The impact of social isolation from COVID-19-related public health measures on cognitive function and mental health among older adults: A systematic review and meta-analysis

Knowledge, attitudes, and practices regarding intrinsic capacity in the elderly population: A cross-sectional study in Shanghai, China

To investigate the knowledge, attitudes, and practices (KAP) of the elderly population regarding their intrinsic capacity, as defined by the World Health Organization as a marker of healthy aging. A cross-sectional study was conducted at the Shanghai Traditional Chinese Medicine Hospital from July to November 2023. Participants' socio-demographic information and KAP scores were collected through a self-designed questionnaire. A total of 507 elderly individuals participated, with 53.25% being male and a mean age of 70.76 ± 7.63 years. The mean knowledge, attitude, and practice scores were 19.58 ± 8.85, 30.07 ± 4.81, and 34.71 ± 7.77, respectively. Pearson's correlation analysis showed significant positive correlations among the KAP scores (all P < 0.001). Multivariate logistic regression indicated that knowledge scores (OR = 1.127, P < 0.001), attitude scores (OR = 1.189, P < 0.001), and current employment status (OR = 2.759, P = 0.009) were associated with proactive practices. Structural equation modeling demonstrated that knowledge had a direct influence on attitude (β = 0.572, P < 0.001) and practice (β = 0.776, P < 0.001), while attitude directly impacted practice (β = 0.412, P < 0.001). The study reveals that the elderly lack knowledge but have positive attitudes and proactive behaviors about intrinsic capacity. Enhancing education and attitudes is vital for healthy aging and well-being.

Government Restrictions During the COVID-19 Pandemic and Depressive Symptoms Following Widowhood

Spousal loss is associated with an immediate increase in depressive symptoms. However, the consequences of widowhood for symptoms of depression during the COVID-19 pandemic have remained largely unexplored. In this study, we use data from the Survey of Health, Ageing and Retirement in Europe and fixed-effects regression modeling to address three research questions. First, how have depressive symptoms changed over time in 10 European countries for older adults by marital status and spousal death timing? Second, do the surviving spouses of persons who died during the pandemic face greater increases in depressive symptoms compared with adults widowed before the pandemic? Third, to what extent did the strictness of government restrictions moderate the pandemic widowhood penalty for symptoms of depression? We find that depressive symptoms increased dramatically for those widowed during the pandemic compared with widowed adults before the pandemic. In addition, the pandemic widowhood penalty does not apply to all those who lost their partners during the pandemic; it applies only to those who lost their partner when governments were enforcing stay-at-home orders. Our findings support the notion that the COVID-19 pandemic and stringent government restrictions exacerbated risk factors and hindered protective factors that affect older adults' resilience to spousal death.

The Impact of the COVID-19 Pandemic in the Interrelationships Among Mental Health, Nutritional Status and Lifestyle Factors of Older Adults: A Cross-Sectional Study in the Pre- and Post-Covid Periods

BACKGROUND/OBJECTIVES

The COVID-19 pandemic has led to detrimental effects on diverse aspects of the mental and physical health of the general population worldwide. The elderly are more susceptible to COVID-19 infection compared to younger age groups. In this aspect, the purpose of the current survey is to evaluate the effect of the COVID-19 pandemic on the interrelationships among the sociodemographic and anthropometric characteristics, depressive behavior, quality of life, cognition status, physical activity and nutritional status of older adults.

METHODS

The present study constitutes a comparative, cross-sectional study of 4162 older adults (mean age ± standard deviation: 72.13 ± 8.1 years and 75.22 ± 8.2 years in the pre- and post-COVID-19 periods, respectively, and a male/female ratio of almost 1:1). We used validated questionnaires to assess depression, cognition function, quality of life, physical activity and nutritional status of the elderly in the pre-Covid and post-Covid periods. Relevant questionnaires were also used for collecting sociodemographic data, while anthropometric data were measured using standard protocols.

