Preventing Anxiety and Depression in Older Hispanics

Inclusion Criteria:

- Latino (self-identified);

- Age 60+;

- Subthreshold depression defined as a score ≥ 5 on the Patient Health Questionnaire
(PHQ-9), OR subthreshold anxiety as defined as a score ≥ 5 on the GAD-7;

- Do not meet criteria for current MDD or GAD as indicated by the Mini International
Neuropsychiatric Inventory (MINI);

- Voluntary informed consent for participation in the study by the participant or by the
participant's legally designated guardian or conservator;

- Medical clearance for participation in a health promotion intervention by a physician,
physician's assistant, or nurse practitioner;

- Not taking steroidal or anti-inflammatory medication (including NSAIDs) within 2 weeks
of treatment randomization;

- Expect to be resident in Miami for the subsequent 2 years.

Exclusion Criteria:

- Have met criteria for major depressive disorder or generalized anxiety disorder within
the past 12 months;

- Have met criteria for alcohol or other substance abuse disorders within the past 12
months;

- Are currently receiving antidepressant medication or participating in other mental
health treatment;

- Have a lifetime history of bipolar disorder or other psychotic disorder including
major depression with psychotic features;

- Have a diagnosis of any neurodegenerative disorder or dementia (Parkinson's disease,
Alzheimer's, vascular, frontotemporal dementia, etc.) or significant cognitive
impairment as indicated by a Mini Mental Status Exam (MMSE) score <24;

- Are current tobacco smokers since smoking influences systemic inflammation;

- Have contraindications to physical activity outlined in the American College of Sports
Medicine standards;

- Have 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;

- Are unable to complete 10 m walk test;

- Currently residing in a nursing or group home;

- Have a terminal physical illness expected to result in the death within one year;

- Any evidence of current infection; and

- Have an acute or severe medical illness that precludes them from safely participating
in a health promotion intervention (further defined in the protocol).