Background: Functioning of Social Behavioral Rhythms (SBRs) may affect resilience toward stressful events across different age groups. However, the impact of SBRs on the coronavirus disease of 2019 (COVID-19) in elder people is yet to ascertain, representing the aim of the present report.
Design and methods: Follow-up of a peer-reviewed randomized controlled trial on exercise on old adults (³65 years), concurrent to the onset of the pandemic-related lockdown. Post-RCT evaluations occurred after further 12 and 36 weeks since the beginning of the lockdown phase. People with Major Depressive Episode (MDE) at week-48 (follow-up endpoint) were deemed as cases, people without such condition were considered controls. MDE was ascertained using the Patient Health Questionnaire-9 (PHQ-9); SBRs functioning at week 12 onward, through the Brief Symptom Rating Scale (BSRS).
Results: Seventy-nine individuals (53.2%, females) entered the RCT-follow-up phase. The frequency of MDE did not significantly change before versus during lockdown (OR 2.60, CI95%=0.87-9.13). People with BSRS>1 standard deviation of the whole sample score at week-12 had an inflated risk of DE during lockdown (OR=5.6, 95%CI: 1.5-21.4) compared to those with lower BSRS scores. Such odd hold after excluding individuals with MDD at week-12. The post-hoc analysis could be potentially affected by selection bias.
Conclusions: Overall, older adults were resilient during the first phase of the pandemic when functioning of pre-lockdown was still preserved, in contrast to the subsequent evaluations when the impairment of daily rhythms was associated with impaired reliance.
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
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
Pearman A, Hughes ML, Smith EL, et al. Age differences in risk and resilience factors in COVID-19-related stress. J Gerontol B Psychol Sci Soc Sci 2021;76:e38-e44. DOI: https://doi.org/10.1093/geronb/gbaa120
Klaiber P, Wen JH, DeLongis A, et al. 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
American Psychological Association. The road to resilience. Washington: American Psychological Association; 2014. Available from: http://www.apa.org/helpcenter/road-resilience.aspx
Southwick SM, Bonanno GA, Masten AS, et al. Resilience definitions, theory, and challenges: interdisciplinary perspectives. Eur J Psychotraumatol 2014;5:25338. DOI: https://doi.org/10.3402/ejpt.v5.25338
Southwick SM, Douglas-Palumberi H, Pietrzak RH. Resilience. In: M.J. Friedman, P.A. Resick, T.M. Keane, Editors. Handbook of PTSD: Science and practice. New York: Guilford Press; 2014.
Carta MG, Cossu G, Pintus E, et al. Moderate exercise improves cognitive function in healthy elderly people: Results of a randomized controlled trial. Clin Pract Epidemiol Ment Health 2021;17:75-80. DOI: https://doi.org/10.2174/1745017902117010075
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
Cossu G, Agus M, Atzori L, et al. Principal component analysis of the social and behavioral rhythms scale in elderly. J Public Health Res 2022;11.2546. DOI: https://doi.org/10.4081/jphr.2021.2546
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
Lin EC, Weintraub MJ, Miklowitz DJ, et al. The associations between illness perceptions and social rhythm stability on mood symptoms among patients with bipolar disorder. J Affect Disord 2020;273:517-23. DOI: https://doi.org/10.1016/j.jad.2020.05.019
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
Hood S, Amir S. The aging clock: circadian rhythms and later life. J Clin Invest 2017;127:437-46. DOI: https://doi.org/10.1172/JCI90328
Fornaro M, Solmi M, Stubbs B, et al. Prevalence and correlates of major depressive disorder, bipolar disorder and schizophrenia among nursing home residents without dementia: systematic review and meta-analysis. Br J Psychiatry 2020;216:6-15. DOI: https://doi.org/10.1192/bjp.2019.5
Leone MJ, Sigman M, Golombek DA. Effects of lockdown on human sleep and chronotype during the COVID-19 pandemic. Curr Biol 2020;30:R930-1. DOI: https://doi.org/10.1016/j.cub.2020.07.015
Spitzer RL, Kroenke K, Williams JB. Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary care evaluation of mental disorders. Patient health questionnaire. JAMA 1999;282:1737-44. DOI: https://doi.org/10.1001/jama.282.18.1737
Cossu G, Abbile Gonzalez CI, Minerba L, et al. Exercise improves long-term social and behavioral rhythms in older adults: Did it play a role during the COVID-19 lockdown? J Public Health Res 2022;11:2432. DOI: https://doi.org/10.4081/jphr.2021.2432
Moro MF, Carta MG, Pintus M, et al. Validation of the Italian version of the Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN): Some considerations on its screening usefulness. Clin Pract Epidemiol Ment Health 2014;10:48-52. DOI: https://doi.org/10.2174/1745017901410010048
Mollaioli D, Sansone A, Ciocca G, et al. Benefits of sexual activity on psychological, relational, and sexual health during the COVID-19 breakout. J Sex Med 2021;18:35-49. DOI: https://doi.org/10.1016/j.jsxm.2020.10.008
Kurotschka PK, Serafini A, Demontis M, et al. General practitioners' experiences during the first phase of the COVID-19 pandemic in Italy: A critical incident technique study. Front Public Health 2021;9:623904. DOI: https://doi.org/10.3389/fpubh.2021.623904
Sotomayor-Beltran C, Matta-Solis H, Perez-Siguas R, et al. Fear of COVID-19 among Peruvian people living in disadvantaged communities: A cross-sectional study. Clin Pract Epidemiol Ment Health 2021;17:19-25. DOI: https://doi.org/10.2174/1745017902117010019
Lee EE, Depp C, Palmer BW, et al. High prevalence and adverse health effects of loneliness in community-dwelling adults across the lifespan: role of wisdom as a protective factor. Int Psychogeriatr 2019;31:1447-62. DOI: https://doi.org/10.1017/S1041610218002120
Czeisler MÉ, Lane RI, Petrosky E, et al. Mental health, substance use, and suicidal ideation during the COVID-19 pandemic-United States. MMWR Morb Mortal Wkly Rep 2020;69:1049-57. DOI: https://doi.org/10.15585/mmwr.mm6932a1
Grandin LD, Alloy LB, Abramson LY. The social zeitgeber theory, circadian rhythms, and mood disorders: review and evaluation. Clin Psychol Rev 2006;26:679-694. DOI: https://doi.org/10.1016/j.cpr.2006.07.001
Margraf J, Lavallee K, Zhang X, et al. Social rhythm and mental health: A cross-cultural comparison. PLoS One 2016;11:e0150312. DOI: https://doi.org/10.1371/journal.pone.0150312
Stafford M, Ben-Shlomo Y, Cooper C, et al. Diurnal cortisol and mental well-being in middle and older age: evidence from four cohort studies. BMJ Open 2017;7:e016085. DOI: https://doi.org/10.1136/bmjopen-2017-016085
Carta MG, Atzeni M, Perra A, et al. Cost-effectiveness of US National Institute of Health and European Union FP7 projects on active ageing and elderly quality of life-Author's reply. Clin Pract Epidemiol Ment Health 2019;15:10-4. DOI: https://doi.org/10.2174/1745017901915010010
Kobrosly RW, van Wijngaarden E, Seplaki CL, et al. Depressive symptoms are associated with allostatic load among community-dwelling older adults. Physiol Behav 2014;123:223-30. DOI: https://doi.org/10.1016/j.physbeh.2013.10.014