RESULTS

The present study finds that the COVID-19 pandemic influenced, in an independent manner, residence location, smoking status, overweight/obesity and abdominal obesity, depressive behavior, quality of life, cognition behavior, physical activity levels and nutritional status of the elderly. The COVID-19 pandemic was also related to employment and living status as well as family economic status. Nevertheless, the above three relationships were insignificant in the multivariate analysis.

CONCLUSIONS

The COVID-19 pandemic exerted deleterious effects on several aspects of the mental and physical health of the elderly, which appeared to strongly persist in the post-Covid period. Future prospective population-based and well-organized surveys should be conducted to establish whether there is a causality long-term effect of the COVID-19 pandemic on diverse aspects of the mental and physical health of the elderly.

Aggression and patterns of co-occurrence mental health problems in Chinese adolescents: a latent class analysis

BACKGROUND

Mental health is an important aspect of adolescents' development and well-being. Mental health problems, such as depression, anxiety, non-suicidal self-injury, suicide ideation, and suicide attempt, are recognized to be interconnected and to occur often. Research has found that aggression is connected to a variety of mental health problems. However, there's limited knowledge about the patterns of how depression, anxiety, non-suicidal self-injury, suicide ideation, and suicide attempt co-occur, and only few studies describe their association with aggression and sex differences.

METHODS

A cross-sectional study that involved 18,555 Chinese adolescents was performed to explore the mental health latent classes and the relationship with aggression.

RESULTS

The results showed four latent classes of mental health problems: low-symptom class (70.8%), self-harm class (9.1%), emotional symptom class (13.4%), and high-symptom class (6.7%). A significant co-occurrence between depression, anxiety, non-suicidal self-injury, suicide ideation, and suicide attempt was found in the high-symptom class. Notably, higher levels of adolescent aggression were associated with comorbid moderate to high mental health problems. Similar four latent classes and associations were found across sexes.

CONCLUSIONS

The present study emphasized the heterogeneity of mental health problems and revealed their co-occurrence patterns. Aggression levels are associated with the latent classes in adolescents, with the most pronounced association observed in the high-symptom class. Preventing aggression could contribute to reducing the severity and co-occurring patterns of mental health problems among adolescents.

Social, Digital and Community Capital Facilitated COVID-19 Pandemic Resilience in a Qualitative Survey of Older Adults With Mild Cognitive Concerns

The COVID-19 pandemic negatively affected known dementia risk factors and cognition in older adults. Our objective was to explore how older adults with cognitive concerns (ie, MCI or SCD) were able, or not able to engage in lifestyle activities associated with dementia prevention and maintain their wellbeing. We invited adults with mild cognitive concerns without dementia, aged ≥60 years participating in a randomised controlled trial of a psychosocial, secondary dementia prevention intervention, to complete a semi-structured survey, regarding how the pandemic impacted their lifestyle and wellbeing in areas relevant to dementia risk: social connections, activities, diet, mental and physical health, community and family support. Data was collected between October 2020 and December 2022; we inductively coded responses using manifest content analysis. 551/748 trial participants completed the survey. Most (n = 530, 96%) described pandemic-related lifestyle or wellbeing changes; two thirds (n = 369/545, 67.7%) reported less activities. A quarter (n = 145, 26.8%) identified no change in social connections, with others reporting less in-person meetings (n = 139, 25.7%) or speaking to less people (n = 99; 18.2%); a minority engaged in compensatory online activities (n = 31, 5.7%) and online (n = 63, 11.6%) or phone (n = 90, 16.6%) social contact. Relatively few reported weight gain (n = 22, 4.0%); two-thirds reported no change in their diet (n = 360, 66.1%). Modes of support changed, with reliance on food parcels, online services and shopping by neighbours. Over half reported (almost exclusively negative) mental health pandemic-related changes (n = 307, 56.9%), including depression, stress, fear and loneliness; many reported declines in physical health (n = 153, 28.1%) and/or fitness (n = 70, 12.8%). Stoical accounts of adaptation and resilience, enabled by technology and community support predominated, but were not possible for all. Creating communities where cognitively frail people are more digitally and socially connected will support resilience of this group and contribute to dementia prevention, now and in any future pandemic.Trial registration- ISRCTN17325135.

