The Effect of COVID-19-related Lockdowns on Diet and Physical Activity in Older Adults: A Systematic Review

Functional limitations in 2004-22 among Europeans aged 55-69 years: time trends according to labor market group and impacts of the COVID-19 pandemic

In terms of work ability, impacts of the Coronavirus disease 2019 (COVID-19) pandemic on functional ability warrant investigation. The aim is to explore trends in functional limitations in 2004-22 focusing on the impacts of the pandemic among older working-aged Europeans in different labor market groups and at different levels of COVID-19 stringency policies. Data come from the Survey of Health, Ageing and Retirement in Europe (SHARE) collected in 2004-22. Individuals aged 55-69 years from 27 countries were included (N = 245 060). Outcome was functional limitations (Global Activity Limitation Index). Generalized estimating equations were used to analyze time trends and COVID-19 impacts within labor market groups and at different levels of COVID-19 stringency policies. In 2004-22, the likelihood of functional limitations increased slightly among men but remained the same among women. Functional limitations were more likely in countries with low and moderate as compared to high COVID-19 stringency (which represents mostly Southern Europe) in both women and men. During the ∼1st year of the pandemic, likelihood of functional limitations decreased especially in countries with moderate COVID-19 stringency. Decreases were observed in all labor market groups. During the ∼2nd year of the pandemic, the likelihood of functional limitations increased in time but not statistically significantly in most groups. Policymakers should be aware of trends in functional limitations and the impacts of policy decisions while pursuing to prolong work careers. Further investigation is required to verify our findings and to explore underlying reasons behind the decreases in functional limitations after the pandemic.

Qualitative Description of Exercise Perceptions and Experiences Among People With Human Immunodeficiency Virus in the High-Intensity Exercise to Attenuate Limitations and Train Habits Study

BACKGROUND

The benefits of physical activity (PA), specifically exercise, among older adults in general are well known. Yet globally, there is concern regarding limited engagement in PA, increased obesity, and frailty among older people with human immunodeficiency virus related to low levels of PA.

METHODS

We conducted in-depth interviews among 30 older, sedentary people with human immunodeficiency virus participating in the ongoing High-Intensity Exercise to Attenuate Limitations and Train Habits (HEALTH study, NCT04550676) between February 2021 and August 2022. A semistructured interview guide, informed by two minds theory, which frames behavior change as an intention-behavior gap between 2 neurocognitive systems, was used to elicit data from participants. Interviews explored general exercise perceptions, self-efficacy for exercise, mobile health intervention tailoring, outcome expectations, and PA goals. Thirty interviews from 33 participants were recorded and transcribed verbatim, and deductive and inductive thematic analysis were used using Dedoose.

RESULTS

Physical activity was defined as maintaining daily living activities and addressing health goals. Previous experiences with PA varied among participants and were influenced by chronic illnesses, including human immunodeficiency virus; motivation; work commitments; interest; and social support. Reported barriers to PA included antiretroviral adverse effects, comorbidities, aging, and the COVID-19 pandemic. Changes in health status, body changes, and relationships were identified as benefits of PA. Conversations with healthcare providers supporting exercise goals were perceived to be important but rarely received by the participants.

CONCLUSION

Understanding how older people with human immunodeficiency virus perceive PA is crucial to developing tailored strategies and structuring service delivery within the healthcare setting to promote a physically active life.

Impact of the COVID-19 pandemic on the incidence of cardiometabolic risk factors among workers: results from the Japan Epidemiology Collaboration on Occupational Health study

BACKGROUND

The COVID-19 pandemic and associated restrictions on human activities have greatly changed lifestyles, which might have deteriorated the cardiometabolic profile.

OBJECTIVE

This study aimed to examine the effect of the COVID-19 pandemic on the incidence of cardiometabolic risk factors among Japanese workers in fiscal years (FY) 2020 and 2021 compared with the prepandemic period.

METHOD

This study comprised an average of 71 025 employees in Japan who underwent annual health check-ups for at least two successive years from 2015 to 2021. Annual incidence rates from 2016 to 2021 were assessed for obesity, diabetes, hypertension, dyslipidaemia and metabolic syndrome (MetS). The observed incidence rates in 2020 and 2021 were compared with the predicted incidence based on prepandemic trends (2016 to 2019).

