behavioral health treatments in gerontology research

Does Online "Working Out Work" as a Treatment and

Prevention for Depression in Older Adults?

Dr. Robelyn A. Garcia

Arizona State University

2011

Online Kinesiofitness Introduction

I bet your wondering,"How can I take a Fitness

Class Online?”

ACKNOWLEDGMENTS

The author would like to thank the following people for their invaluable support, guidance, and assistance during the process of this investigation.

1. Dr. Brenda Shackleford2. Dr. Jen King3. Paula Lippert4. Kathleen Waldron5. The Senior University Staff6. The volunteers who participated in the study.

SPECIAL ACKNOWLEDGMENT

I would like to give a special acknowledgment to my dear Mother, the late Evelyn June Garcia. As a Senior Adult, “Mother” inspired my studies in Gerontology.

Thank You

Presentation byRobelyn A. Garcia, M.S., G.C., Ph.D.

Capstone for Aging and Lifespan Development in the College of

Liberal Arts and Sciences, Arizona State University

ALD 593 APPLIED PROJECT

An Analysis of a Prescribed and Monitored Exercise

Program Administered via the Internet for Senior Adults

with Depression.

POSTER Presented byRobelyn Garcia, M.S., G.C., Ph.D.

ABSTRACTOBJECTIVE: The purpose of this study is to investigate, access, and analyze the effectiveness of an online prescribed and monitored exercise program for the treatment of depression in Older Adults.

The Dependent Variable for the study is Depression.

The Independent Variable for the study is the Effects of Exercise administered via the Internet.

The Population is SENIOR adults.

COOPERATING ORGANIZATION

SENIOR UNIVERSITY: The study was conducted and data was collected at Senior University online website. This organization serves older adults in the Scottsdale, North Phoenix, and Paradise Valley areas.

www.SeniorUniversityEdu.us

SENIOR UNIVERSITY SENIOR UNIVERSITY

ORGANIZATIONAL CHART

Senior AdultInstructors

Senior UniversitySponsors

VolunteerStaff

Senior UniversityInterns

Community ServiceWorkers

Senior UniversityStaff

Dr. Brenda ShacklefordDirector

RESEARCH QUESTION

Does Online "Working Out Work" as a Treatment and

Prevention for Depression in Older

Adults?

By the year 2030, an estimated 70 million people will be older than 65.

Exercise has been shown as ONE of the most effective treatments for depression in elderly people, (Singh 2001).

Health professionals from all disciplines concur on the myriad of mental health benefits that a regular exercise program can provide, (Dias 2003).

REVIEW OF LITERATURE

According to the Surgeon General, "Lack of exercise is the #1 health concern facing this country," (2011).

77.3 % of United States population use the internet, (Internet World Stats, 2010).

“We have the technology to improve the overall fitness and health of the nation,” says Paul Williams, scientist in Berkeley Lab, U.S. Government, (2010).

REVIEW OF LITERATURE

DEPRESSION

Depression is defined by Princeton University Scholars as a mental state characterized by a pessimistic sense of inadequacy and a despondent lack of activity.

DEPRESSION The presence and severity of

depression will be assessed by using THE MERCK MANUAL OF GERIATRICS (GDS) Geriatric Depression Scale. Assessments will be performed at baseline before and after the treatment exercise is concluded.

METHODS THE MERCK MANUAL OF GERIATRICS

Geriatric Depression Scale (GDS) QUESTIONNAIRE

Circle the best answer for how you have felt over the past week:

1. Are you basically satisfied with your life? YES / NO

2. Have you dropped many of your activities and interests? YES / NO

3. Do you feel that your life is empty? YES / NO

4. Do you often get bored? YES / NO

5. Are you in good spirits most of the time? YES / NO

6. Are you afraid that something bad is going to happen to you? YES / NO

7. Do you feel happy most of the time? YES / NO

METHODSTHE MERCK MANUAL OF GERIATRICS (GDS)

8. Do you often feel helpless? YES / NO

9. Do you prefer to stay at home, rather than going out and doing new things? YES / NO

10. Do you feel you have more problems with memory than most? YES / NO

11. Do you think it is wonderful to be alive now? YES / NO

12. Do you feel pretty worthless the way you are now? YES / NO

13. Do you feel full of energy? YES / NO

14. Do you feel that your situation is hopeless? YES / NO

15. Do you think that most people are better off than you are? YES / NO

METHODS GERIATRIC DEPRESSION SCALE SCORING

Score: 1 point for "No" to questions 1, 5, 7, 11, and 13. 1 point for "Yes" to other questions.

----------------------------------------------------------------------------------------------------------------------------------------------

Normal: ≤ 3

Mildly depressed: 7 - 4

Moderately depressed: 8 - 11

Very depressed: ≥ 12----------------------------------------------------------------------------------------------------------------------------------------------

(Adapted from Sheikh JI, Yesavage JA: "Geriatric depression (GDS)." Edited by TL Brink, A Guide to Assessment and Intervention, Clinical Gerontology, pp. 165 -173. Haworth Press Inc., Binghampton, N.Y., 1986.)

METHODS GERIATRIC DEPRESSION SCALE SCORING

----------------------------------------------------------------------

INCLUSION CRITERIA

Mildly depressed: 7 - 4

Moderately depressed: 8 - 11

EXCLUSION CRITERIA

Normal (Not Depressed): ≤ 3

----------------------------------------------------------------------

METHODSResearch DesignResearch Design

Quantitative Research Design.

Pre-Test / Post-Test Design..

One Treatment / Intervention Group Design..

