Behavioral Health Treatments in Gerontology Research.

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Does Online"Working Out Work" as a Treatment and Prevention for Depression in Older Adults?

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Behavioral Health Treatments in Gerontology Research.

  1. 1. Does Online "Working Out Work" as a Treatment and Prevention for Depression in Older Adults? Dr. Robelyn A. Garcia Arizona State University 2011
  2. 2. Online Kinesiofitness Introduction I bet your wondering, "How can I take a Fitness Class Online?”
  3. 3. 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 Shackleford 2. Dr. Jen King 3. Paula Lippert 4. Kathleen Waldron 5. The Senior University Staff 6. 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
  4. 4. Presentation by Robelyn A. Garcia, M.S., G.C., Ph.D. <ul><li>Capstone for Aging and Lifespan Development in the College of Liberal Arts and Sciences, Arizona State University </li></ul>ALD 593 APPLIED PROJECT
  5. 5. An Analysis of a Prescribed and Monitored Exercise Program Administered via the Internet for Senior Adults with Depression. <ul><li>POSTER Presented by </li></ul><ul><li>Robelyn Garcia, M.S., G.C., Ph.D. </li></ul>
  6. 6. ABSTRACT <ul><li>OBJECTIVE : 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. </li></ul><ul><li>The Dependent Variable for the study is Depression. </li></ul><ul><li>The Independent Variable for the study is the Effects of Exercise administered via the Internet. </li></ul><ul><li>The Population is SENIOR adults. </li></ul>
  7. 7. COOPERATING ORGANIZATION <ul><li>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. </li></ul>www.SeniorUniversityEdu.us
  8. 8. SENIOR UNIVERSITY
  9. 9. RESEARCH QUESTION <ul><li>Does Online &quot;Working Out Work&quot; as a Treatment and Prevention for Depression in Older Adults? </li></ul>
  10. 10. <ul><li>By the year 2030, an estimated 70 million people will be older than 65. </li></ul><ul><li>Exercise has been shown as ONE of the most effective treatments for depression in elderly people, (Singh 2001). </li></ul><ul><li>Health professionals from all disciplines concur on the myriad of mental health benefits that a regular exercise program can provide, (Dias 2003). </li></ul>REVIEW OF LITERATURE
  11. 11. <ul><li>According to the Surgeon General, &quot;Lack of exercise is the #1 health concern facing this country,&quot; (2011). </li></ul><ul><li>77.3 % of United States population use the internet, (Internet World Stats, 2010). </li></ul><ul><li>“ 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). </li></ul>REVIEW OF LITERATURE
  12. 12. DEPRESSION <ul><li>Depression is defined by Princeton University Scholars as a mental state characterized by a pessimistic sense of inadequacy and a despondent lack of activity. </li></ul>
  13. 13. DEPRESSION <ul><li>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. </li></ul>
  14. 14. METHODS <ul><li>THE MERCK MANUAL OF GERIATRICS </li></ul><ul><li>Geriatric Depression Scale (GDS) QUESTIONNAIRE </li></ul><ul><li>Circle the best answer for how you have felt over the past week: </li></ul><ul><li>1. Are you basically satisfied with your life? YES / NO </li></ul><ul><li>2. Have you dropped many of your activities and interests? YES / NO </li></ul><ul><li>3. Do you feel that your life is empty? YES / NO </li></ul><ul><li>4. Do you often get bored? YES / NO </li></ul><ul><li>5. Are you in good spirits most of the time? YES / NO </li></ul><ul><li>6. Are you afraid that something bad is going to happen to you? YES / NO </li></ul><ul><li>7. Do you feel happy most of the time? YES / NO </li></ul>
  15. 15. METHODS <ul><li>THE MERCK MANUAL OF GERIATRICS (GDS) </li></ul><ul><li>8. Do you often feel helpless? YES / NO </li></ul><ul><li>9. Do you prefer to stay at home, rather than going out and doing new things? YES / NO </li></ul><ul><li>10 . Do you feel you have more problems with memory than most? YES / NO </li></ul><ul><li>11. Do you think it is wonderful to be alive now? YES / NO </li></ul><ul><li>12. Do you feel pretty worthless the way you are now? YES / NO </li></ul><ul><li>13. Do you feel full of energy? YES / NO </li></ul><ul><li>14. Do you feel that your situation is hopeless? YES / NO </li></ul><ul><li>15. Do you think that most people are better off than you are? YES / NO </li></ul>