Effect of Social Restriction Due to the COVID-19 Pandemic on Activity of Daily Living and Disease Severity of Patients With Alzheimer Disease: Sub-analysis of a Double-blinded Noninferiority Study of Donepezil Patches and Donepezil Tablets

BACKGROUND

We previously reported that social restrictions due to the COVID-19 pandemic led to a decline in cognitive function in patients with Alzheimer disease (AD). Here, we assessed the effects of COVID-19 restrictions on the activities of daily living (ADL) and disease severity in patients by comparing them to a control group.

METHODS

We examined the impact on ADL, evaluated using disability assessment for dementia (DAD), and disease severity, evaluated using the ABC dementia scale, in patients with mild-to-moderate AD. We conducted a post hoc subgroup analysis of a double-blinded, noninferiority study of donepezil 27.5 mg patches and donepezil hydrochloride 5 mg tablets (JapicCTI-194582). After showing the noninferiority of both treatments, we combined the data from both groups for analysis.

RESULTS

The subpopulation of the per-protocol set grouped by completing the double-blinded evaluation before and on/after the mild lockdown was balanced (n=136 and n=120). Patient demographics were similar between the subgroups. The decline in the DAD and ABC dementia scale scores [least-squares mean (SE)] was ameliorated by social restriction [-3.810 (0.743) and -1.871 (0.697) and -1.147 (0.285) and -0.419 (0.267), respectively (not significant)].

CONCLUSION

Normalcy and expectation biases can affect the evaluation of ADL and disease severity by caregivers under high stress and deterioration of mental conditions.

Excess mortality during and after the COVID-19 emergency in Japan: a two-stage interrupted time-series design

Summary

Background

The COVID-19 pandemic has had unprecedented impacts on mortality worldwide. This study aimed to estimate excess all-cause mortality in Japan from 2020 to 2023, stratified by age, sex and prefecture, to assess the evolving impact of the pandemic, particularly in the latter years. The study period extends beyond Japan ending the public health emergency.

Methods

Using national vital statistics data from 2015 to 2023, we employed a two-stage interrupted time series analysis to estimate excess mortality during the COVID-19 pandemic (2020-2023) compared with the prepandemic period (2015-2019). Models were adjusted for seasonality, long-term trends, temperature and influenza activity. We calculated excess deaths during (14 January 2020 to 7 May 2023) and after (8 May 2023 to 31 December 2023) the COVID-19 emergency.

Results

Japan experienced 219 516 excess deaths (95% empirical CI (eCI) 138 142 to 301 590) during the study period, corresponding to 3.7% (95% eCI 2.33 to 5.09) excess mortality. Excess mortality was negative in 2020 (-1.67%, 95% eCI -2.76 to -0.55), becoming positive in 2021 (2.19%, 95% eCI 0.9 to 3.49) and peaking in 2022 (7.55%, 95% eCI 5.96 to 9.13) before declining in 2023 (5.76%, 95% eCI 4.29 to 7.24). The <60 age group consistently showed the highest percentage excess mortality. Males had slightly higher excess mortality than females. By 2022, all prefectures exhibited positive excess mortality. The relative risk peaked in late 2022, with a smaller peak in summer 2023, coinciding with the post-emergency period. Comparing this post-emergency period with prior years shows the highest percentage excess mortality in 2022. Rural prefectures, and those with lower influenza cases, showed reduced excess mortality during the latter and post-emergency period.

Conclusion

Despite initial success in mitigating excess deaths, Japan saw increasing excess mortality as the pandemic progressed, with continued elevation post-emergency. The varying impact across age groups and time highlights the complex factors affecting mortality. This study's findings underline the importance of continuous monitoring of excess mortality as a key indicator for public health dynamics.