RESULTS

Relative to the prepandemic, the incidence of all the outcomes, except for dyslipidaemia, significantly increased in 2020. Between FY 2016 and 2019, the adjusted mean incidence of obesity, diabetes, hypertension, dyslipidaemia and MetS was 5.0%, 1.4%, 5.3%, 17.4% and 7.6%, respectively. In FY 2020, the adjusted incidence (95% CI) of these outcomes increased to 6.02 (5.80 to 6.24), 1.84 (1.73 to 1.96), 6.62 (6.40 to 6.83), 19.31 (18.83 to 19.78) and 8.51 (8.23 to 8.78), which were higher than the predicted incidence of 5.24 (4.99 to 5.49), 1.54 (1.41 to 1.67), 6.02 (5.76 to 6.27), 18.58 (18.00 to 19.16) and 8.05 (7.71 to 8.38) for 2020, respectively. The incidence returned to the prepandemic levels in FY 2021.

CONCLUSION

Results showed a worsening of the cardiometabolic profile during the initial year of the pandemic, which was reverted in the second year to the levels before the pandemic.

Increasing Incidence of Pickleball Injuries Presenting to US Emergency Departments: A 10-year Epidemiologic Analysis of Mechanisms and Trends

Background

Pickleball is one of the fastest-growing sports in the United States. It is popular among seniors but has recently grown across all age groups. As pickleball has gained interest, its corresponding injury burden has also increased.

Purpose/Hypothesis

The purpose of this study was to identify pickleball-related injury trends and underlying mechanisms across different age groups presenting to US emergency departments. It was hypothesized that (1) pickleball-related injuries would increase significantly between 2013 and 2022, (2) older age groups would have the greatest frequency of injury, and (3) falls would be the most common mechanism of injury.

Study Design

Descriptive epidemiology study.

Methods

The National Electronic Injury Surveillance System (NEISS) was queried for pickleball injuries between January 1, 2013, and December 31, 2022. The demographic information, injury site, and diagnosis were recorded, and case narratives were reviewed to identify the injury mechanism. The statistical sample weight assigned for NEISS cases by hospital was used to calculate national estimates (NEs). Injury trends over time were evaluated by linear regression.

Results

A total of 1110 NEISS cases representing 66,350 nationally estimated pickleball-related injuries were included. The mean age was 64 ± 14.7 years (range, 4-93 years). Most injuries occurred in those aged 65 to 80 years (NEISS cases = 643; NE = 40,507 [61.1%]), followed by those aged 35 to 64 years (NEISS cases = 349; NE = 20,785 [31.3%]). Falls were the most common injury mechanism overall (NEISS cases = 699; NE = 43,434 [65.5%]). However, being hit with a paddle and a twist/inversion were the most common mechanisms for ages 0 to 17 and 18 to 34 years, respectively. Fractures were the most common diagnosis (NEISS cases = 363; NE = 21,703 [32.7%]), followed by strains/sprains (NEISS cases = 327; NE = 20,419 [30.8%]). Also, 69.1% of all fractures occurred in female players. The wrist was the most injured, accounting for 12.7% of all injuries. Significant increases in pickleball injuries were seen over time (P < .001) and across all age groups (P < .05).

Conclusion

There was a significant increase in pickleball-related injuries presenting between 2013 and 2022, with most injuries arising from a fall. Notably, injuries decreased by 14% between 2019 and 2020 but rose again by 41% between 2020 and 2021 during the coronavirus 2019 pandemic. Older players disproportionately presented to the emergency department with pickleball-related injuries. Increased awareness and comprehensive injury prevention initiatives may be warranted to address the considerable prevalence of fractures and overuse/strain injuries.

Everyday Social Support for Health Behaviours in Older Adults during Times of Challenge: Evidence from Daily Life Assessments

The COVID-19 pandemic challenged older adults' health behaviours, making it even more difficult to engage in healthy diets and physical activity than it had been prepandemic. A resource to promote these could be social support. This study uses data from 136 older adults (Mage = 71.39 years, SD = 5.15, range: 63-87) who reported their daily fruit and vegetable consumption, steps, and health-behaviour-specific support from a close other every evening for up to 10 consecutive days. Findings show that on days when participants reported more emotional support than usual, fruit and vegetable consumption and step counts were higher. Daily instrumental support was positively associated with step counts, only. Participants receiving more overall emotional support across the study period consumed more fruit and vegetables; no parallel person-level association was found for overall steps. There were no significant interactions between dyad type and support links for our outcomes.