  16. 16. METHODS <ul><li>GERIATRIC DEPRESSION SCALE SCORING </li></ul><ul><li>Score: 1 point for &quot;No&quot; to questions 1, 5, 7, 11, and 13. 1 point for &quot;Yes&quot; to other questions. </li></ul><ul><li>---------------------------------------------------------------------------------------------------------------------------------------------- </li></ul><ul><li>Normal: ≤ 3 </li></ul><ul><li>Mildly depressed: 7 - 4 </li></ul><ul><li>Moderately depressed: 8 - 11 </li></ul><ul><li>Very depressed: ≥ 12 </li></ul><ul><li>---------------------------------------------------------------------------------------------------------------------------------------------- </li></ul><ul><li> (Adapted from Sheikh JI, Yesavage JA: &quot;Geriatric depression (GDS).&quot; Edited by TL Brink, A Guide to Assessment and Intervention, Clinical Gerontology, pp. 165 -173. Haworth Press Inc., Binghampton, N.Y., 1986.) </li></ul>
  17. 17. METHODS <ul><li>GERIATRIC DEPRESSION SCALE SCORING </li></ul><ul><li>---------------------------------------------------------------------- </li></ul><ul><li>INCLUSION CRITERIA </li></ul><ul><li>Mildly depressed: 7 - 4 </li></ul><ul><li>Moderately depressed: 8 - 11 </li></ul><ul><li>EXCLUSION CRITERIA </li></ul><ul><li>Normal (Not Depressed): ≤ 3 </li></ul><ul><li>---------------------------------------------------------------------- </li></ul>
  18. 18. METHODS <ul><li>Research Design </li></ul><ul><ul><li>Quantitative Research Design. </li></ul></ul><ul><ul><li>Pre-Test / Post-Test Design . </li></ul></ul><ul><ul><li>One Treatment / Intervention Group Design . </li></ul></ul>
  19. 19. METHODS <ul><li>Measurement of Variables </li></ul><ul><ul><li>Dependent Variable - The Dependent Variable for the study is Depression. Dependent Variable of Depression will be measured using THE MERCK MANUAL OF GERIATRICS (GDS) Geriatric Depression Scale Questionnaire. </li></ul></ul><ul><ul><li>Independent Variable - The Independent Variable for the study is the Effects of Exercise. This is measured by comparing the GDS scores before and after the subject’s participation in the treatment exercise. </li></ul></ul>
  20. 20. METHODS <ul><li>The population is older adults. </li></ul><ul><li>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. </li></ul><ul><li>Participants had no medical contraindications to exercise as demonstrated by completion of the (PAR-Q) Physical Activity Readiness Questionnaire . </li></ul>
  21. 21. DATA COLLECTION <ul><li>Baseline: Before Exercise </li></ul><ul><li>Prior to participating in the treatment exercise program the subjects completed: </li></ul><ul><li>The (PAR-Q) Physical Activity Readiness Questionnaire. </li></ul><ul><li>A Basic Minimal Risk Consent form. </li></ul><ul><li>A Personal Information form. </li></ul>
  22. 22. DATA COLLECTION <ul><li>Intervention Treatment Exercise Program </li></ul><ul><li>“ Working Out” will include the following: </li></ul><ul><li>On completion of the baseline assessments, participants completed the following exercise program, with a frequency of 3 times per week for 8 weeks: </li></ul><ul><ul><ul><li>Warm-up </li></ul></ul></ul><ul><ul><ul><ul><li>Flexibility Exercises </li></ul></ul></ul></ul><ul><ul><ul><li>Exercise Prescription </li></ul></ul></ul><ul><ul><ul><ul><li>Cardiovascular Endurance Activity (30 minutes) </li></ul></ul></ul></ul><ul><ul><ul><li>Cool-down </li></ul></ul></ul><ul><ul><ul><ul><li>Flexibility Exercises </li></ul></ul></ul></ul>
  23. 23. DATA COLLECTION <ul><li>Intervention Treatment Exercise Program </li></ul><ul><li>Warm-up & Cool-down Flexibility Exercises </li></ul><ul><li>1. Inverted Hurdler 6. Bicep Stretch </li></ul><ul><li>2. Butterfly Stretch 7. Tricep Stretch </li></ul><ul><li>3. Pretzel Stretch 8. Shoulder Crosses </li></ul><ul><li>4. Straddle Stretch 9. Chest Door Stretch </li></ul><ul><li>5. Quadricep Stretch 10. Calf Stretch </li></ul>