The short-term impacts of COVID-2019 on depressive symptoms and cognitive decline: A community-based cohort study

Background

Neurological and psychological sequelae may persist after the infection of coronavirus disease 2019 (COVID-19). Depression and cognitive decline could increase the risk of Alzheimer's disease.

Objective

To estimate the impacts of COVID-19 on depressive symptoms and cognitive decline.

Methods

The data was from Beijing Research on Ageing and Vessel (BRAVE), which included all residents in the Xishan community. The first wave survey was performed from October to November 2019 (baseline) before the COVID-19 pandemic. The second wave survey was interrupted into two periods due to the introduction of the Ten New Measures, from October to November 2022 (no participants were infected) and from March to April 2023 (most participants were infected), providing an excellent opportunity to investigate the short-term impacts of COVID-19 on depressive symptoms and cognitive function with linear mixed models.

Results

Among a total of 1012 participants, the median (interquartile range, IQR) age at baseline was 60.00 (56.00, 65.00) years, with 374 (36.96%) men and 479 participants COVID-19 infected. Compared with uninfected participants, the infected did not suffer pronounced depressive symptoms (β = -0.047; 95% CI -0.204 to 0.110) and accelerated declines in global cognition (β = 0.116; 95% CI -0.001 to 0.234) from wave 1 to wave 2. Sensitive analyses shared generally consistent findings.

Conclusions

The impacts of COVID-19 infection on depressive symptoms and cognitive decline were not significant among participants in the BRAVE cohort. Further research is needed to investigate the long-term impacts on neurological and psychiatric symptoms.

Evaluating the sociodemographic, anthropometric and lifestyle parameters, depression, quality of life, cognitive status, physical activity, and Mediterranean diet adherence of older adults in pre- and post-Covid-19 periods: a comparative cross-sectional study

Ojective: Covid-19 pandemic has exerted deleterious effects on several aspect of mental health worldwide. The detrimental medical complications, the increased prevalence of morbidity and the rapid international spread of Covid-19 have resulted in urgent public health concerns and political measures across the world. This comparative, cross-sectional study aims to assess the changes that were established in sociodemographic, anthropometric and lifestyle parameters and several aspects of mental health of older adults due to Covid-19 pandemic by comparing the pre-Covid period with the post-Covid period. Methods: Qualified questionnaires were applied for assessing the prevalence of depression, quality of life, cognitive status, and Mediterranean Diet (MD) adherence, as well as sociodemographic, anthropometric and lifestyle parameters in 3388 older adults in the pre- and post-Covid period. Results: Covid-19 pandemic independently affected type of residence, smoking habits, BMI and WHR status, risk of depression, quality of life, cognitive status, physical activity levels, and MD adherence. Conclusions: Covid -19 pandemic has exerted persistent detrimental effects on daily quality of life and mental health of older adults in the post-Covid period. Future strategies and public policies should develop healthcare programs to provide psychological and nutritional counseling and support to older adults to minimize the detrimental effects of Covid pandemic.

Development of a tool measuring various aspects of social detachment: The social detachment questionnaire for older population

BACKGROUND

Social detachment includes the subjective aspect "loneliness" and the objective aspect "social isolation," but tools to assess both dimensions are limited. This study aims to develop a questionnaire, the Social Detachment Questionnaire for Older Population (SDQO), that considers multiple dimensions of social detachment simultaneously.

METHODS

The study collected 600 valid samples from individuals aged 55 and above to examine the psychometric properties of the developed SDQO. Item analysis was conducted to assess the performance of each item, and exploratory factor analysis (EFA) was employed to analyze its initial structure and eliminate less ideal items. Subsequently, confirmatory factor analysis (CFA) was used to examine the model fit of the suggested structure by EFA, using different subsamples. Internal consistency, concurrent validity, and other analyses were also performed.

RESULTS

The original 27-item SDQO was reduced to 17 items after removing 4 questions in item analysis and 6 questions in EFA. The Cronbach's alpha for the 17-item version of SDQO was 0.80. Both EFA and CFA supported its 6-factor structure, with factors identified as community activities, loneliness, personal resources, leisure activities, friendship, and family resources. SDQO also demonstrated expected performance in concurrent validity.

