HEALTH STATUS AND LIFESTYLE HABITS OF VULNERABLE, COMMUNITY-DWELLING OLDER PEOPLE DURING THE COVID-19 LOCKDOWN

The role of frailty on quality of life in older adults during the COVID-19 pandemic

AIM

The impact of frailty, a physiological state characterized by reduced reserve for stressors and related to worse outcomes, on older adults during the pandemic is unclear. Our aim was to identify the effects of frailty among older adults during the COVID-19 pandemic.

METHODS

A total of 197 older adults who were not exposed to COVID-19 were assessed with an online survey one year after the pandemic began in Turkey. Frailty, quality of life, and fear of COVID-19 were assessed with the Tilburg Frailty Indicator, the Nottingham Health Profile, and the Fear of COVID-19 Scale, respectively. Since March 2020, changes in pain severity and localization, fatigue, and fear of falling were assessed. Multiple linear regression analyses were conducted.

RESULTS

In this study, 62.5% of the participants were frail. The prevalence of pain was significantly increased during the COVID-19 pandemic, but only among the frail. The increases in pain severity, fear of falling, and fatigue were significantly higher for the frail than the non-frail. The model including physical and psychological components of frailty and pain severity explained 49% of the variation in quality of life (R = 0.696; R² = 0.485; p < 0.001). The physical component of frailty had the highest impact on quality of life (B = 20.591; β = 0.334).

CONCLUSION

This study focused on negative outcomes that were experienced more by frail older adults compared to non-frail older adults when they were locked down at home for an extended period of time during the COVID-19 pandemic. It is necessary to quickly improve and maintain the health of these affected individuals.

Energy Costs of Chair Sitting and Standing Video Exercises in Chinese Older Adults Over 60 Years

Home-based video exercise interventions improve older adults' physiological performance and functional capacity. Little is known about the energy costs of video exercises in older adults. The Compendium of Physical Activities (PAs) has few items with PA metabolic equivalents (METs) in older adults. This study measured the energy costs of four chair and two standing exercises (sitting Tai Chi, Yoga, mobility ball, aerobics: standing, slow aerobics, and fast aerobics). Fifteen females and 14 males, 62-87 years (M ± SD, 73 ± 7.7 years), were categorized into three age groups (60-69, 70-79, 80-89). Oxygen uptake (VO2, ml·min-1·kg-1) and heart rate (HR, b·min-1) were measured by indirect calorimetry and heart rate monitor. MET values were calculated as standard- (activity VO2/3.5), rounded- (significant digit rounded to 0, 3, 5, 8), and corrected METs (individual resting metabolism). Results showed chair Yoga, Tai Chi, and mobility ball ranged from 2.0 to 2.8 rounded METs (light intensity). Chair- and standing aerobics ranged from 3.0 to 4.3 rounded METs (moderate intensity). Averaged HR ranged from 91.9 ± 12.7 b·min-1 to 115.4 ± 19.1 b·min-1 for all PAs. Corrected METs were higher than standard METs (P < .05). Standard METs were similar between age groups (P > .05). In conclusion, this study is unique as it measures the energy costs of sitting and standing video exercises that can be performed by older adults at home or in an exercise facility. Knowing the energy costs of PAs for older adults can provide exercises interventions to prevent sedentary lifestyles.

Relationship between nutritional status, lifestyle and prognosis in patients diagnosed with COVID-19 hospitalized in the state of Pernambuco

Objective: To analyze the relationship between nutritional status and lifestyle habits and the prognosis of hospitalized patients with COVID-19 in Pernambuco. Methods: Multicenter, cross-sectional study, associated with prospective analysis variables, involving patients with COVID-19 and admitted to 8 hospitals. Individuals aged ≥ 18 years of both sexes, hospitalized from June 2020 to June 2021, were included. Socioeconomic, clinical, anthropometric, lifestyle and prognostic variables were collected. Results: The sample consisted of 263 individuals with a mean age of 62.9 ± 16.6 years and homogeneous distribution between genders. It was observed that 8.2% were smokers, 20.9% reported alcohol consumption, and 80.1% were sedentary. The anthropometric profile indicated that 49.5% were overweight and 7.0% were underweight. Malnutrition and excess weight were associated with more extended hospital stays (66.7% weight loss and 64.5% weight gain vs. 30.0% eutrophy; p = 0.021), smoking with death (tab 65 .0% vs. non-tab 33.7%; p = 0.006) and need for admission to the intensive care unit (yes 64.3%, no 31.5%; p = 0.014). The frequency of dyspnea was higher in patients who reported drinking alcohol (yes 69.6% vs. no 48.1%; p = 0.007). Physical activity was not associated with any prognostic factor. Conclusion: Nutritional extremes and bad lifestyle habits, such as smoking and alcohol consumption, are risk factors for a poor prognosis in individuals with COVID-19.