No social distancing from food: How the COVID-19 pandemic shaped student food-related activities in the Western Balkans

BACKGROUND

The COVID-19 pandemic has influenced food preparation and consumption habits, as well as food wastage. The pandemic also affected the lives of university students worldwide; their learning and living environments changed, influencing their eating habits.

AIM

The purpose of this study was to evaluate the repercussions of the COVID-19 pandemic on students' food-related activities in four countries in the Western Balkans: Bosnia and Herzegovina, Serbia, North Macedonia, and Montenegro.

METHODS

The research draws upon an online survey gathered through the SurveyMonkey platform in four Balkan countries-viz. Bosnia and Herzegovina, Serbia, North Macedonia, and Montenegro-and used a structured questionnaire. The information was collected during the second wave of COVID-19 in October-November 2020. A total of 1658 valid responses were received. Descriptive statistics and nonparametric tests were used to analyze the survey findings.

RESULTS

The research results suggest that the pandemic influenced students' food purchase habits, diets, and food-related behaviors and practices such as food preparation, cooking, and food waste management at the household level. In particular, students have been eating healthier and shopping less frequently during the pandemic. Meanwhile, the pandemic improved their attitude toward food wastage.

CONCLUSION

This study is the first to examine how students in the Balkan region perceive the impact of the COVID-19 pandemic on their eating habits, laying the groundwork for future studies into the disease's consequences. This and other studies will assist in preparing students and education institutions for future calamities and pandemics. The findings will also help develop evidence-based postpandemic recovery options targeting youth and students in the Western Balkans.

Neurological Sequelae of Post-COVID-19 Fatigue: A Narrative Review of Dipeptidyl Peptidase IV-Mediated Cerebrovascular Complications

Coronavirus disease 2019 (COVID-19) has been a global pandemic affecting millions of people's lives, which has led to 'post-COVID-19 fatigue'. Alarmingly, severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) not only infects the lungs but also influences the heart and brain. Endothelial cell dysfunction and hypercoagulation, which we know occur with this infection, lead to thrombo-inflammation that can manifest as many myriad cardio-cerebrovascular disorders, such as brain fog, fatigue, cognitive dysfunction, etc. Additionally, SARS-CoV-2 has been associated with oxidative stress, protein aggregation, cytokine storm, and mitochondrial dysfunction in neurodegenerative diseases. Accordingly, the identification of molecular targets involved in these actions could provide strategies for preventing and treating this disease. In particular, the very common enzyme dipeptidyl peptidase IV (DPPIV) has recently been identified as a candidate co-receptor for the cell entry of the SARS-CoV-2 virus with its involvement in infection. In addition, DPPIV has been reported as a co-receptor for some viruses such as Middle East respiratory syndrome-coronavirus (MERS-CoV). It mediates immunologic reactions and diseases such as type 2 diabetes mellitus, obesity, and hypertension, which have been considered the prime risk factors for stroke among other types of cardio-cerebrovascular diseases. Unlike angiotensin-converting enzyme 2 (ACE2), DPPIV has been implicated in aggravating the course of infection due to its disruptive effect on inflammatory signaling networks and the neuro-glia-vascular unit. Regarding the neurological, physiological, and molecular grounds governing post-COVID-19 fatigue, this review focuses on DPPIV as one of such reasons that progressively establishes cerebrovascular grievances following SARS-CoV infection.

Self-reported physical activity and sleep quality is associated with working memory function in middle-aged and older adults during the COVID-19 pandemic

While previous work has shown a positive relationship between cognitive performance and lifestyle factors in younger adults, evidence for this relationship among middle-aged and older adults has been mixed. The current study aimed to further test the relationship among physical activity, sleep quality, and memory performance in middle-aged and older adults, and to test whether this relationship holds up during the COVID-19 pandemic. Our results showed that physical activity was associated with better sleep quality and better working memory performance, and better sleep quality was associated with better working memory and self-perceptions of everyday memory abilities. Additionally, we found that the effects of physical activity on working memory were partially mediated by sleep quality. While these effects were small and only correlational in nature, they lend further support to the notion that sleep quality and physical activity are beneficial to memory later in life, even during a global pandemic.

