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

Mauro Giovanni Carta1, Cesar Ivan Aviles Gonzalez2, 3, Luigi Minerba1, Massimiliano Pau4, Mario Musu1, Fernanda Velluzzi1, Caterina Ferreli1, Elisa Pintus1, Sergio Machado5, 6, Ferdinando Romano7, Veronica Vacca1, Antonio Preti8, Giulia Cossu1, Laura Atzori1, *
1 Department Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
2 Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy
3 Universidad del Cesar, Valledupar, Colombia
4 Dipartimento di Ingegneria Meccanica, Chimica e dei Materiali, Università degli Studi di Cagliari, Cagliari, Italy
5 Department of Sports and Methods Techniques, Federal University of Santa Maria (UFSM), Brazil
6 Laboratory of Physical Activity Neuroscience, Neurodiversity Institute, Queimados-RJ, Brazil
7 Department of Public Health and Infectious Diseases, Università Roma Sapienza, Roma, Italy
8 Department of Medical Sciences and Public Health, University of Turin, Turin, Italy

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© 2022 Carta et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department Medical Sciences and Public Health, University of Cagliari, Italy; Tel: +393388526881; Fax: +3907051092303; E-mail:



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.


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).


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).


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)

Keywords: Physical exercise, Depressive symptoms, Older adults, COVID-19 lockdown, Prevention, Moderate physical activity.