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

  • Giulia Cossu
    Department of Medical Sciences and Public Health, University of Cagliari, Italy.
  • Cesar Ivan Abbile Gonzalez
    University Hospital of Cagliari, Italy.
  • Luigi Minerba
    Department of Medical Sciences and Public Health, University of Cagliari, Italy.
  • Roberto Demontis
    Department of Medical Sciences and Public Health, University of Cagliari, Italy.
  • Massimiliano Pau
    Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Italy.
  • Fernanda Velluzzi
    Department of Medical Sciences and Public Health, University of Cagliari, Italy.
  • Caterina Ferreli
    Department of Medical Sciences and Public Health, University of Cagliari, Italy.
  • Laura Atzori
    Department of Medical Sciences and Public Health, University of Cagliari, Italy.
  • Sergio Machado
    Department of Sports and Methods Techniques, Federal University of Santa Maria (UFSM), Brazil.
  • Dario Fortin
    University of Trento, Italy.
  • Ferdinando Romano
    La Sapienza University of Rome, Italy.
  • Mauro Giovanni Carta
    Department of Medical Sciences and Public Health, University of Cagliari, Italy.


The study aimed to verify whether exercise training in older adults can improve social behavioral rhythms (SBR) and if any modification is maintained over time. Older adults (n=120) from a previous randomized controlled trial, were randomly allocated to either a moderate-intensity exercise group or a control group. SBR was evaluated at t0, t26, and t48 weeks (during the COVID-19 lockdown), using the brief social rhythms scale (BSRS). Seventy-nine participants completed the follow-up (age 72.3±4.7, women 55.3%). An improvement in the BSRS score was found in the exercise group at 26 weeks (p=0.035) when the exercise program was concluded, and it was maintained at 48 weeks (p=0.013). No improvements were observed in the control group. To conclude, SBR, previously found as a resilience factor in older adults during COVID-19, appear to improve after a moderate 12 weeks exercise program, and the improvement persisted even after stopping exercise during the COVID-19 lockdown.


Haupt S, Eckstein ML, Wolf A, et al. Eat, train, sleep-retreat? Hormonal interactions of intermittent fasting, exercise and circadian rhythm. Biomolecules 2021;11:516. DOI: https://doi.org/10.3390/biom11040516

Pack W, Hill DD, Wong KY. Melatonin modulates M4-type ganglion-cell photoreceptors. Neuroscience 2015;303:178-88. DOI: https://doi.org/10.1016/j.neuroscience.2015.06.046

Van Cauter E, Leproult R, Kupfer DJ. Effects of gender and age on the levels and circadian rhythmicity of plasma cortisol. J Clinl Endocrinol Metab 1996;81:2468-73. DOI: https://doi.org/10.1210/jc.81.7.2468

Carta MG, Ouali U, Perra A, et al. Living with bipolar disorder in the time of Covid-19: Biorhythms during the severe lockdown in Cagliari, Italy, and the moderate lockdown in Tunis, Tunisia. Front Psychiatry 2021;12:634765. DOI: https://doi.org/10.3389/fpsyt.2021.634765

Lieverse R, de Vries R, Hoogendoorn AW, et al. Social support and social rhythm regularity in elderly patients with major depressive disorder. Am J Geriatr Psychiatry. 2013;21:1144-53. DOI: https://doi.org/10.1016/j.jagp.2013.01.052

Liu M, Meng Y, Wei W, Li T. Relationship between circadian rhythm related brain dysfunction and bipolar disorder. J South Med Univ 2020;40:822-7.

Lopes MC, Boarati MA, Fu IL. Sleep disturbance in bipolar disorder: Neuroglia and circadian rhythms. Front Psychiatry 2020;10:1021. DOI: https://doi.org/10.3389/fpsyt.2019.01021

Carta MG, Preti A, Akiskal HS. Coping with the new era: Noise and light pollution, Hperactivity and steroid hormones. Towards an evolutionary view of bipolar disorders. Clin Pract Epidemiol Ment Health 2018;14:33-36. DOI: https://doi.org/10.2174/1745017901814010033

Carta MG, Pintus E, Zaccheddu R, et al. Social and behavioral rhythms as a marker of well-being indicator in old adults living at home. J Clin Med 2021 (in press). DOI: https://doi.org/10.20944/preprints202105.0089.v1

Carta MG, Fornaro M, Cossu G, et al. Social and behavioral rhythms affect resilience to COVID-19-related stress among old adults living at home. J Affect Disord 2021 (in press).