Changes in older people's quality of life in the COVID-19 era: a population-based study in Finland

PURPOSE

We investigated how quality of life (QoL) changed between 2018 and 2020, and how its related factors, i.e., communication with friends and family, loneliness, and sleeping difficulties changed amid the early-phase COVID-19 pandemic among Finnish older people.

METHODS

This study utilizes data from a repeated cross-sectional, population-based FinSote survey in 2018 and 2020. Participants were community-dwelling people aged 75 years or older (N = 9781 in 2018 and N = 9919 in 2020). QoL was assessed with the EUROHIS-QoL-8 scale. Changes in QoL-related factors were self-evaluated in 2020. Statistical methods included t test, Cohen's D, and chi-square test. To identify potential risk groups, all analyses were stratified by socio-demographic features including sex, age, economic deprivation, living alone, and difficulties in Instrumental Activities of Daily Living (IADL).

RESULTS

QoL improved slightly from 2018 to 2020 (means 3.68 and 3.81, respectively). Only those reporting economic deprivation demonstrated a slight decrease in QoL (3.24 vs. 3.14). Of respondents, 63% reported having less communication with friends and family, 42% having felt lonelier, and 20% having more sleeping difficulties amid the pandemic. Negative changes were more often reported by women, the oldest old, those living alone, reporting economic deprivation, or manifesting IADL difficulties.

CONCLUSION

Finnish older people's QoL was not affected as much as expected amid the pandemic, although some population groups were, however, more susceptible to the negative effects of the pandemic on QoL-related factors. Results imply that various socio-demographic features may shape the effects of a global pandemic and its control measures on wellbeing.

Factors for the change in frailty status during the COVID-19 pandemic: A prospective cohort study over six- and 12-month periods in Japan

We aimed to verify the frailty status and the factors associated with the change in frailty status during the COVID-19 pandemic. A three-wave cohort study was conducted every six months, from May to July 2020, November 2020 to January 2021, and again from May to July 2021. The frailty status was assessed using the frailty screening index. Multivariate generalized linear mixed-effects models were used to determine whether changes in frailty status were associated with health conditions and lifestyle. The 404 survey forms were analyzed. Decline in chewing function (beta = 0.552) and leg muscle strength weakness (beta = 0.515) were significantly associated with the change in frailty status over six months, and leg muscle strength weakness (beta = 0.512) was significantly associated over 12 months. Risk factors associated with worsening health should be assessed for appropriate support. It is especially important to assess subjective leg muscle weakness in older adults.

Surgical treatment for fragility hip fractures during the COVID-19 pandemic resulted in lower short-term postoperative functional outcome and a higher complication rate compared to the pre-pandemic period

The COVID-19 pandemic adversely affected the functional outcomes of fragility hip fracture patients. This study revealed a higher in-hospital complication rate and lower postoperative function at 3 months among patients treated during the pandemic. Therefore, modified in-hospital and post-discharge protocols should be developed for implementation during pandemic crisis periods.

INTRODUCTION

This study aims to investigate the in-hospital complication rate and short-term postoperative functional outcomes of fragility hip fracture (FHF) patients compared between during the COVID-19 pandemic and the same 14-month time period 1 year prior to the pandemic.

METHODS

Using data from the Siriraj Fracture Liaison Service registry, FHF patients treated during the COVID-19 pandemic (1 March 2020 to 30 April 2021) were time-matched with FHF patients treated during the pre-pandemic period (1 March 2018 to 30 April 2019). We collected the rate of in-hospital postoperative complications and the postoperative functional outcomes at discharge and 3 months as measured by the Barthel Index (BI) and EuroQol visual analog scale (EQ-VAS). Functional outcome measures were compared between the pre-pandemic and pandemic periods.

RESULTS

There were 197 and 287 patients in the pre-pandemic and pandemic groups, respectively. At the 3-month postoperative follow-up, the mean postoperative BI score and change in BI score were both significantly lower in the pandemic group indicating poorer postoperative function. Moreover, FHF patients treated during the pandemic had significantly more in-hospital complications (36.6% vs. 22.8%, p = 0.002). There was no significant difference in the 3-month EQ-VAS or change in the EQ-VAS between groups.

CONCLUSION

The results of this study revealed a higher in-hospital complication rate and lower postoperative function at 3 months among FHF patients treated during the COVID-19 pandemic compared to the pre-pandemic period. Therefore, modified in-hospital and post-discharge protocols should be developed for implementation during pandemic crisis periods.