How Did the COVID-19 Lockdown Pandemic Affect the Depression Symptomatology in Mediterranean Older Adults with Metabolic Syndrome?
Authors: Paz-Graniel Indira , Babio Nancy , Nishi Stephanie K. , Martínez-González Miguel Ángel , Corella Dolores , Fitó Montserrat , Martínez Alfredo , Alonso-Gómez Ángel M. , Wärnberg Julia , Vioque Jesús , Romaguera Dora , López-Miranda José , Estruch Ramon , Tinahones Francisco J. , Santos-Lozano José Manuel , Serra-Majem J. Luís , Bueno-Cavanillas Aurora , Tur Josep A. , Sánchez Vicente Martín , Pintó Xavier , Delgado-Rodríguez Miguel , Matía-Martín Pilar , Vidal Josep , Calderon-Sanchez Cristina , Daimiel Lidia , Ros Emili , Fernández-Aranda Fernando , Toledo Estefania , Valle-Hita Cristina , Sorli Jose V. , Lassale Camille , Garcia-Rios Antonio , Oncina-Canovas Alejandro , Barón-López Francisco Javier , Zulet M. Angeles , Rayó Elena , Casas Rosa , Thomas-Carazo Esther , Tojal-Sierra Lucas , Damas-Fuentes Miguel , Ruiz-Canela Miguel , De las Heras-Delgado Sara , Fernandez-Carrión Rebeca , Castañer Olga , Peña-Orihuela Patricia J. , Gonzalez-Palacios Sandra , Buil-Cosiales Pilar , Goday Albert , Salas-Salvadó Jordi 
Published: July 2023

Background and Aims. To control the COVID-19 spread, in March 2020, a forced home lockdown was established in Spain. In the present study, we aimed to assess the effect of mobility and social COVID-19-established restrictions on depressive symptomatology in older adults with metabolic syndrome. We hypothesize that severe restrictions might have resulted in detrimental changes in depressive symptomatology. Methods. 2,312 PREDIMED-Plus study participants (

men
=
53.9

%; mean

age
=
64.9
±
4.8

years) who completed a COVID-19 lockdown questionnaire to assess the severity of restrictions/lockdown and the validated Spanish version of the Beck Depression Inventory-II (BDI-II) during the three established phases concerning the COVID-19 lockdown in Spain (prelockdown, lockdown, and postlockdown) were included in this longitudinal analysis. Participants were categorized according to high or low lockdown severity. Analyses of covariance were performed to assess changes in depressive symptomatology across lockdown phases. Results. No significant differences in participant depression symptomatology changes were observed between lockdown severity categories (low/high) at the studied phases. During the lockdown phase, participants showed a decrease in BDI-II score compared to the prelockdown phase (mean (95% CI), -0.48 (-0.24, -0.72),

P
<
0.001

); a nonsignificantly larger decrease was observed in participants allocated in the low-lockdown category (low: -0.59 (-0.95, -0.23), high: -0.43 (-0.67, -0.19)). Similar decreases in depression symptomatology were found for the physical environment dimension. The post- and prelockdown phase BDI-II scores were roughly similar. Conclusions. The COVID-19 pandemic lockdown was associated with a decrease in depressive symptomatology that returned to prelockdown levels after the lockdown. The degree of lockdown was not associated with depressive symptomatology. The potential preventive role of the physical environment and social interactions on mental disorders during forced home lockdown should be further studied. This trial is registered with ISRCTN89898870. Retrospectively registered on 24 July 2014.