Previous functional social and behavioral rhythms affect resilience to COVID-19-related stress among old adults

  • Mauro Giovanni Carta
    Department of Medical Science and Public Health, University of Cagliari, Italy.
  • Michele Fornaro
    Department of Psychiatry, Federico II University of Naples, Italy.
  • Luigi Minerba
    Department of Medical Science 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 Science and Public Health, University of Cagliari, Italy.
  • Laura Atzori
    Department of Medical Science and Public Health, University of Cagliari, Italy.
  • Cesar Ivan Aviles Gonzalez
    Universidad Popular del Cesar, Valledupar, Colombia.
  • Ferdinando Romano
    University La Sapienza, Rome, Italy.
  • Roberto Littera
    Unit of Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Sardinian Regional Company for the Protection of Health (ATS Sardegna), Cagliari, Italy.
  • Luchino Chessa
    Department of Medical Science and Public Health, University of Cagliari, Italy.
  • Davide Firinu
    Department of Medical Science and Public Health, University of Cagliari, Italy.
  • Stefano Del Giacco
    Department of Medical Science and Public Health, University of Cagliari, Italy.
  • Angelo Restivo
    Department of Surgical Sciences, University of Cagliari, Italy.
  • Simona Deidda
    Department of Surgical Sciences, University of Cagliari, Italy.
  • Germano Orrù
    Department of Surgical Sciences, University of Cagliari, Italy.
  • Alessandra Scano
  • Simona Onali
    Department of Medical Science and Public Health, University of Cagliari, Italy.
  • Ferdinando Coghe
    Clinical Chemical and Microbiology Laboratory, University Hospital of Cagliari, Italy.
  • Goce Kalcev
    International Ph.D in Innovation Sciences and Technologies, University of Cagliari, Italy.
  • Giulia Cossu
    Department of Medical Science and Public Health, University of Cagliari, Italy.


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).

: 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.

: 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.


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