Abstract
BackgroundIn 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.ObjectiveThe 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.MethodsThe 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 (ngroup=80, npersonal=82, ncontrol=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.ResultsThe results of latent growth modeling revealed no intervention effects for flourishing, life satisfaction, or depression symptoms (P>.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 (P=.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, P=.069) and 12 (ES=0.258, P=.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 P=.271).ConclusionsThere 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.Trial RegistrationClinicalTrials.gov NCT04412343; https://clinicaltrials.gov/ct2/show/NCT04412343
Highlights
As the full scale and impact of the COVID-19 pandemic became evident in early 2020, older adults were identified as being susceptible to severe illness and mortality [1]
In this study we sought to examine the efficacy of 2 different types of exercise programs, both delivered online, to support the mental health of previously low active older adults within the context of the current COVID-19 pandemic in comparison to participants in a waitlist control (WLC) condition
Because individuals who live alone may benefit more from a group-based exercise program that fosters social connectivity compared with those who live with others, we investigated whether intervention effects are stronger in those who live alone versus with others
Summary
As the full scale and impact of the COVID-19 pandemic became evident in early 2020, older adults were identified as being susceptible to severe illness and mortality [1]. Mental health experts emphasized the importance of developing approaches to support and maintain the physical and mental health of older adults during this unprecedented time [2]. Nonpharmacological, and cost-effective approach promoted by the World Health Organization to support mental health during the pandemic corresponds to regular physical activity [4]. Some correlational studies [5,6], including those focused on older adults [7,8], point to the possibility that regular physical activity may protect against depleted psychological well-being during the pandemic, there has been a distinct absence of experimental studies through which causality might be better ascertained. 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
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