inclusion criteria and 40 participants providing data that permitted analysis . All participants had a diagnosis of mild to moderate Major Depressive Episode . Participants were r and omly allocated to receive either TAU alone or CBT alone . RESULTS Participants in both treatment conditions benefited from treatment with reduced scores on primary measures of mood at end of treatment and at 6 months follow-up from the end of treatment . When adjusting for differences in baseline scores , gender and living arrangements , CBT may be beneficial in levels of hopelessness at 6 months follow-up . When evaluating outcome in terms of numbers of participants meeting Research Diagnostic Criteria for depression , there were significant differences favouring the CBT condition at the end of treatment and at 3 months follow-up after treatment . CONCLUSIONS CBT alone and TAU alone produced significant reductions in depressive symptoms at the end of treatment and at 6 months follow-up . CBT on its own is shown to be an effective treatment procedure for mild to moderate late life depression and has utility as a treatment alternative for older people who can not or will not tolerate physical treatment approaches for depression Anxiety and depression are commonly comorbid in older adults and are associated with worse physical and mental health outcomes and poorer response to psychological and pharmacological treatments . However , little research has examined the effectiveness of psychological programs to treat comorbid anxiety and depression in older adults . Sixty-two community dwelling adults aged over 60 years with comorbid anxiety and depression were r and omly allocated to group cognitive behavioural therapy or a waitlist condition and were assessed immediately following and three months after treatment . After controlling for cognitive ability at pre-treatment , cognitive behaviour therapy result ed in significantly greater reductions , than waitlist , on symptoms of anxiety and depression based on a semi-structured diagnostic interview rated by clinicians unaware of treatment condition . Significant time by treatment interactions were also found for self-report measures of anxiety and depression and these gains were maintained at the three month follow up period . In contrast no significant differences were found between groups on measures of worry and well-being . In conclusion , group cognitive behavioural therapy is efficacious in reducing comorbid anxiety and depression in geriatric population s and gains maintain for at least three months CONTEXT In older people , depressive symptoms are common , psychological adjustment to aging is complex , and associated chronic physical illness limits the use of antidepressants . Despite this , older people are rarely offered psychological interventions , and only 3 r and omized controlled trials of individual cognitive behavioral therapy ( CBT ) in a primary care setting have been published . OBJECTIVE To determine the clinical effectiveness of CBT delivered in primary care for older people with depression . DESIGN A single-blind , r and omized , controlled trial with 4- and 10-month follow-up visits . PATIENTS A total of 204 people aged 65 years or older ( mean [ SD ] age , 74.1 [ 7.0 ] years ; 79.4 % female ; 20.6 % male ) with a Geriatric Mental State diagnosis of depression were recruited from primary care . INTERVENTIONS Treatment as usual ( TAU ) , TAU plus a talking control ( TC ) , or TAU plus CBT . The TC and CBT were offered over 4 months . OUTCOME MEASURES Beck Depression Inventory-II ( BDI-II ) scores collected at baseline , end of therapy ( 4 months ) , and 10 months after the baseline visit . Subsidiary measures were the Beck Anxiety Inventory , Social Functioning Question naire , and Euroqol . Intent to treat using Generalized Estimating Equation and Compliance Average Causal Effect analyses were used . RESULTS Eighty percent of participants were followed up . The mean number of sessions of TC or  CBT was just greater than 7 . Intent-to-treat analysis found improvements of -3.07 ( 95 % confidence interval [ CI ] , -5.73 to -0.42 ) and -3.65 ( 95 % CI , -6.18 to -1.12 ) in BDI-II scores in favor of CBT vs TAU and TC , respectively . Compliance Average Causal Effect analysis compared CBT with TC . A significant benefit of CBT of 0.4 points ( 95 % CI , 0. 
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DISCUSSION We conclude that the effects of several treatments are promising , but need to be replicated before they can be implemented more widely in primary care .