Neuro-molecular perspectives on long COVID-19 impacted cerebrovascular diseases - a role for dipeptidyl peptidase IV

The coronavirus disease 2019 (COVID-19) has caused immense devastation globally with many outcomes that are now extending to its long-term sequel called long COVID. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infects not only lungs, but also the brain and heart in association with endothelial cell dysfunction, coagulation abnormalities, and thrombosis leading to cardio-cerebrovascular health issues. Fatigue, cognitive decline, and brain fog are common neurological symptoms in persisting long COVID. Neurodegenerative processes and SARS-CoV-2 infection manifest overlapping molecular mechanisms, such as cytokine dysregulation, inflammation, protein aggregation, mitochondrial dysfunction, and oxidative stress. Identifying the key molecules in these processes is of importance for prevention and treatment of this disease. In particular, Dipeptidyl peptidase IV (DPPIV), a multifunctional peptidase has recently drawn attention as a potential co-receptor for SARS-CoV-2 infection and cellular entry. DPPIV is a known co-receptor for some other COVID viruses including MERS-Co-V. DPPIV regulates the immune responses, obesity, glucose metabolism, diabetes, and hypertension that are associated with cerebrovascular manifestations including stroke. DPPIV likely worsens persisting COVID-19 by disrupting inflammatory signaling pathways and the neurovascular system. This review highlights the neurological, cellular and molecular processes concerning long COVID, and DPPIV as a potential key factor contributing to cerebrovascular dysfunctions following SARS-CoV-2 infection.

Assessing Food Access, Exercise, and Dietary History among Older African American Parishioners During the COVID-19 Pandemic (C-FED Study): Design, Opportunities, Challenges, and Lessons Learned

OBJECTIVES

Unhealthy diets and inadequate exercise are associated with chronic health conditions and excess mortality. Older African Americans do not meet dietary and exercise guidelines, and this may have worsened during the COVID-19 pandemic due to individual and environmental factors, including food insecurity. Studies evaluating these dynamics are essential for developing interventions. This narrative details a study protocol and data collection experiences during the pandemic.

METHODS

Participants > 55 years African American old completed detailed food frequency, exercise, and food access questionnaires between October 2020 and July 2021. Observations of the study administrators (authors of this manuscript) for the duration of the study are presented. Details on the study design and reflections on the opportunities, challenges, and lessons learned are summarized. Future manuscripts will report data analysis of study findings.

RESULTS

A total of 123 older African American adults participated in the study, and 118 (70% female) completed all three questionnaires. More than 50% of the participants had at least two primary chronic conditions. About 85% were fully vaccinated against COVID-19. Applying community-based participatory approaches, leveraging partnerships, and exercising flexibility approaches were pivotal to successfully implementing the study protocol.

CONCLUSIONS

Despite challenges related to the COVID-19 pandemic, detailed data on older African American adults' diet and exercise habits were obtained. Our study design and experiences will benefit future researchers. More importantly, results from our study will inform interventions and policies aimed at minimizing consequences associated with poor diet and exercise habits during the pandemic among this vulnerable population.

The Impact of the COVID-19 Pandemic on Older Adults Who Participate in Group Physical Exercise Program

The COVID pandemic exposed the vulnerability of older adults in myriad ways and social service organizations faced unprecedented challenges in safely providing support for older adults. Since 2007, Hawai'i Healthy Aging Partnership (HHAP) has offered Enhance®Fitness, an evidence-based program to reduce the risk of falls and promote health among older adults. Due to the pandemic, all the Enhance®Fitness sites had to close and stop offering the program. The HHAP started to provide alternative activities remotely in May 2020. To explore the pandemic's impact, the feasibility of online exercise programs, and the support needed among older adults to stay physically active, HHAP surveyed existing Enhance®Fitness participants and received 291 responses (59% response rate). The study used frequency distributions, comparison of means, and chi-square to analyze the survey data. Findings showed that the shutdown of the group exercise program during the pandemic led to a health status decline, a reduction in physical activities, and a shift from group to individual physical activities among older adult participants. Most respondents tried the remote exercise opportunities during the pandemic and would consider joining the remote programs in the future. However, about one-fourth of the respondents did not participate in remote exercise activities due to the lack of electronic devices, internet access, or interest in remote activity formats. To ensure equitable access to physical exercise programs for older adults in the post-pandemic era, it is critical to address the access challenges and resources needed for providing multiple programming options.

