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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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Depression 82% Improvement Relative Risk Exercise  Carta et al.  Prophylaxis  RCT c19early.org Favorsexercise Favorsinactivity 0 0.5 1 1.5 2+
Exercise for COVID-19
9th treatment shown to reduce risk in October 2020, now with p < 0.00000000001 from 68 studies.
No treatment is 100% effective. Protocols combine treatments.
5,100+ studies for 110 treatments. c19early.org
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). Contact: atzoril@unica.it.
This PaperExerciseAll
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..
References
Ammar, Boukhris, Halfpaap, Four weeks of detraining [18] induced by covid-19 reverse cardiac improvements from eight weeks of fitness-dance training in older adults with mild cognitive impairment, Int J Environ Res Public Health, doi:10.3390/ijerph18115930
Carta, Atzeni, Perra, Cost-effectiveness of US national
Carta, Cossu, Pintus, Active elderly and health-can
Carta, Cossu, Pintus, None
Carta, Fornaro, Cossu, Minerba, Pau et al., Social [25] and behavioral rhythms affect resilience to COVID-19-related stress among old adults living at home, Int J Curr Res Rev in Press
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Carta, Orrù, Scano, None
Carta, Ouali, Perra, Living with bipolar disorder in the [24] time of covid-19: Biorhythms during the severe lockdown in Cagliari, Italy, and the moderate lockdown in Tunis, Tunisia. Front Psychiatry, doi:10.3389/fpsyt.2021.634765
Carta, Preti, Akiskal, Coping with the new era: Noise and [23] light pollution, hperactivity and steroid hormones. towards an evolutionary view of bipolar disorders, Clin Pract Epidemiol Ment Health, doi:10.2174/1745017901814010033
Codella, Luzi, Inverardi, Ricordi, None
Cossu, Gonzalez, Minerba, Exercise improves [20] long-term social and behavioral rhythms in older adults: Did it play a role during the COVID-19 lockdown?, J Public Health Res, doi:10.4081/jphr.2021.2432
Gibson-Moore, Chief, What's new and how can we get people more active?, doi:10.1111/nbu.12409
Klaiber, Wen, Delongis, Sin, The ups and downs of daily [15] life during covid-19: Age differences in affect, stress, and positive events, J Gerontol B Psychol Sci Soc Sci, doi:10.1093/geronb/gbaa096
Liang, Xu, Lin, Jia, Zhang et al., Comparison of [8] multiple interventions for older adults with Alzheimer disease or mild cognitive impairment: A PRISMA-compliant network meta-analysis, Medicine (Baltimore), doi:10.1097/MD.0000000000010744
Lieverse, De Vries, Hoogendoorn, Smit, Hoogendijk, None
Lorito, Long, Byrne, Exercise interventions for older [12] adults: A systematic review of meta-analyses, J Sport Health Sci, doi:10.1016/j.jshs.2020.06.003
Mura, Carta, Physical activity in depressed elderly. A [4] systematic review, Clin Pract Epidemiol Ment Health, doi:10.2174/1745017901309010125
Nice, Mental wellbeing and independence for older people quality [10] standard [QS137] Quality statement 2: Physical
Ojagbemi, Gureje, Typology of social network structures and [19] late-life depression in low-and middle-income countries, Clin Pract Epidemiol Ment Health, doi:10.2174/1745017901915010134
Smith, Belderson, Dainty, None
Spitzer, Kroenke, Williams, Validation and utility of a self-[14] report version of PRIME-MD: The PHQ primary care study. Primary care evaluation of mental disorders. patient health questionnaire, JAMA, doi:10.1001/jama.282.18.1737
Wjg ; Liu, Meng, Wei, Li, Social support and social rhythm regularity in elderly patients with major depressive disorder, Nan Fang Yi Ke Da Xue Xue Bao, doi:10.1016/j.jagp.2013.01.052
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