CONCLUSION

The 17-item version of SDQO exhibited good reliability and validity, measuring various aspects of social detachment behavior, feelings, and resources. It holds value for future research applications.

The effects of the COVID-19 pandemic on the activities of Initial-phase Intensive Support Team for Dementia in Kobe City

BACKGROUND

This study aimed to review the activities of the Kobe City Initial-phase Intensive Support Team for Dementia pre- and during the coronavirus disease 2019 (COVID-19) pandemic, to compare the characteristics of the target population and the performance of the team's activities, and determine the impact of the pandemic on the team's project.

METHODS

The summary data obtained at the time of consultation, team activities, and participants' characteristics were extracted from 662 participants who started to receive support between April 2018 and March 2022. Statistical analysis was performed by dividing the participants into the following two groups: pre- and during COVID-19 pandemic groups.

RESULTS

There was no significant difference in the number of new cases or cases that led to a dementia diagnosis between the pre- and during COVID-19 pandemic groups. However, there were significant differences in the number of home visits and rate of introduction of medical care between the two groups. In our study population, the number of participants with financial management difficulties and delusions increased and the number of participants who refused visitations slightly decreased.

CONCLUSION

The Kobe City Initial-phase Intensive Support Team was able to continue its activities during the pandemic partly because the team is an independent, dedicated team. During the pandemic, there was an increase in the number of participants who were isolated because they were deprived of opportunities to interact with others, and who developed delusions and other psychiatric symptoms. Despite this situation, the professional team responded quickly through individual assessment of the individual needs by continuous outreach, taking into account the infection situation, and thus this outreach team functioned well even under the COVID-19 pandemic.

Effect of Social Isolation Due to the COVID-19 Pandemic on Cognitive Dysfunction of Patients With Alzheimer Disease: Subanalysis of Double-blinded Noninferiority Study of Donepezil Patches and Donepezil Tablets

BACKGROUND

Previous studies were examined effects of social restriction by COVID-19 pandemic on elderly peoples or compared difference of before/after restrictions on patients with Alzheimer disease-related dementia (ADRD). Here, we assessed the effects of restrictions on the cognitive function of the patients by comparing control group.

METHODS

We examined the impact on cognitive function using the Alzheimer Disease Assessment Scale (Japanese version) cognitive subscale (ADAS-JCOG), in patients with mild to moderate ADRD by a post hoc subgroup analysis of double-blinded, noninferiority study of donepezil 27.5 mg patches and donepezil hydrochloride 5 mg tablets (JapicCTI-194582). After demonstrating the noninferiority of both treatments, we used combined data for this analysis.

RESULTS

The analyzed subpopulation of the per-protocol set groups was balanced (n=126 and 135, respectively). Patient demographics were similar between subgroups. The difference of ADAS-JCOG scores [least-squares mean (95%CI)] between the groups was 0.388 (-0.377 to 1.152, not statistically significant).

CONCLUSION

Social isolation affects cognitive function on ADRD and this knowledge should be considered in future.

The effect of social isolation on the cognitive ability of the oldest old in Chinese nursing homes in post-COVID-19: a moderated chain mediation model

Background

Both pre-or post-COVID-19, older adults residing in nursing homes are at significant risk for social isolation, which is negatively associated with cognitive ability. Currently, the elderly aged 80 years and older are the fastest-growing age group globally. The extent of social isolation within this group post-COVID-19 and its impact on cognitive abilities remain inadequately explored.

Objective

This research aimed to evaluate the prevalence of social isolation among the oldest old in Chinese nursing homes post-COVID-19 and to investigate the mediating and moderating roles of basic activities of daily living (BADL), depression, and subjective socioeconomic status in the relationship between social isolation and cognitive ability.

