# Impact of Pre-lockdown Hyper-energy on Mood and Rhythm Dysregulation in Older Adults During the COVID-19 Pandemic

## TL;DR

Older adults with hyper-energy before lockdown showed worse mood and rhythm regulation during the pandemic compared to those without hyper-energy.

## Contribution

The study identifies a link between pre-lockdown hyper-energy and increased vulnerability to mood and rhythm dysregulation during lockdown in older adults.

## Key findings

- Individuals with pre-lockdown hyper-energy showed significantly higher increases in rhythm dysregulation and depressive symptoms during lockdown.
- A strong inverse correlation was found between perceived energy and depressive symptoms, especially during lockdown.
- Those who no longer had hyper-energy at T1 still showed greater increases in BSRS and PHQ-9 scores compared to those without hyper-energy.

## Abstract

The aim of this work is to verify whether a cohort of elderly people with hyper-energy tended to increase depressive symptoms and misaligned social and personal rhythms during the lockdown compared to a cohort of older adults without hyper-energy one year before the lockdown.

The two cohorts were evaluated in April 2019 (T0) and in April 2020 (T1). Hyper-energy, cognitive performance, depressive symptoms, and social and personal rhythms were evaluated at T0 and T1.

In the measure of the Brief Social Rhythm Scale (BSRS) score, the differences between groups in the two observation times reach statistical significance. The sub-group with previous hyper-energy at T0 but no longer having hyper-energy at T1 increases the score by more than 5 points (a higher score indicates greater rhythm dysregulation, thus having a worse regulation of rhythms at T1), while in those individuals who didn’t have hyper-energy, the score remains substantially unchanged (+0.06). However, if the increase in the score from T0 and T1 is measured, both groups with hyper-energy at T0 presented a greater mean increase compared to people who did not have hyper-energy at T1. In the total of the eleven elderly people with hyper-energy at T0, the mean increase in BSRS score was 1.05±1.19 versus 0.06±0.98 (F=9.407, P=0.003), and in people who no longer had hyper-energy at T1, it was 1.05±1.19 versus 5.50±3.83 (F=105.0, P<0.0001). In people with hyper-energy at T0, the mean increase in the Patient Health Questionnaire-9 (PHQ-9) score was 0.72±0.75 versus 0.01±0.28 (F=37.153, P<0.0001). The gain was even higher in people who no longer had hyper-energy at T1, 1.38±1.03 vs. 0.01±0.28 (F=87.386, P<0.0001). An inverse linear correlation was found between energy perception (measured as the score of Item 10 of SF-12) and the score of PHQ-9 measuring depressive symptoms both at T0 and, more strongly, at T1, as well as with the BSRS scores, but only at T1.

The study, despite the limitations of a small sample, seems to confirm a greater vulnerability to the lockdown situation in people with hyperactivity, even in the absence of psychopathology (i.e., part of the bipolar spectrum).