Exploratory Analysis of Mental Health and Quality of Life Outcomes in a Randomized Controlled Trial to Reduce Sitting Time in Older Adults With Obesity

BACKGROUND: Both sedentary behavior and mental health issues are highly prevalent among older adults. Observational data indicate positive associations between high sedentary behavior and conditions like depression and anxiety. However, it is not known if reducing sedentary behavior leads to changes in mental health. PURPOSE: We conducted an exploratory analysis of a sedentary behavior reduction intervention's effect on self-reported mental health outcomes and quality of life in older adults with obesity. METHODS: The Health Aging Resources to Thrive trial (clinicaltrials.gov # NCT03739762) enrolled older adults aged 60-89 years with a body mass index of 30-50 kg/m2, who self-reported sitting >6 hr/day. Participants were randomized to a sedentary behavior reduction intervention or a healthy living attention-control group. The intervention included 10 behavioral coaching sessions, sitting reduction goals, a standing desk, and a fitness tracker. The attention-control group received 10 coaching contacts to set general healthy living goals excluding physical activity or sedentary behavior. Mental health and quality of life outcomes (depressive symptoms, anxiety symptoms, loneliness, quality of life, sleep disturbance, and pain interference) were measured at baseline, 3 months, and 6 months. We used linear regression models with generalized estimating equations to estimate adjusted mean changes from baseline for each outcome and mean change difference between groups. RESULTS: Participants (N = 283, n = 140 intervention, n = 143 control; mean age = 68.8 years, 65.7% women, 68.9% White non-Hispanic, 55.5% retired) in the intervention group had significant reductions in perceived loneliness score compared with the control group at 6 months (-0.27; 95% confidence interval [-0.52, -0.02]). Depressive symptoms, pain, sleep disturbance, and quality of life improved in both the intervention and control groups, but differences between groups were not statistically significant at 3 or 6 months. CONCLUSIONS: Sedentary behavior reduction may positively impact loneliness in older adults.