Methods

This cross-sectional study included 453 participants aged 80 years and older from 11 nursing homes in Ningbo, Zhejiang Province, China. Social isolation was assessed using the Lubben Social Network Scale-6 (LSNS-6), cognitive ability using the Mini-Mental State Examination (MMSE), BADL using the Barthel Index (BI), and depression using the Patient Health Questionnaire-9 items (PHQ-9). Mediation and moderation effects were statistically analyzed using SPSS 23.0 and PROCESS 3.5.

Results

The mean age of the study sample was 87.1 ± 3.8 years, among whom 60.3% (n = 273) were female, and 56.1% experienced social isolation, with 41.1% and 63.1% being isolated from family and friends, respectively. Social isolation indirectly affected cognitive ability through BADL and depression, respectively, and through the chain mediation effect of BADL and depression. Subjective socioeconomic status moderated the relationships between social isolation and BADL and between social isolation and depression. However, no moderating effect of subjective socioeconomic status was found between social isolation and cognitive ability.

Conclusion

This study deepens our understanding of the current state of social isolation and its mechanisms of action in the oldest old post-COVID-19 and provides a new basis for future public health policy development and related research.

Impact of the COVID-19 pandemic on psychosocial health in rheumatic patients: A longitudinal study

AIM

To describe the impact of the COVID-19 on the psychosocial health of patients with rheumatoid arthritis (RA), spondyloarthritis (SpA), and systemic lupus erythematosus (SLE).

DESIGN

Longitudinal observational study of a series of patients with rheumatic disease.

METHODS

The main outcome measure was impairment of the ability to participate in social activities, as measured using the PROMIS-APS instrument Short Form-8a. We evaluated social activities in various settings and performed a multivariate analysis to study the association between worsening of social participation during the COVID-19 pandemic and implicated factors.

RESULTS

One hundred and twenty-five patients had completed the prospective follow-up: 40 with AR (32%), 42 with SpA (33.6%), and 43 with SLE (34.4%). Overall, poorer mean PROMIS scores were recorded after the COVID-19 pandemic for: satisfaction with social roles (p=0.029), depression (p=0.039), and ability to participate in social activities (p=0.024). The factors associated with ability to participate in social activities after the COVID-19 pandemic were older age (β=-0.215; p=0.012), diagnosis of SLE (β=-0.203; p=0.015), depression (β=-0.295; p=0.003) and satisfaction with social roles (β=0.211; p=0.037).

CONCLUSION

The ability to participate in social activities after the COVID-19 pandemic is affected in patients with rheumatic disease, especially in SLE.

The effect of perceived stress on social isolation in young and middle-aged maintenance haemodialysis patients: A polynomial regression and response surface analysis

Patients on maintenance haemodialysis (MHD) face social isolation due to the far-reaching effects of their disease and treatment. Based on the Transactional Model of Stress and Coping, we analysed the relationship between perceived stress and social isolation in patients, and the mediating role of internal health-related locus of control (IHLC) from the perspective of co-existence of perceived helplessness (HEL) and perceived self-efficacy (SEL). We used structured questionnaires to investigate 332 cases of young and middle-aged MHD patients in four tertiary hospitals in Guangdong, China. Polynomial regression and response surface analysis were conducted, along with tests of mediating effects on the data. The research was based on STROBE guidelines. The results showed that perceived stress is significantly and positively associated with social isolation. When the HEL and SEL of perceived stress were congruent, the joint effect of the two was in a positive curvilinear relationship to social isolation, when the two were incongruent, the risk of social isolation was lower for "low HEL-high SEL" patients compared to the "high HEL-low SEL" combination. The more congruent in HEL -SEL, the lower the risk of social isolation for the patients, with the IHLC playing a mediating role in this association. This study reveals that the coexistence of perceived stress's HEL and SEL affects social isolation through congruent and incongruent matching mechanism, providing additional explanations for the mechanism of occurrence of patients' social isolation.

