scholarly journals Online-Delivered Group and Personal Exercise Programs to Support Low Active Older Adults’ Mental Health During the COVID-19 Pandemic: Randomized Controlled Trial (Preprint)

2021 ◽  
Author(s):  
Mark R Beauchamp ◽  
Ryan M Hulteen ◽  
Geralyn R Ruissen ◽  
Yan Liu ◽  
Ryan E Rhodes ◽  
...  

BACKGROUND In response to the COVID-19 pandemic, experts in mental health science emphasized the importance of developing and evaluating approaches to support and maintain the mental health of older adults. OBJECTIVE The aim of this study was to assess whether a group-based exercise program relative to a personal exercise program (both delivered online) and waitlist control (WLC) can improve the psychological health of previously low active older adults during the early stages of the COVID-19 pandemic. METHODS The Seniors COVID-19 Pandemic and Exercise (SCOPE) trial was a 3-arm, parallel randomized controlled trial conducted between May and September 2020 in which low active older adults (aged ≥65 years) were recruited via media outlets and social media. After baseline assessments, consented participants were randomized to one of two 12-week exercise programs (delivered online by older adult instructors) or a WLC condition. A total of 241 older adults (n=187 women) provided baseline measures (via online questionnaires), were randomized (n<sub>group</sub>=80, n<sub>personal</sub>=82, n<sub>control</sub>=79), and completed measures every 2 weeks for the duration of the trial. The trial’s primary outcome was psychological flourishing. Secondary outcomes included global measures of mental and physical health, life satisfaction, and depression symptoms. RESULTS The results of latent growth modeling revealed no intervention effects for flourishing, life satisfaction, or depression symptoms (<i>P</i>&gt;.05 for all). Participants in the group condition displayed improved mental health relative to WLC participants over the first 10 weeks (effect size [ES]=0.288-0.601), and although the week 12 effect (ES=0.375) was in the same direction the difference was not statistically significant (<i>P</i>=.089). Participants in the personal condition displayed improved mental health, when compared with WLC participants, in the same medium ES range (ES=0.293-0.565) over the first 8 weeks, and while the effects were of a similar magnitude at weeks 10 (ES=0.455, <i>P</i>=.069) and 12 (ES=0.258, <i>P</i>=.353), they were not statistically significant. In addition, participants in the group condition displayed improvements in physical health when compared with the WLC (ES=0.079-0.496) across all 12 weeks of the study following baseline. No differences were observed between the personal exercise condition and WLC for physical health (slope <i>P</i>=.271). CONCLUSIONS There were no intervention effects for the trial’s primary outcome (ie, psychological flourishing). It is possible that the high levels of psychological flourishing at baseline may have limited the extent to which those indicators could continue to improve further through intervention (ie, potential ceiling effects). However, the intervention effects for mental and physical health point to the potential capacity of low-cost and scalable at-home programs to support the mental and physical health of previously inactive adults in the COVID-19 pandemic. CLINICALTRIAL ClinicalTrials.gov NCT04412343; https://clinicaltrials.gov/ct2/show/NCT04412343

Author(s):  
Adam G Gavarkovs

The link between physical inactivity and poor health outcomes is well established. Older adults are especially at risk for many health conditions, and are one of the most inactive populations in Canada. Increasing levels of neighbourhood greenness has shown a positive relationship with walking and exercise behaviours, which in turn affects both mental and physical health. Currently in Ontario, the provincial Planning Act outlines the process of parkland dedication that individual municipalities are responsible for carrying out. This policy brief will discuss the inadequacies of the current system in effectively creating greenspace for older adults, and will propose several recommendations to resolve these issues.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 731-731
Author(s):  
Judith Scott ◽  
Sara Qualls ◽  
Stacy Yun

Abstract Indirect effects of stay-at-home guidelines may negatively affect mental health by reducing health self-care behaviors and engagement in social participation. This study reports on the impact of the COVID-19 pandemic on community-dwelling older adults’ perceived physical and mental health and everyday health behaviors. 126 older adults participated in a county-wide telephone survey during June-July of 2020, asking about changes in mental and physical health, and adaptations in health behaviors. We investigated the effects of three negative everyday health behavior changes during the pandemic (changes in health services access, perceived changes in health, and increased social isolation) as well as two positive everyday health behaviors (adherence to stay-at-home guidelines to reduce risk, and adaptive coping activities) on mental health and COVID-related distress. Examples of active coping strategies were stockpiling resources, spiritual practices, or outreach to others. Descriptive statistics, bivariate correlations, and multiple regressions characterized the impact of COVID-19 on perceived mental health. Descriptive data included changes in health service access, changes in mental and physical health, reduced social engagement, increased adherence to guidelines, and increased adaptive coping activities. Significant predictors of mental health impact of the pandemic were changes in health service access (β = .18, p &lt; .05), health changes (β = .25, p &lt; .01), and adaptive coping activities (β = .21, p &lt; .05). Findings suggest COVID-19 distress may be alleviated with improved health care access and increased social contact. Mental health challenges may also benefit from increased engagement in adaptive coping activities.