Impact of the pandemic on leisure physical activity and alcohol consumption

BACKGROUND

The COVID-19 pandemic precipitated heightened morbidity and elevated mortality attributed to the SARS-CoV-2 infection. The pandemic also influenced health behaviors such as physical activity (PA) and alcohol consumption. The aim of this study was to examine changes in leisure PA and alcohol consumption in Sweden during the pandemic, and elucidate potential discrepancies in changes across demographic strata and socioeconomic status (SES).

METHODS

Data were retrieved from two waves of the longitudinal cohort study Life conditions, Stress and Health (LSH) (n = 2,523). Two measures of change were used; longitudinal change relative to baseline (2012-2015) and reported change compared to before the pandemic. For these two change measures, differences between sex, age group and SES were analyzed using multinomial logistic regression.

RESULTS

Regardless of the change measure, the proportion of individuals with diminished PA was notably higher among females compared to males. Furthermore, relative to baseline, females were less likely to have increased their PA, however according to the reported change they were more likely to have increased PA. Longitudinal change in PA compared to baseline followed a reversed age gradient, while, according to reported change, a decrease in PA during the pandemic was most prevalent in respondents 45 years of age at baseline (OR = 1.8, CI: 1.2-2.5) and respondents 50 years of age at baseline (OR = 1.7, CI: 1.2-2.4). High SES was associated with a greater variability in PA. Alcohol consumption was generally reduced during the pandemic. However, individuals aged 40 or 45 years at baseline were more likely than others to have initiated risky alcohol consumption.

CONCLUSIONS

Females exhibited a greater propensity to alter their PA levels during the pandemic, with the most profound decreases observed among individuals of working ages. Despite a general downturn in alcohol consumption, individuals aged 40 and 45 had a heightened likelihood of having initiated risky alcohol consumption compared to individuals in other age cohorts. In conclusion, societal restrictions during a pandemic render a dual impact on PA levels. While posing a risk for decreased PA among individuals in working ages, the restrictions also present a potential window of opportunity to increase PA, particularly among females.

Older Adults' Exposure to Food Media Induced Unhealthy Eating during the COVID-19 Omicron Lockdown? Exploring Negative Emotions and Associated Literacy and Efficacy on Shanghainese

The COVID-19 pandemic, propelled by the highly transmissible Omicron variant, had a global impact and significantly affected Shanghai, a major city in China. This study investigates how food media exposure influenced unhealthy eating habits among older adults during the COVID-19 lockdown in Shanghai, focusing on the roles of negative emotions, food literacy, health consciousness, and eating self-efficacy. The random sample comprised 400 individuals aged ≥50 years who lived in Shanghai from March to June 2022. A path and correlation analysis was performed. The exposure of older adults to food media resulted in the acceleration of unhealthy eating. The relationship was significantly exacerbated by food literacy and negative emotions. In contrast, eating self-efficacy and health consciousness effectively countered the media. The enhanced pathway from food-related media influence to eating habits through negative emotions or self-efficacy towards health awareness and food literacy showed significant effects. The findings provide insights for future research and public health strategies. Importantly, this study has practical significance for media professionals, public health decision-makers, and healthy food businesses regarding how to enhance older adults' cognition to respond to unhealthy eating crises.

THE EFFECTS OF RESTRICTIONS DURING THE COVID-19 PANDEMIC ON PHYSICAL ACTIVITY AND MENTAL HEALTH OF THE ELDERLY

Regular physical activity and maintaining fitness reduce the risk of chronic cardiovascular and metabolic diseases, reduce the risk of exacerbation of existing diseases, maintain physical and mental health, and contribute to healthy and successful aging in the elderly. It is of particular importance during the prolonged COVID-19 pandemic. The aim of this review is to present relevant knowledge about the effects of restrictions and social distancing established with the aim of suppressing the COVID-19 pandemic, on physical activity and mental health of elderly people. During the pandemic, numerous authors have reported a decrease in the share of physically active population and those that used to exercise regularly. The time spent in activity decreases, energy expenditure decreases, and the time spent sedentary increases although the results in all segments related to physical activity are not consistent. Lockdown measures significantly worsen insomnia, sleep quality, feelings of loneliness, anxiety and depression in older people, especially in women. During the restrictive measures caused by the COVID-19 pandemic, physical activity and exercise significantly contribute to the maintenance and improvement of physical and mental health.