METHODSMeasurement of VariablesMeasurement of Variables

Dependent Variable -- The Dependent The Dependent Variable for the study is Depression. Variable for the study is Depression. Dependent Variable of Depression will be Dependent Variable of Depression will be measured using THE MERCK MANUAL OF measured using THE MERCK MANUAL OF GERIATRICS (GDS) Geriatric Depression GERIATRICS (GDS) Geriatric Depression Scale Questionnaire.Scale Questionnaire.

Independent Variable -- The Independent The Independent Variable for the study is the Effects of Variable for the study is the Effects of Exercise. This is measured by comparing the Exercise. This is measured by comparing the GDS scores before and after the subject’s GDS scores before and after the subject’s participation in the treatment exercise.participation in the treatment exercise.

METHODSThe population is older adults.The population is older adults.

Participants were volunteers aged 50 to 80 years old who met the criteria for mild or moderate depression and scored at least 4 on the GDS at study entry.

Participants had no medical contraindications to exercise as demonstrated by completion of the (PAR-Q) Physical Activity Readiness Questionnaire.

DATA COLLECTIONBaseline:Baseline: Before Exercise

Prior to participating in the treatment exercise program the subjects completed:

1. The (PAR-Q) Physical Activity Readiness Questionnaire.

2. A Basic Minimal Risk Consent form.

3. A Personal Information form.

DATA COLLECTIONIntervention Treatment Exercise Program

“Working Out” will include the following:

On completion of the baseline assessments, participants completed the following exercise program, with a frequency of 3 times per week for 8 weeks:

1.1. Warm-up Warm-up •Flexibility Exercises

2.2. Exercise PrescriptionExercise Prescription•Cardiovascular Endurance Activity (30 minutes)

l Cool-downCool-down•Flexibility Exercises


Warm-up & Cool-down Flexibility Exercises Warm-up & Cool-down Flexibility Exercises 1. Inverted Hurdler 6. Bicep Stretch

2. Butterfly Stretch 7. Tricep Stretch

3. Pretzel Stretch 8. Shoulder Crosses

4. Straddle Stretch 9. Chest Door Stretch

5. Quadricep Stretch 10. Calf Stretch


Exercise Prescription: Exercise Prescription: Cardiovascular Endurance Activity

Participants completed 30 minutes of one the following Cardiovascular Endurance Activities:

1. Brisk Walking2. Stationery Bicycle3. Elliptical Machine4. Swimming

(frequency of 3 times per week for 8 weeks for a total of 24 workouts)

DATA COLLECTIONwww.SeniorUniversityEdu.us

DATA COLLECTION

DATA COLLECTIONwww.SeniorUniversityEdu.us

DATA COLLECTION www.SeniorUniversityEdu.us

RESEARCH HYPOTHESES

Based on the literature review, it is hypothesized that a monitored online exercise program will have a beneficial effect on depression among SENIOR ADULTS.

STATISTICAL PROCEDURE Descriptive interpretation of GDS Questionnaire scores represented in mathematical terms.

Dependent analysis of numerical (QUANTITATIVE) data for Pre and Post Test Mean Differences of one Group.

RESULTS OF THE ANALYSISParticipant Demographics Table

(ADHERENCE TO TREATMENT: Only one participant dropped out of the study.)

Gender Male 38% Female 62%

12 participants 19 Participants

Age 50-60 years 61-69 years

20 Participants 10 Participants

70-80 years1 Participant

Marital Status Single 66% Married 34%

21 Participants 10 Participants

RESULTS OF THE ANALYSISDepression Scale Post-Test Statistics

Scores: 5,2,3,4,5,4,3,4,4,3,3,4,4,4,3,4,5,3,3,4,3,3,5,5,5,5,4,3,4,5

Total Numbers: 30Range: 3 Mean (Average): 3.86667Standard deviation: 0.86037Variance (Standard deviation): 0.74023Population Standard deviation: 0.84591Variance (Population Standard deviation): 0.71556

REFLECTS A NORMAL DISTRIBUTIONALL n POST-TEST SCORES WERE LOWER THAN PRE-TEST

RESULTS OF THE ANALYSIS

-4

1

6

11

Scores

Depressed to Normal

Decrease in Depression Scale

Before OnlineFitness ClassAfter OnlineFitness Class


0

1

2

3

4

5

6

7

Depressed Normal

Before OnlineExercise ClassAfter OnlineExercise Class

Depression Scale Mean Scores

Before After

----->


0123456789

Depressed Not Depressed

Before OnlineExercise ClassAfter OnlineExercise Class

Depression Scale Scores Range = 7

Before After

----->

RESULTS OF THE ANALYSISDepression Scale Scores Range = 7

Before After

----->


00.5

11.5

22.5

33.5

44.5

5

Mean High Low

Mean ScoreHigh/Low Scores

Depression Scale Post-Test Range

Post-Test Range = 3

----->

RESULTS OF THE ANALYSISDepression Scale Mean Scores

Before After 6.06 3.9 Numerical Average

-->

CONCLUSIONS

1. This research study provides evidence and empirical support for the importance of exercise in reducing depression symptoms in Senior adults.

3. Online “Working Out Works” as a Treatment for Depression in Older Adults.

2. A regular exercise program (3 times per week) administered via the internet is an effective aid in the treatment of depression in SENIOR ADULTS.

IMPLICATIONS FOR FURTHER RESEARCH

1. Further research could compare and analyze the effects of a muscular strength training exercise program verses a cardiovascular training exercise program.

2. Research could also include a larger population size with varied levels of depression.

3. In addition, a control group can be added to future research for more detailed analysis and comparison of data.

DISCUSSION

Online“Working Out Works” as a Treatment for Depression in Older

Adults.THE END

behavioral health treatments in gerontology research

Health & Medicine