Evolution of the profiles of new psychotropic drug users before and during the COVID-19 crisis: an original longitudinal approach through multichannel sequence analysis using the French health-care database

The COVID-19 pandemic has had a substantial impact on mental health. An increase in the use of anxiolytic, hypnotic, and antidepressant drugs has been highlighted in France, but with no information at the individual level (trajectories) or concerning patient characteristics. The objective of this study was to describe the profile of new psychotropic drug users since the beginning of the pandemic. We formed two historical cohorts using the Pays-de-la-Loire regional component of the National Health Data System (SNDS): a "COVID-19 crisis cohort" (2020-2021) and a "control cohort" (2018-2019). We analyzed reimbursements for psychotropic medications (anxiolytics, antidepressants, hypnotics, mood stabilizers, and antipsychotics) using a multichannel sequence analysis and performed clustering analysis of sequences. The proportion of new consumers of psychotropic drugs was higher in the COVID-19 crisis cohort (18.0%) than that in the control cohort (16.0%). In the COVID-19 cohort, three clusters of psychotropic drug users were identified, whereas four clusters were identified in the control cohort. A time lag in treatment initiation was observed in the COVID-19 crisis cohort (September) compared with the control cohort (July). This study is one of the first to analyze the profile of psychotropic treatment users during the COVID-19 crisis. Our analysis sheds light on changes in patterns of psychotropic drug use during the COVID-19 pandemic, possibly associated with changes in prescribing conditions and mental health conditions during the crisis. This study also provides an example of the application of an innovative longitudinal analysis methodology in the field of pharmacoepidemiology.

Factors associated with older adults' cognitive decline 6 months after gamma-variant SARS-CoV-2 infection

Background

Cognitive deficits are commonly reported after COVID-19 recovery, but little is known in the older population. This study aims to investigate possible cognitive damage in older adults 6 months after contracting COVID-19, as well as individual risk factors.

Methods

This cross-sectional study involved 70 participants aged 60-78 with COVID-19 6 months prior and 153 healthy controls. Montreal Cognitive Assessment-Basic (MoCA-B) screened for cognitive impairment; Geriatric Depression Scale and Geriatric Anxiety Inventory screened for depression and anxiety. Data were collected on demographics and self-reports of comorbid conditions.

Results

The mean age of participants was 66.97 ± 4.64 years. A higher proportion of individuals in the COVID group complained about cognitive deficits (χ2 = 3.574; p = 0.029) and presented with deficient MoCA-B scores (χ2 = 6.098, p = 0.014) compared to controls. After controlling for multiple variables, all the following factors resulted in greater odds of a deficient MoCA-B: COVID-19 6-months prior (OR, 2.44; p = 0.018), age (OR, 1.15; p < 0.001), lower income (OR, 0.36; p = 0.070), and overweight (OR, 2.83; p = 0.013). Further analysis pointed to individual characteristics in COVID-19-affected patients that could explain the severity of the cognitive decline: age (p = 0.015), lower income (p < 0.001), anxiety (p = 0.049), ageusia (p = 0.054), overweight (p < 0.001), and absence of cognitively stimulating activities (p = 0.062).

Conclusion

Our study highlights a profile of cognitive risk aggravation over aging after COVID-19 infection, which is likely mitigated by wealth but worsened in the presence of overweight. Ageusia at the time of acute COVID-19, anxiety, being overweight, and absence of routine intellectual activities are risk factors for more prominent cognitive decline among those infected by COVID-19.

The mental health impact of the COVID-19 pandemic on older adults: a systematic review and meta-analysis

BACKGROUND

Early in the COVID-19 pandemic, many experts pointed to potential adverse mental health effects for older adults. By contrast, many studies in young to middle-aged adults found older age to be associated with reduced mental burden. However, a systematic review on older adults is missing.

OBJECTIVES

To comprehensively assess the pandemic's mental health impact on older adults.

DATA SOURCES

We searched nine databases from December 2019 to April 2022.

STUDY SELECTION

We included longitudinal and repeated cross-sectional studies assessing pre- and/or peri-pandemic mental distress and/or positive mental health indicators (e.g. wellbeing) on at least two occasions.