Association of physical activity with socio-economic status and chronic disease in older adults in China: cross-sectional findings from the survey of CLASS 2020 after the outbreak of COVID-19

BACKGROUND

In 2021, China had a population of 264·01 million individuals over the age of 60, indicating a high prevalence of chronic diseases. Among older adults, physical inactivity (PI) is a significant risk factor for chronic diseases. However, few studies have been conducted on the correlation of physical activity (PA) with the economic status, geography and chronic disease risks in Chinese elderly. The objectives of this study were to better understand the distribution of PA among older adults in China and its relationship with economic status, geography, and chronic disease risks.

METHODS

This study utilized data from the China Longitudinal Aging Social Survey (CLASS) in 2020, post-COVID-19. The study employed a stratified, multistage, probabilistic sampling approach and included 11,396 adults over the age of 59 from 28 provinces in China. Data on demographics, the duration and intensity of PA, history of diseases and personalized factors influencing PA were collected via structured interviews by researchers. In this study, we conducted a comprehensive analysis, employing a range of statistical methods including descriptive analysis, Wilcoxon rank-sum tests, Bayesian networks, and chi-square tests.

RESULTS

The prevalence of PI among older adults over 59 in China is 28·82%. Significant regional differences were observed in the duration of PA at different intensities. Older adults residing in more economically developed areas were more likely to engage in moderate-to-vigorous physical activity (MVPA) and exhibited longer sedentary behavior. Economic status and urban-rural disparities consistently emerged as direct influential factors across all intensity types. Chronic disease risks were significantly lower in active older adults compared to inactive ones. Lack of social guidance, family support, and personal inclination towards sedentary behavior were the main personalized factors affecting PA among older adults, and these factors could be relatively easily modified.

CONCLUSIONS

Economic status, geography, and living areas (urban and rural) significantly influenced the distribution of physical activities in China. Particularly, economic status and living areas acted as direct factors. Older adults reaching the recommended standards for PA had significantly lower chronic disease risks, highlighting the importance of improving personalized factors which are crucial for promoting PA.

A multidomain intervention against cognitive decline in an at-risk-population in Germany: Results from the cluster-randomized AgeWell.de trial

INTRODUCTION

We investigated the effectiveness of a multidomain intervention to preserve cognitive function in older adults at risk for dementia in Germany in a cluster-randomized trial.

METHODS

Individuals with a Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) risk score ≥ 9 aged 60 to 77 years were recruited. After randomization of their general practitioner (GP), patients received a multidomain intervention (including optimization of nutrition and medication, and physical, social, and cognitive activity) or general health advice and GP treatment as usual over 24 months. Primary outcome was global cognitive performance (composite z score, based on domain-specific neuropsychological tests).

RESULTS

Of 1030 participants at baseline, n = 819 completed the 24-month follow-up assessment. No differences regarding global cognitive performance (average marginal effect = 0.010, 95% confidence interval: -0.113, 0.133) were found between groups at follow-up. Perceived restrictions in intervention conduct by the COVID-19 pandemic did not impact intervention effectiveness.

DISCUSSION

The intervention did not improve global cognitive performance.

HIGHLIGHTS

Overall, no intervention effects on global cognitive performance were detected. The multidomain intervention improved health-related quality of life in the total sample. In women, the multidomain intervention reduced depressive symptoms. The intervention was completed during the COVID-19 pandemic.

Low micronutrient intake in nursing home residents, a cross-sectional study

Low intake of micronutrients is associated with health-related problems in nursing home residents. As their food intake is generally low, it is expected that their micronutrient intake will be low as well. The nutrient intake of 189 residents (mean age 85.0 years (SD: 7.4)) in five different Dutch nursing homes was measured based on 3-day direct observations of intake. Micronutrient intake, without supplementation, was calculated using the Dutch food composition table, and SPADE software was used to model habitual intake. Intake was compared to the estimated average requirement (EAR) or adequate intake (AI) as described in the Dutch dietary reference values. A low intake was defined as >10% not meeting the EAR or when the P50 (median) intake was below the AI. Vitamin A, thiamin, riboflavin, niacin, B6, folate, B12, C, D, E, copper, iron, zinc, calcium, iodine, magnesium, phosphorus, potassium, and selenium were investigated. Our data showed that vitamin and mineral intake was low for most assessed nutrients. An AI was only seen for vitamin B12 (men only), iodine (men only), and phosphorus. A total of 50% of the population had an intake below the EAR for riboflavin, vit B6, folate, and vitamin D. For reference values expressed in AI, P50 intake of vitamin E, calcium, iodine, magnesium, potassium, and selenium was below the AI. To conclude: micronutrient intake in nursing home residents is far too low in most of the nursing home population. A "food-first" approach could increase dietary intake, but supplements could be considered if the "food-first" approach is not successful.

