exercise to prevent depression and anxiety in older hispanics

Conditions: Anxiety; Depression

Summary: the study is a randomized pilot trial of a health promotion intervention in the prevention of anxiety and depression in older hispanics.

eligible participants will be randomized to either the happy older latinos are active (hola) intervention or a psychoeducation condition. participants randomized to hola will participate in a group exercise, 3 times a week, for 16 weeks. the exercise is a moderate intensity walk at a centrally located park in miami-dade county and will last for an hour (10 minute warmup/stretching, 30 minute walk, 5 minute cool down). groups will consist of 6 participants and be led by a community health worker. during the cool down phase, participants will plan a pleasant event to be done in between sessions. participants randomized to the psychoeducation component will receive a fotonovela and will meet once a month after they receive the fotonovela to discuss their thoughts on the materials they received. these discussion groups will last one hour and will consist of 10 participants. a total of 60 participants will be randomized (30 to hola, 30 to fotonovela). assessments will be conducted at baseline, post intervention, 6 months post-intervention, and 12 months post-intervention.

Eligibility criteria:
inclusion criteria: 1. hispanic (self-identified); 2. age 60+; 3. minor depression as defined by a primary dsm-iv axis i diagnosis of minor depressive disorder or subthreshold depression defined as a score ≥ 3 on the patient health questionnaire (phq-2), or subthreshold anxiety as defined as a score ≥ 3 on the generalized anxiety disorder-2 scale (gad-2); 4. absence of episodes of major depression and anxiety disorders for past 12 months (as determined by the mini); 5. voluntary informed consent for participation in the study by the participant or by the participant's legally designated guardian or conservator; 6. medical clearance for participation in an exercise program by a physician, physician's assistant, or nurse practitioner; 7. expect to be resident in miami for the subsequent 12 months. exclusion criteria: 1. currently residing in a nursing or group home; 2. a terminal physical illness expected to result in the death within one year; 3. a diagnosis of dementia, co-morbid diagnosis of dementia, or significant cognitive impairment as indicated by an mmse score \<24; 4. presence of any axis 1 psychiatric disorder or substance abuse during preceding 12 months; 5. history of psychiatric disorders other than non-psychotic unipolar major depression or anxiety disorder; 6. high suicide risk, i.e., intent or plan to attempt suicide in the near future (a response of "yes" to questions 3, 4, and/or 5 on the paykel questionnaire); 7. participants taking cognitive enhancing medication or psychotropic medications (e.g. antidepressants); 8. unable to complete 400 m walk test in less than 15 min; 9. if participant heart rate exceeded 170 beats per minute or systolic blood pressure exceeds 180 during 400 m walk test; 10. chest or leg pain, dyspnea, dizziness, feeling faint, or other significant symptoms while completing 400 m walk test; (i) acute or severe medical illness that would prevent participants from walking at a moderate pace for 45 minutes, three times a week.