2021 ◽  
Author(s):  
Esther García-Esquinas ◽  
Rosario Ortolá ◽  
Iago Gine-Vázquez ◽  
José A Carnicero ◽  
Asier Mañas ◽  
...  

AbstractBackgroundWe aimed to examine main changes in health behaviors, mental and physical health among older adults under severe lockdown restrictions during the COVID-19.MethodsWe used prospective data from 3041 participants in four cohorts of community-dwelling individuals aged ≥65 years in Spain. Data were obtained using validated questionnaires through a pre-pandemic face-to-face interview and a telephone interview conducted between weeks 7 to 15 after the beginning the COVID-19 lockdown. Lineal or multinomial, as appropriate, regression models with adjustment for the main confounders were used to assess changes in the outcome variables from the pre-pandemic to the confinement period, and to identify their associated factors.ResultsOn average, the confinement was not associated with a deterioration in lifestyle risk factors (smoking, alcohol intake, diet or weight), except for a decreased physical activity and increased sedentary time, which reversed with the end of confinement. However, chronic pain worsened, and moderate declines in mental health, that did not seem to reverse after restrictions were lifted, were observed. Several subgroups of individuals were at increased risk of developing unhealthier lifestyles or mental health decline with confinement: (i)-males (for physical activity and sedentariness), (ii)-those with greater social isolation (for diet, physical activity, mental health), (iii)-feelings of loneliness (for diet, sleep quality, mental health), (iv)-poor housing conditions (for diet, physical activity, TV viewing time), (v)-unhealthy sleep duration (for physical activity and sedentariness), and (vi-worse overall health or chronic morbidities (for physical activity, screen time, mental health). On the other hand, previously having a greater adherence to the Mediterranean diet and doing more physical activity protected older adults from developing unhealthier lifestyles with confinement.ConclusionsThe lockdown during the first wave of the COVID-19 in Spain, which was one of the most restrictive in Europe, only led to minor average changes in health behaviors among older adults. However, mental health was moderately affected. If another lockdown were imposed on this or future pandemics, public health programs should specially address the needs of older individuals with male sex, greater social isolation, poor housing conditions and chronic morbidities, because of their greater vulnerability to the enacted movement restrictions


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 128-128
Author(s):  
Daniel Jimenez ◽  
Giyeon Kim

Abstract Older adults from racial/ethnic backgrounds as well as those from rural areas experience a disproportionate burden of physical and mental health risk factors. Given the prevalence of comorbid physical and mental health conditions in later life, the inadequacies of current treatment approaches for averting years living with disability, the disparities in access to the health care delivery system (including mental health care), and the workforce shortages to meet the mental and physical health needs of racial/ethnic and rural populations, development and testing of innovative strategies to address these disparities are of great public health significance and have the potential to change practice. This session will illustrate how four different interventions are being used to address mental and physical health needs in Latino and rural-dwelling older adults with the goal of reducing and ultimately eliminating disparities in these populations. Particular attention will be paid to the use of non-traditional interventions (e.g. social support, health promotion, technology). Results of clinical research studies will be presented alongside clinical case presentations. This integrated focus highlights the importance of adapting research interventions to real-world clinical settings.


2001 ◽  
Vol 9 (2) ◽  
pp. 142-160 ◽  
Author(s):  
Barbara Resnick

The purpose of this study was to test a model of overall activity in older adults. It was hypothesized that (a) mental and physical health directly influence sell-efficacy expectations; (b) mental and physical health, age, and self-efficacy expectations influence outcome expectations; and (c) all of these variables directly or indirectly influence overall activity. The sample included 175 older adults living in a continuing care retirement community, and a one-time interview was conducted. The mean age of the participants was 86 ± 5.7 years, and the majority were Caucasian (n = 173, 99%), women (n = 136, 78%), and unmarried (widowed or single; n = 137, 78%). Seven of the 10 hypothesized paths were significant. The variables physical health, self-efficacy expectations. and outcome expectations directly influenced activity, and age and mental health indirectly influenced activity through self-efficacy and outcome expectations. The data fit the model, and combined, these variables accounted for 29% of the variance in activity.


BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e026466 ◽  
Author(s):  
Charlotte Stringer ◽  
Mike Loosemore ◽  
Eloise Moller ◽  
Sarah E Jackson ◽  
Guillermo Felipe López-Sánchez ◽  
...  

IntroductionPeople who are homeless, or at risk of homelessness, have substantially poorer health. Sustained and regular participation in physical activity is beneficial for both mental and physical health. Limited data suggest that levels of physical activity in the homeless and those at risk of homelessness are low, and access to community-based exercise is limited or non-existent for this population. Nonetheless, exercise programmes for the homeless could provide a feasible and scalable intervention for providing beneficial effects on physical and mental health in this population. The primary aim of this study is to evaluate the impact of a group exercise intervention on activity levels in people who are homeless or at risk of homelessness in central London, UK. The secondary aim is to evaluate the impact of the intervention on mental and physical health outcomes.Method and analysisA 2-arm, individually randomised controlled trial in people who are homeless and those vulnerable and at risk of homelessness in central London, UK. Participants will be recruited through a London-based homeless charity, Single Homeless Project. Following baseline assessments and allocation to intervention (exercise classes) or control (usual care), participants will be followed up at 3, 6, 9 and 12 months. The primary outcomes will be change in objective physical activity. The secondary outcomes will include change in fitness assessments and mental health parameters. Changes in drug use and alcohol dependency will also be explored.Ethics and disseminationEthical approval to process and analyse data and disseminate findings was obtained through the Anglia Ruskin University Department of Sport and Exercise Sciences Research Ethics Committee. Results of this study will be disseminated through peer-reviewed publications and scientific presentations.


2019 ◽  
Author(s):  
Benjamin W. Domingue ◽  
Laramie Duncan ◽  
Amal Harrati ◽  
Daniel W. Belsky

AbstractObjectiveDeath of a spouse is a common late-life event with mental- and physical-health sequelae. Whereas mental-health sequelae of spousal death tend to be transient, physical-health sequelae may persist, leading to disability and mortality. Growing evidence linking poor mental health to aging-related disease suggests the hypothesis that transient poor mental health following death of a spouse could be a harbinger of physical health decline. If so, identification of bereavement-related mental health symptoms could provide an opportunity for prevention.MethodsWe analyzed data from N=35,103 individuals followed from 1994-2014 in the US Health and Retirement Study (HRS) and identified N=4,629 who were widowed during follow-up. We tested change in mental and physical health from pre-bereavement through the 5-year period following spousal death.ResultsBereaved spouses experienced an immediate increase in depressive symptoms following their spouses’ deaths but the depressive shock attenuated within one year. Bereaved spouses also experienced increases in disability, chronic-disease morbidity, and hospitalization, which grew in magnitude with time since spousal death, especially among older HRS participants. Bereaved spouses were at increased risk of death compared to HRS participants who were not bereaved. The magnitude of depressive symptoms in the immediate aftermath of spousal death predicted physical-health decline and mortality risk over 5 years of follow-up.ConclusionsBereavement-related depressive symptoms provide an indicator of risk for physical health decline and death in older adults. Screening for depressive symptoms in bereaved older adults may represent an opportunity for intervention to preserve healthy lifespan.Plain Language SummaryThe clinical significance of depressive symptoms during bereavement for long-term health is not well understood. We analyzed longitudinal data tracking mental and physical health of more than 4,000 older adults who were widowed during follow-up. Widows and widowers who experienced more severe depressive symptoms immediately following their spouse’s death were at increased risk for incident disability, chronic disease, hospitalization, and mortality over the five years following their spouse’s death. Transient depressive symptoms related to bereavement may provide a clinical indicator of risk for long-term physical health decline in older adults. Findings motivate increased integration of psychiatric assessment in geriatric care.


2017 ◽  
Vol 14 (02) ◽  
pp. 103-110
Author(s):  
S. Tomassi ◽  
M. Ruggeri

Summary Background: The global crisis that began in 2007 has been the most prolonged economic recession since 1929. It has caused worldwide tangible costs in terms of cuts in employment and income, which have been widely recognised also as major social determinants of mental health (1, 2). The so-called “Great Recession” has disproportionately affected the most vulnerable part of society of the whole Eurozone (3). Across Europe, an increase in suicides and deaths rates due to mental and behavioural disorders was reported among those who lost their jobs, houses and economic activities as a consequence of the crisis.


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