Older adults' perspectives on physical activity and sedentary behaviour within their home using socio-ecological model

BACKGROUND

There are few studies that focus explicitly on the impact of the home environment on older adults' sedentary behaviour (SB) and physical activity (PA) using the socio-ecological model (SEM). This study aims to investigate older adults' PA and SB within the home environment integrating the SEM as a theoretical framework.

METHODS

A qualitative exploratory research design was employed to conduct 33 in-depth interviews (IDIs) and five focus group (FGs; n = 16) with multi-diverse ethnic older adults (mean age 72±5 years). Using reflexive thematic analysis themes were generated from the data set and were interpreted using the SEM.

RESULTS

The findings indicate that different levels of the SEM had an impact on older adults' PA and SB. These include the 1) Individual level: Attitude, perception and motivation 2) Interpersonal level: Family and Friends: a motive to remain active 3) Organisational level: healthcare institutes, 4) Community level factors: Significance of social groups, 5) Physical Environment: Microenvironment and 6) Policy level factors (lockdown restrictions and healthcare system). This model can be utilised to foster activity within the home by focusing on the facilitators and barriers identified at each of these levels of influence.

CONCLUSION

The study findings suggest that modifying PA and SB in the home environment is complex and is influenced across different levels of the SEM. Therefore, a holistic approach is required that integrates these multiple influences. This understanding can inform the design of interventions that seek to optimize PA and minimize SB within the home environment.

Anti-obesity effect of Neoagaro-oligosaccharides with overweight and obese subjects: a 16-week, randomized, double-blind, placebo-controlled clinical trial

BACKGROUND

This trial aimed to evaluate the anti-obesity effects and safety of Neoagaro-oligosaccharides (NAOs) in humans in a 16 week, randomized, double-blind, placebo-controlled clinical trial.

METHODS

One hundred overweight or obese subjects with a body mass index of 23 to 34.9 kg/m2 and a percent body fat of > 25% for males or > 30% for females were enrolled. NAOs or placebo products were administered at 3 g (twice a day, four capsules once) each for 16 weeks. Efficacy and safety biomarkers were measured before and after intervention.

RESULTS

After 16 weeks of intervention, the group administered with NAOs had statistically significant decreases in visceral fat area and visceral-subcutaneous fat area ratio compared to the placebo group. The NAOs group suppressed the increase in weight and BMI compared to the placebo group, which was significant between groups. High-density lipoprotein- cholesterol was increased in the group administered with NAOs, which showed a significant trend compared to the placebo group. Clinical changes were not observed for any safety biomarkers.

CONCLUSIONS

These results suggest that NAOs have a beneficial effect on obesity. Thus, NAOs could be used as an anti-obesity supplement without side effects.

TRIAL REGISTRATION

cris.nih.go.kr: (KCT0006640, 07/10/2021).

Loneliness and depression among community-dwelling older adults in China during the COVID-19 epidemic: The mediating role of social support

The psychological condition of community-dwelling older adults is a global concern under coronavirus disease 2019. Loneliness is the key risk factor for depression among community-dwelling older adults. This study aims to explore the role of social support as a mediating factor in the relationship between depression and loneliness among community-dwelling older adults. We conducted a cross-sectional study in Chenzhou, Hunan Province, China, from June to December 2021. The sample consisted of 570 community-dwelling adults aged over 60 years. Data were collected through a general information questionnaire, the Social Support Rating Scale, the University of California at Los Angeles Loneliness Scale, and the Center for Epidemiological Survey, Depression Scale. Statistical Package for the Social Sciences PROCESS macro was used to examine the mediating effect of social support between loneliness and depression. This study found that depression was negatively associated with social support (r = -0.381, P < .001), but it was positively correlated with loneliness (r = 0.403, P < .001); loneliness was a predictor of depression (B = 0.333, P < .001). In addition, social support significantly mediated the relationship between loneliness and depression, with an indirect effect of 0.239 (95% Bootstrap CI -0.264 to -0.510), the overall effect value for depression was 0.572, accounting for 56.3% of the total variance in depression within this model. In conclusion, the findings suggest that social support plays a mediating role between depression and loneliness in older adults. This implies that interventions aimed at reducing loneliness and enhancing social support have the potential to alleviate depressive symptoms among this population. By addressing these factors, healthcare professionals and caregivers can promote the mental well-being of older adults and contribute to improved overall quality of life.

