Exercise and Horticultural Programs for Older Adults with Depressive Symptoms and Memory Problems: A Randomized Controlled Trial

Abstract

Depressive symptoms and memory problems are risk factors for dementia. Exercise can reduce these in older people, and horticultural activity can benefit people with dementia. This study assessed the efficacy of exercise and horticultural interventions for community-dwelling older adults with depressive symptoms and mild memory decline. In this randomized controlled trial, older adults (n = 89) were assigned to exercise, horticultural, or control groups. Exercise and horticultural programs included 20 weekly 90-min sessions. The control group attended two 90-min classes. Outcomes were assessed at baseline, and then 6- and 12-months post-intervention. Primary outcome measures were the Geriatric Depression Scale-15 (GDS-15) and Wechsler Memory Scale-Revised. Walking speed, two-minute walking test scores, social network, life space, and subjective daily physical activity were secondary outcome measures. Compared with the control group, the exercise group obtained higher immediate and delayed recall logical memory scores, and the increase in immediate recall scores remained 12-months post-intervention. Two-minute walking performance improved in the exercise group, but not after 12 months. GDS-15 scores showed no significant improvements. The horticultural and control groups showed no differences. Exercise may improve memory, while horticultural activity may not. The effects of exercise and horticultural interventions on depressive symptoms remain unclear.

Effects of Types of Horticultural Activity on the Physical and Mental State of Elderly Individuals

“…According to a report in 2015, by the Ministry of Health and Welfare of Taiwan, the healthy or subhealthy accounted for 83.5% of the elderly population in Taiwan and the disabled account for 16.5% [ 2 ]. Whether healthy or disabled, as the elderly population ages they must face the decline of physiological function and cognitive function, which leads to the negative impact of their physiological, psychological, and social functions [ 3 , 4 , 5 , 6 ]. Studies have indicated that elders who contact nature or plants or engage in horticultural activities could maintain health, delay aging, and improve the benefits of physical, psychological, cognitive, and social functions [ 3 , 5 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 ].…”

“…Moreover, we can use questionnaires or scales to understand more subjective mental states [ 16 , 42 ]. Commonly used questionnaires are the Profile of Mood States (POMS) [ 33 , 34 , 43 ], Life Satisfaction Index [ 5 , 16 , 44 ], stress scale [ 28 ], and depression related scale [ 6 , 15 , 18 , 24 ]. Many studies have explored how contact with nature and engagement in horticultural activities affects mental states [ 5 , 6 , 7 , 16 , 33 , 34 , 42 ].…”

“…First, the elders living in nursing homes who were cognitively intact, and no visual or auditory impairment occurred to them [ 5 , 7 , 16 ]. Second, the elders with depressive symptoms and memory problems [ 6 ]. Third, middle-aged and elderly individuals with or without chronic diseases [ 34 ].…”

Modeling the SARS-CoV-2 mutation based on geographical regions and time

“…The worldwide outbreak happens to provide good environments for SARS-CoV-2 mutations. The accumulation of these mutations may cause the COVID-19 to develop in an uncertain direction, which will have a huge impact on society and personal life 4 . According to other epidemiological studies, mutations in the genome of an epidemic will be inherited from the spreader to the next generation of patients.…”

“…The worldwide outbreak happens to provide good environments for SARS-CoV-2 mutations. The accumulation of these mutations may cause the COVID-19 to develop in an uncertain direction, which will have a huge impact on society and personal life 4 .…”