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Exercise in Older Adults to Prevent Depressive Symptoms at the Time of Covid-19: Results of a Randomized Controlled Trial with Follow-Up

Carta et al., Clinical Practice & Epidemiology in Mental Health, doi:10.2174/17450179-v18-e2112231, NCT03858114
Mar 2022  
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Exercise RCT with followup during COVID-19 lockdowns, showing lower risk of depression during lockdowns for the exercise group.
risk of depression, 82.3% lower, RR 0.18, p = 0.009, high activity levels 2 of 44 (4.5%), low activity levels 9 of 35 (25.7%), NNT 4.7.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Carta et al., 15 Mar 2022, Randomized Controlled Trial, Italy, peer-reviewed, 14 authors, trial NCT03858114 (history).
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Exercise in Older Adults to Prevent Depressive Symptoms at the Time of Covid-19: Results of a Randomized Controlled Trial with Follow-Up
Mauro Giovanni Carta, Cesar Ivan Aviles Gonzalez, Luigi Minerba, Massimiliano Pau, Mario Musu, Fernanda Velluzzi, Caterina Ferreli, Elisa Pintus, Sergio Machado, Ferdinando Romano, Veronica Vacca, Antonio Preti, Giulia Cossu, Laura Atzori
Clinical Practice & Epidemiology in Mental Health, doi:10.2174/17450179-v18-e2112231
Background: This study aimed to verify, through a randomized controlled trial, whether a medium-intensity mixing/aerobic/anaerobic exercise (accessible to older adults even with mild chronic diseases) can effectively counteract depressive episodes. A characteristic of the trial was that the follow-up coincided (unscheduled) with the lockdown due to Covid-19. Methods: Participants (N=120) were randomized into an intervention group, performing physical exercise, and a control group. Participants, aged 65 years and older, belonged to both genders, living at home, and cleared a medical examination, were evaluated with a screening tool to detect depressive episodes, the PHQ9, at pre-treatment, end of the trial (12-week), and follow-up (48-week). Results: A decrease in the frequency of depressive episodes after the trial (T1) was found in both groups; however, a statistically significant difference was observed only in the control group (p=0.0039). From T1 to follow-up (conducted during the lockdown), the frequency of depressive episodes increased in the control group, reaching a frequency equal to the time of study entry (p=0.788). In the experimental group, the frequency of depressive episodes did not change at the end of the trial but reached a statistically significant difference compared to the start of the study (p = 0.004) and was higher than the control group (p=0.028). Conclusion: Moderate-intensity physical exercise can be conducted safely, benefitting older adults even suffering from mild chronic disorders. Physical exercise seems to guarantee a long-term preventive effect towards depressive symptoms, especially in serious stressful situations such as the lockdown due to the Covid-19 pandemic.
AUTHORS' CONTRIBUTIONS The study was initially designed by MGC and GC and then discussed with MP, FV, LA, LM, RD, SM, DF, FM, and CIAG. The methodology was decided by MGC, GC, LA, FR, and GC. The MGC conducted the data analysis. The results were collectively discussed. MGC and GC drafted the paper, and FV and LA revised the manuscript. All authors read and approved the final manuscript. ETHICS APPROVAL AND CONSENT TO PARTI-CIPATE The ethical committee of the "Azienda Ospedaliero-Universitaria di Cagliari" approved the study protocol (number PG/2018/15546 of October 25, 2018). The researchers provided information about the study and informed participants about the possibility of discontinuing the interview if they wished. HUMAN AND ANIMAL RIGHTS No animals were used in this research. All human research procedures were followed in accordance with the ethical standards of the committee responsible for human experimentation (institutional and national), and with the Helsinki Declaration of 1975, as revised in 2013. CONSENT FOR PUBLICATION Informed consent was obtained from the participants for the publication of this study. STANDARDS OF REPORTING CONSORT guidelines and methodologies were followed in this study. AVAILABILITY OF DATA AND MATERIALS The datasets are available only after requests for access directed to project leader Mauro Giovanni Carta as guarantor, according to the agreement shared with the participants and partners, and as stated in the..
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