DATA SYNTHESIS

We identified 108 studies comprising 102,136 participants (≥60 years). After removal of outliers, there was a small increase in mental distress from pre-to-peri-pandemic assessments, standardised mean difference (SMD) = 0.10, 95% confidence interval (CI) [0.01, 0.18]. Furthermore, a small peri-pandemic decrease in anxiety symptoms was observed, whereas other symptoms remained unchanged. For positive mental health indicators, wellbeing and quality of life showed an initial decrease, whereas overall positive mental health increased during the pandemic, SMD = 0.08, 95% CI [0.01, 0.15]. Being female was related to larger peri-pandemic increases in mental distress.

CONCLUSIONS

Based on many studies, this review demonstrated small decreases in mental health during early stages of the pandemic in older adults, with evidence for later recovery. These findings are similar to those for younger adults and correct earlier claims that older adults are at particular risk for negative mental health consequences. The results ask for further research into resilience and adaptation processes in older adults.

Is there a correlation between sensory impairments and social isolation in middle-aged and older Chinese population? Cross-sectional and longitudinal evidence from a nationally representative survey

Purpose

The aim of this study is to investigate the cross-sectional and longitudinal associations between sensory impairments (SIs) including single vision impairment (SVI), single hearing impairment (SHI), and dual sensory impairments (DSI) with social isolation in the middle-aged and older Chinese population.

Methods

Data were obtained from the China Health and Retirement Longitudinal Survey (CHARLS). In total, 11,674 Chinese older adults aged over 45 were included at baseline 2011, and 6,859 participants who accomplished all four interviews from 2011 to 2018 were adapted for longitudinal analyses. Sensory status and social isolation measurements including social disconnectedness and self-perceived loneliness were collected. Assessment of social disconnectedness included the number of types of social activities in which they participated and the frequency of such participation. Loneliness referred to the subjective perception of loneliness. Other covariates included socio-demographic characteristics, medical conditions, and lifestyle-related factors. The impacts of baseline sensory status on social disconnectedness and loneliness were assessed using univariate and multivariate generalized linear models. A generalized linear model with generalized estimation equations (GEE) was used to assess the association between time-varying sensory statuses with social disconnectedness or loneliness over 8 years after being adjusted with multi-confounding factors.

Results

Participants with SIs had significantly higher levels of social disconnectedness and self-perceived loneliness, compared to those who were free of SI. All kinds of SIs were significantly associated with loneliness according to both cross-sectional and longitudinal data. The correlations between DSI and social disconnectedness or loneliness at baseline and over 8 years were also noticed. SHI was found to be significantly associated with both frequency and types of social activities according to cross-sectional data and with the frequency of social activity participation in longitudinal analysis. SVI was only associated with the types of social activities at baseline (all p-values &lt; 0.05).

Conclusion

Sensory impairments, especially dual sensory impairments, have explicitly detrimental effects on social isolation among the older Chinese population. Over time, single hearing impairment specifically jeopardizes their frequency rather than types of social activities participation.

Epidemic Features of COVID-19 and Potential Impact of Hospital Strain During the Omicron Wave — Australia, 2022

What is already known about this topic?

Hospitals have experienced a surge in admissions due to the increasing number of Omicron cases. Understanding the epidemiological features of coronavirus disease 2019 (COVID-19) and the strain it places on hospitals will provide scientific evidence to help policymakers better prepare for and respond to future outbreaks.

What is added by this report?

The case fatality rate of COVID-19 was 1.4 per 1,000 persons during the Omicron wave. Over 90% of COVID-19-related deaths occurred in individuals aged 60 years or older, with pre-existing chronic conditions such as cardiac conditions and dementia, particularly among males aged 80 years or older.

What are the implications for public health practice?

Public health policy is essential for preparing and preserving medical resource capacity, as well as recruiting additional clinicians and front-line staff in hospitals to address the increased demand. High-risk individuals should be prioritized for healthcare, vaccines, and targeted interventions.