Objective: To evaluate the associations of moderate to vigorous physical activity (MVPA), vigorous physical activity (VPA), moderate physical activity (MPA), and sedentary behavior (SB) with depressive, anxiety, and co-occurring depressive and anxiety symptoms (D&A) during the COVID-19 pandemic in Brazil.Methods: Cross-sectional online survey in self-isolating people. Self-reported MVPA, VPA, MPA, and SB (exposures), and depressive and anxiety symptoms (Beck Depression and Anxiety Inventories [BDI and BAI]) were collected. Associations of MVPA, VPA, MPA, and SB with prevalent depressive (BDI>9), anxiety (BAI>7), and D&A (BDI>9+BAI>7) symptoms were investigated using logistic regressions, presented as odds ratio (OR) and 95% confidence interval (95%CI). Linear regressions were performed testing associations with symptom severity. Models were adjusted for confounding factors. Results: Participants (n=937, females=72.3%) performing ≥30min/day MVPA or ≥15min/day VPA had lower odds of prevalent depressive (ORMVPA=0.71, 95%CI=0.53-0.96; ORVPA=0.60, 95%CI=0.43-0.82), anxiety (ORMVPA=0.71, 95%CI=0.54-0.96; ORVPA=0.70, 95%CI=0.51-0.96), and co-occurring D&A symptoms (ORMVPA=0.71, 95%CI=0.52-0.96; ORVPA=0.59, 95%CI=0.41-0.83). People spending ≥10h/day sedentary were more likely to have depressive symptoms (OR=1.39,95%CI=1.02-1.90). Each hour spent sedentary corresponded to 0.22 (95%CI=0.10-0.33) points and 0.16 (95%CI=0.02-0.31) points higher on the BDI and BAI, respectively.Conclusion: Higher MVPA and VPA levels are associated with lower odds of depressive, anxiety and D&A symptoms. Higher SB is associated with higher odds of depressive symptoms.

Objective: To evaluate the antidepressant effects of exercise in older adults, using randomized controlled trial (RCT) data. Methods: We conducted a meta-analysis of exercise in older adults, addressing limitations of previous works. RCTs of exercise interventions in older people with depression (≥ 60 years) comparing exercise vs. control were eligible. A random-effects meta-analysis calculating the standardized mean difference (SMD) (95% confidence interval [95%CI]), meta-regressions, and trim, fill, and fail-safe number analyses were conducted. Results: Eight RCTs were included, representing 138 participants in exercise arms and 129 controls. Exercise had a large and significant effect on depression (SMD = -0.90 [95%CI -0.29 to -1.51]), with a fail-safe number of 71 studies. Significant effects were found for 1) mixed aerobic and anaerobic interventions, 2) at moderate intensity, 3) that were group-based, 4) that utilized mixed supervised and unsupervised formats, and 5) in people without other clinical comorbidities. Conclusion: Adjusting for publication bias increased the beneficial effects of exercise in three subgroup analysis, suggesting that previous meta-analyses have underestimated the benefits of exercise due to publication bias. We advocate that exercise be considered as a routine component of the management of depression in older adults.