Carta MG, Cossu G, Pintus E, et al. Active elderly and health-can moderate exercise improve health and wellbeing in older adults? Protocol for a randomized controlled trial. Trials 2021;22:331. DOI: https://doi.org/10.1186/s13063-021-05278-6

Carta MG, Cossu G, Pintus E, et al. Moderate exercise improves cognitive function in healthy elderly people: Results of a randomized controlled trial (Active Elderly and Health – ClinicalTrials.gov, NCT03858114). Clin Pract Epidemiol Ment Health 2021 (in press).

Southwick SM, Bonanno GA, Masten AS, et al. Resilience definitions, theory, and challenges: Interdisciplinary perspectives. Eur J Psychotraumatol 2014;5:1. DOI: https://doi.org/10.3402/ejpt.v5.25338

Lee PMY, Huang B, Liao G, et al. Changes in physical activity and rest-activity circadian rhythm among Hong Kong community aged population before and during COVID-19. BMC Public Health 2021;21:836. DOI: https://doi.org/10.1186/s12889-021-10890-x

Tocco F, Crisafulli A, Milia R, et al. Nervous facilitation in cardiodynamic response of exercising athletes to superimposed mental tasks: Implications in depressive disorder. Clin Pract Epidemiol Ment Health 2015;11:166-73. DOI: https://doi.org/10.2174/1745017901511010166

Margraf J, Lavallee K, Zhang X, Schneider S. Social rhythm and mental health: A. Cross-cultural comparison. PLoS One 2016;11:e0150312. DOI: https://doi.org/10.1371/journal.pone.0150312

Monk TH, Flaherty JF, Frank E, et al. The social rhythm metric. An instrument to quantify the daily rhythms of life. J Nerv Ment Dis 1990;178:120-6. DOI: https://doi.org/10.1097/00005053-199002000-00007

Klaiber P, Wen JH, DeLongis A, Sin NL. The ups and downs of daily life during COVID-19: Age differences in affect, stress, and positive events. J Gerontol B Psychol Sci Soc Sci 2021;76:e30-7. DOI: https://doi.org/10.1093/geronb/gbaa096

Carta MG, Romano F, Orrù G. The true challenges of the Covid-19 epidemics: The need for essential levels of care for all. Open Respir Med J 2020;14:8-9. DOI: https://doi.org/10.2174/1874306402014010008

Leone MJ, Sigman M, Golombek DA. Effects of lockdown on human sleep and chronotype during the COVID-19 pandemic. Curr Biol 2020;30:R930-R931. DOI: https://doi.org/10.1016/j.cub.2020.07.015

Fossati C, Torre G, Borrione P, et al. Biohumoral indicators influenced by physical activity in the elderly. J Clin Med 2020;9:1115. DOI: https://doi.org/10.3390/jcm9041115

Velluzzi F, Tocco F, Deledda A, et al. Training impulses: A method to quantify exercise intensity in postmenopausal obese women. 2016 IEEE International Symposium on Medical Measurements and Applications (meMeA). 2016:7533784. DOI: https://doi.org/10.1109/MeMeA.2016.7533784

Vahia IV, Jeste DV, Reynolds CF 3rd. Older adults and the mental health effects of COVID-19. JAMA 2020;324:2253-4. DOI: https://doi.org/10.1001/jama.2020.21753

D’Silva KM, Serling-Boyd N, Wallwork R, et al. Clinical characteristics and outcomes of patients with coronavirus disease 2019 (COVID-19) and rheumatic disease: A comparative cohort study from a US “hot spot”. Ann Rheum Dis 2020;79:1156-62. DOI: https://doi.org/10.1136/annrheumdis-2020-217888

Most read articles by the same author(s)