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 Table of Contents  
Year : 2020  |  Volume : 7  |  Issue : 2  |  Page : 116-117

Improving the mental health of older adults in the era of COVID-19 pandemic through home-based physical activity

Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy

Date of Submission28-Oct-2020
Date of Decision28-Nov-2020
Date of Acceptance23-Dec-2020
Date of Web Publication21-Jan-2021

Correspondence Address:
Dr. Chidiebere Emmanuel Okechukwu
Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jgmh.jgmh_45_20

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How to cite this article:
Okechukwu CE. Improving the mental health of older adults in the era of COVID-19 pandemic through home-based physical activity. J Geriatr Ment Health 2020;7:116-7

How to cite this URL:
Okechukwu CE. Improving the mental health of older adults in the era of COVID-19 pandemic through home-based physical activity. J Geriatr Ment Health [serial online] 2020 [cited 2021 Jun 25];7:116-7. Available from:


Participating in physical activity (PA) could decrease the symptoms of major depressive disorder. PA exerts neuroprotective effects against mood disorders and age-related cognitive decline, and PA decreases neuroinflammation and oxidative stress.[1] Older adults are mostly at increased risk of developing severe mental health problems because of the social isolation associated with coronavirus disease 2019 (COVID-19) pandemic; therefore, optimal levels of PA could lessen the psychological distress in older adults.[2]

Combined PA intervention is believed to be the most suitable for the elderly. A combined PA intervention consisting of flexibility/mobility, aerobic, resistance, balance, and coordination exercises could improve the physical and mental health of older adults. The standard guidelines of PA for older adults recommend moderate intensity exercise at least for 5days/week, at least 150–300 min/week of aerobic exercise, and 2 resistance training sessions/week. Flexibility/mobility exercises should be completed on all the workout days, and balance and coordination should be performed at least twice per week. The frequency and intensity of training can be increased for older adults based on their adaptation and progress in the PA routine.[3] For the elderly who are functionally limited, or have chronic diseases that affect their ability to perform PA, physicians should tailor and recommend a light-intensity PA such as light walking, or light aerobics, at an intensity of 1.1–3.0 metabolic equivalents, or 35'–50' heart rate reserve, or rating of perceived exertion 1–3, at the commencement of an exercise training routine, at a duration of 30 min, for 5 days/week. An older individual's advancement to moderate-intensity exercise training routine should depend on the tolerance and functional capacity of the individual.[4]

Home-based PA regimen should be tailored and prescribed by a physician according to an elderly person's current clinical status, PA activity level, exercise tolerance, functional capacity, and PA preferences [Table 1].[4] Consequently, the COVID-19 pandemic fosters sedentariness, which increases skeletal muscle wasting among older adults; hence, home-based resistance training would be a useful strategy to enhance and maintain skeletal muscle function, thus preventing skeletal muscle atrophy in older individuals.[5] Moreover, due to prolonged quarantine, older adults may likely encounter anxiety, depression, and posttraumatic stress symptoms in the time of COVID-19, mostly among the elderly who lost their friends or family members during the pandemic, thereby hindering their participation in leisure time PA.[6] Furthermore, prolonged quarantine and social isolation measures aimed to reduce the spread of COVID-19 among vulnerable older population, will further decondition the elderly who already have reduced cardiorespiratory fitness, muscle strength, and muscle mass by encouraging confinement at their homes or care centers, thereby restricting their movement consequently decreasing their PA levels.[7] However, regarding outdoor PA, exposure to green environment has significant mental health advantages both in young and older population.[8] Alternatively, rather than closing the parks meant for outdoor PA in the era of COVID-19 pandemic, these parks can be regulated and made more safer for leisure-time PA, making it possible for for older adults to perform moderate-intensity aerobic, resistance, flexibility, balance, coordination, and mobility exercises in outdoor spaces. This can be achieved, through adjustments in the opening and closing hours, and minimizing the number of visitors at one time in the parks creating an avenue for proper physical distancing. Furthermore, the use of face masks, hand sanitizers and maintenance of personal hygiene should be properly emphasized for older adults exercising in green spaces and parks, also regular upkeep and improvements of green spaces and parks in rural and urban areas should be strongly encouraged in the era of COVID-19 pandemic.[9]
Table 1: A guideline for tailoring and prescribing home-based physical activity for older adults based on intensity using metabolic equivalent level, heart rate reserve, and rating of perceived exertion

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In conclusion, health-care providers should encourage older adults to perform mind–body exercises, aerobic exercise, and resistance training at home to promote their mental health and quality of life. Some of the PAs that can be carried out at home are mind–body exercises such as any of yoga, tai chi, and qigong at least for 10 min during the days scheduled for exercise, followed by endurance exercises such as walk with arms up, heel hit behind, tiptoe, arm adduction/abduction, and knee lift at least for 10 min during the days scheduled for exercise and then strength training such as pelvic floor muscle exercises, squat, leg raise, knee extension, unilateral knee flexion exercise, leg adduction/abduction exercise, leg kickback, shoulder press, bench press, bicep curl, triceps dip, lateral flexion exercise, sit-up exercise, and back extension for at least 10 min twice per week. Home-based exercise routine should be personalized and prescribed for older individuals by a physician or physiotherapist during the time of ?COVID-19 pandemic to improve their mental health and quality of life. The adaptation and progress of an older individual in a personalized home-based PA program should be constantly monitored by the health-care provider through a telehealth platform in the era of COVID-19 pandemic. However, exercising in a well-monitored, safer, and hygienic environment can serve as an alternative to home-based PA for older adults in the era of COVID-19.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Kandola A, Ashdown-Franks G, Hendrikse J, Sabiston CM, Stubbs B. Physical activity and depression: Towards understanding the antidepressant mechanisms of physical activity. Neurosci Biobehav Rev 2019;107:525-39.  Back to cited text no. 1
Callow DD, Arnold-Nedimala NA, Jordan LS, Pena GS, Won J, Woodard JL, et al. The mental health benefits of physical activity in older adults survive the COVID-19 pandemic. Am J Geriatr Psychiatry 2020;28:1046-57.  Back to cited text no. 2
Jiménez-Pavón D, Carbonell-Baeza A, Lavie CJ. Physical exercise as therapy to fight against the mental and physical consequences of COVID-19 quarantine: Special focus in older people. Prog Cardiovasc Dis 2020;63:386-8.  Back to cited text no. 3
Okechukwu CE, Deb AA, Emara S, Abbas SA. Physical activity as preventive therapy for older adults: A narrative review. Niger J Exp Clin Biosci 2019;7:82-92.  Back to cited text no. 4
  [Full text]  
Machado CL, Pinto RS, Brusco CM, Cadore EL, Radaelli R. COVID-19 pandemic is an urgent time for older people to practice resistance exercise at home. Exp Gerontol 2020;141:111101.  Back to cited text no. 5
Goveas JS, Shear MK. Grief and the COVID-19 pandemic in older adults. Am J Geriatr Psychiatry 2020;28:1119-25.  Back to cited text no. 6
Pelicioni PH, Lord SR. COVID-19 will severely impact older people's lives, and in many more ways than you think! Braz J Phys Ther 2020;24:293-4.  Back to cited text no. 7
Okechukwu CE. Role of green exercise in mental health promotion among adolescents. Int J Prev Med 2020;11:143.  Back to cited text no. 8
  [Full text]  
Slater SJ, Christiana RW, Gustat J. Recommendations for keeping parks and green space accessible for mental and physical health during COVID-19 and other pandemics. Prev Chronic Dis 2020;17:E59.  Back to cited text no. 9


  [Table 1]

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