  24. 24. DATA COLLECTION <ul><li>Intervention Treatment Exercise Program </li></ul><ul><li>Exercise Prescription: Cardiovascular Endurance Activity </li></ul><ul><li>Participants completed 30 minutes of one the following </li></ul><ul><li>Cardiovascular Endurance Activities: </li></ul><ul><li>Brisk Walking </li></ul><ul><li>Stationery Bicycle </li></ul><ul><li>Elliptical Machine </li></ul><ul><li>Swimming </li></ul><ul><li>(frequency of 3 times per week for 8 weeks for a total of </li></ul><ul><li>24 workouts) </li></ul>
  25. 25. DATA COLLECTION www.SeniorUniversityEdu.us
  26. 26. DATA COLLECTION www.SeniorUniversityEdu.us
  27. 27. DATA COLLECTION
  28. 28. DATA COLLECTION www.SeniorUniversityEdu.us
  29. 29. DATA COLLECTION www.SeniorUniversityEdu.us
  30. 30. DATA COLLECTION www.SeniorUniversityEdu.us
  31. 31. DATA COLLECTION www.SeniorUniversityEdu.us
  32. 32. RESEARCH HYPOTHESES <ul><li>Based on the literature review, it is hypothesized that a monitored online exercise program will have a beneficial effect on depression among SENIOR ADULTS. </li></ul>
  33. 33. STATISTICAL PROCEDURE <ul><li>Descriptive interpretation of GDS Questionnaire scores represented in mathematical terms. </li></ul><ul><li>Dependent analysis of numerical (QUANTITATIVE) data for Pre and Post Test Mean Differences of one Group. </li></ul>
  34. 34. RESULTS OF THE ANALYSIS <ul><li>Participant Demographics Table </li></ul><ul><li>(ADHERENCE TO TREATMENT: Only one participant dropped out of the study.) </li></ul>10 Participants 21 Participants Married 34% Single 66% Marital Status 10 Participants 70-80 years 1 Participant 20 Participants 61-69 years 50-60 years Age 19 Participants 12 participants Female 62% Male 38% Gender
  35. 35. RESULTS OF THE ANALYSIS Depression Scale Post-Test Statistics <ul><li>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 </li></ul><ul><li>Total Numbers: 30 </li></ul><ul><li>Range: 3 </li></ul><ul><li>Mean (Average): 3.86667 </li></ul><ul><li>Standard deviation: 0.86037 </li></ul><ul><li>Variance (Standard deviation): 0.74023 </li></ul><ul><li>Population Standard deviation: 0.84591 </li></ul><ul><li>Variance (Population Standard deviation): 0.71556 </li></ul><ul><li>REFLECTS A NORMAL DISTRIBUTION </li></ul><ul><li>ALL n POST-TEST SCORES WERE LOWER THAN PRE-TEST </li></ul>
  36. 36. RESULTS OF THE ANALYSIS
  37. 37. RESULTS OF THE ANALYSIS Depression Scale Mean Scores Before After ----->
  38. 38. RESULTS OF THE ANALYSIS Depression Scale Scores Range = 7 Before After ----->
  39. 39. RESULTS OF THE ANALYSIS Depression Scale Scores Range = 7 Before After ----->
  40. 40. RESULTS OF THE ANALYSIS Depression Scale Post-Test Range Post-Test Range = 3 ----->
  41. 41. RESULTS OF THE ANALYSIS Depression Scale Mean Scores Before After 6.06 3.9 Numerical Average -->
  42. 42. CONCLUSIONS <ul><li>1. This research study provides evidence and empirical support for the importance of exercise in reducing depression symptoms in Senior adults. </li></ul><ul><ul><li>3. Online “Working Out Works” as a </li></ul></ul><ul><ul><li> Treatment for Depression in Older Adults. </li></ul></ul><ul><ul><li>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. </li></ul></ul>
  43. 43. IMPLICATIONS FOR FURTHER RESEARCH <ul><li>Further research could compare and analyze the effects of a muscular strength training exercise program verses a cardiovascular training exercise program. </li></ul><ul><li>2. Research could also include a larger population size with varied levels of depression. </li></ul><ul><li>3. In addition, a control group can be added to future research for more detailed analysis and comparison of data. </li></ul>
  44. 44. DISCUSSION <ul><ul><li>Online </li></ul></ul><ul><ul><li>“ Working Out Works” as a Treatment for Depression in Older Adults. </li></ul></ul>THE END

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