Exercise improves long-term social and behavioral rhythms in older adults: Did it play a role during the COVID-19 lockdown?

A Recovery-Oriented Program for People with Bipolar Disorder through Virtual Reality-Based Cognitive Remediation: Results of a Feasibility Randomized Clinical Trial

Background: Cognitive impairment is a frequent consequence of bipolar disorder (BD) that is difficult to prevent and treat. In addition, the quality of the preliminary evidence on the treatment of BD through Cognitive Remediation (CR) with traditional methods is poor. This study aims to evaluate the feasibility of a CR intervention with fully immersive Virtual Reality (VR) as an additional treatment for BD and offers preliminary data on its efficacy. Methods: Feasibility randomized controlled cross-over clinical study, with experimental condition lasting three months, crossed between two groups. Experimental condition: CR fully immersive VR recovery-oriented program plus conventional care; Control condition: conventional care. The control group began the experimental condition after a three months period of conventional care (waiting list). After the randomization of 50 people with BD diagnosis, the final sample consists of 39 participants in the experimental condition and 25 in the control condition because of dropouts. Results: Acceptability and tolerability of the intervention were good. Compared to the waitlist group, the experimental group reported a significant improvement regarding cognitive functions (memory: p = 0.003; attention: p = 0.002, verbal fluency: p = 0.010, executive function: p = 0.003), depressive symptoms (p = 0.030), emotional awareness (p = 0.007) and biological rhythms (p = 0.029). Conclusions: The results are preliminary and cannot be considered exhaustive due to the small sample size. However, the evidence of efficacy, together with the good acceptability of the intervention, is of interest. These results suggest the need to conduct studies with larger samples that can confirm this data. Trial registration: ClinicalTrialsgov NCT05070065, registered in September 2021

Emotional Contagion Scale and Mental Health Status during the First Wave of COVID-19 Pandemic, National Assessment

Background

This great pandemic of COVID-19 has been a unique stressor that affected all communities in 2020. This study aims to examine the prevalence of anxiety and depression due to the COVID-19 pandemic in Saudi Arabia and to study the emotional cognition scale in the Kingdom of Saudi Arabia (KSA) in relation to the COVID-19 pandemic.

Methodology

A descriptive cross-sectional study was conducted on 857 inhabitants randomly selected from the 13 administrative regions of Saudi Arabia, using a validated self-administrated questionnaire comprising six sections. The collected data were summarized and analyzed.

Results

Among the majority of the studied participants, 377 (44.0%) were aged from 35 to less than 50 y. There were 489 (57.1%) females and 368 (42.9%) males, 616 (71.9%) Saudi nationals, 715 (83.4%) university-educated or postgraduate, 619 (72.2%) unmarried and 238 (27.8%) married, and 663 (77.4%) living in areas under partial lockdown. The resultant elevated total depression score was statistically significant (p<0.05) for the following: participants younger than 35y, females, Saudis, those with lower education levels, those who were married, students, those with work suspension during the COVID-19 pandemic, and amongst those who experienced complete lockdown. Among the majority of the studied participants, 355 (41.2%) showed mild depression, and 281(32.6) showed moderate anxiety, and were in the growth zone. In addition, the elevated total anxiety score was statistically significant (p<0.05) amongst the following; younger participants, females, Saudi nationals, those with lower educational levels, those who were unmarried, students, those with telework, and those with no curfew.

Conclusion

The adverse mental health effects were more prevalent among particular groups of the population, such as females, adults under 35 years old, students, those with lower educational attainments, and those suffering from chronic illnesses. Anxiety was significantly correlated with depression. The practice of preventive measures, e.g., wearing masks, and social distancing to prevent the spread of COVID-19, may have had psychological benefits during the pandemic.

Summary

We assessed the mental health status in Saudi Arabia during the first wave of the COVID-19 pandemic. Mild depression and moderate anxiety were prevalent problems, with many determinants and interrelations. Fear was the most infectious emotion, while happiness was the highest.

Effect of a Low-Moderate Exercise Program on Dysmetabolism in Older Adults: Results of a Randomized Controlled Trial

Physical exercise has been shown to improve dysmetabolism in older adults, reducing cardiovascular risk, while its role in preventing dysmetabolism is less known. Moreover, most of the trials use exercise programs that are difficult to put into daily practice. The purpose of this Randomized Controlled Trial (RCT) was to evaluate the effectiveness of a 3-month moderate exercise program in improving or preventing dysmetabolism in 120 older adults, randomly selected for the exercise program (experimental group) or cultural activities (control group). None of the subjects were following a hypocaloric diet, and all of them reported healthy eating habits. Anthropometric (Body Mass Index (BMI) and Waist Circumference (WC)) and metabolic variables (fasting plasma glucose (FPG), High-Density Lipoprotein Cholesterol (HDL-C), and triglycerides (TG)) were assessed at baseline (T0) and at the end of the trial (T1). Dysmetabolism was defined by the presence of an increased WC plus at least two metabolic alterations. At T0, the two groups did not differ by sex, age, education, BMI, WC, FPG, HDL-C levels, and prevalence of dysmetabolism. The mean BMI value indicated overweight, and WC values were higher than the cut-off. At T1, a slight reduction in the number of people with dysmetabolism was found only in the experimental group. However, none of the individuals without dysmetabolism at T0 in the experimental group developed it at T1, while 11.4% developed it in the control group (p = 0.032). This study highlights that a moderate exercise program, accessible in daily practice, can prevent dysmetabolism in older adults, even while being overweight, while if dysmetabolism is already present, more prolonged combined nutritional and exercise interventions will be needed.

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

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.

Clinical Trial Registration Number NCT03858114