The impact of the COVID-19 pandemic on global trade-embodied carbon emissions

We evaluate the response of global supply chains to carbon emissions through compiling multi-regional input-output (MRIO) models for import and export shocks in 14 countries/territories dominated by the COVID-19 crisis. Instead of traditional production-based inventories, we achieve CO2 emissions inventories based on intermediate inputs and final consumption to analyze the connected environmental impacts. In addition, we adopt the available data up to date to construct inventories of carbon emissions involved in imports and exports from different sectors. The results show that global carbon emissions could be decreased by 6.01% during the COVID-19, while export carbon emissions remained basically unchanged. As a result, imported carbon emissions fell by 5.2%, with the energy products sector most affected by the pandemic. Transport sector witnessed 18.42% carbon emission reduction. The impact of developing countries with a large proportion of resource-based industries is comparatively higher than that of developed countries with the technological advantage. International trade plays a crucial role in the choice of supply chain partners to control carbon emissions. Building a sustainable supply chain and reducing the "trade carbon deficit" between countries/regions requires the coordination of all departments of each country/region to promote the trade of energy-saving products, environmental protection services and environmental services.

Aging During the Pandemic: Untangling the Complexities of COVID-19 and Geriatric Care

The COVID-19 pandemic has posed unprecedented challenges to the global healthcare system, with the elderly population being particularly vulnerable. This comprehensive review synthesizes the findings from publications in "Aging and Disease", highlighting the unique challenges older adults encountered during the pandemic and providing solutions thereof. These studies provide invaluable insights into the elderly population's vulnerabilities and needs during the COVID-19 pandemic. The susceptibility to the virus in older individuals remains debatable, and research on the clinical picture of COVID-19 in older populations has yielded insights into clinical features, molecular mechanisms, and potential therapeutic strategies. This review intends to shed light on the need of sustaining physical and mental well-being among older adults during the periods of lockdown by extensively exploring these concerns and emphasizing the need for targeted interventions and support systems for this population. Ultimately, the findings of these studies contribute to developing more effective and comprehensive approaches to managing and mitigating the risks posed by the pandemic to the elderly.

To Eat or Not to Eat-A Qualitative Exploration and Typology of Restrictive Dietary Practices among Middle-Aged and Older Adults

Favorable diets often include restrictive practices that have proven health benefits, even if initiated later in life. The aim of this qualitative study is to gain a comprehensive understanding of Restrictive Dietary Practices (RDPs) among a sample of middle-aged and older German adults (aged 59-78 years). We conducted 24 narrative in-depth interviews and analyzed the data using qualitative content analysis (Kuckartz). Following an inductive thematic approach, a typology was reconstructed comprising four typical RDP characteristics: I. The Holistically Restraining Type, II. The Dissonant-savoring Restraining Type, III. The Reactively Restraining Type, and IV. The Unintentionally Restraining Type. These types differed regarding the practical implementation of, e.g., restrictive food choice into everyday routines, barriers to do so, as well as with respect to attitudes and motives underlying RDPs. The major motives for adopting a RDP involved health, well-being, ethical, and ecological concerns. The most prominent barriers to a 'successful' adoption of RDPs were the enjoyment of food and the desire for spontaneity and freedom of (food) choice. Our study offers an in-depth understanding of the aspects that shape the widespread practice of dietary restriction among middle-aged and older adults. Lifeworld-related changes in RDPs and possible 'type shiftings' are discussed as well as the meaning and chances of RDPs for public health promotion.

Unintended Consequences of COVID-19 Non-Pharmaceutical Interventions (NPIs) for Population Health and Health Inequalities

Since the start of the COVID-19 pandemic in early 2020, governments around the world have adopted an array of measures intended to control the transmission of the SARS-CoV-2 virus, using both pharmaceutical and non-pharmaceutical interventions (NPIs). NPIs are public health interventions that do not rely on vaccines or medicines and include policies such as lockdowns, stay-at-home orders, school closures, and travel restrictions. Although the intention was to slow viral transmission, emerging research indicates that these NPIs have also had unintended consequences for other aspects of public health. Hence, we conducted a narrative review of studies investigating these unintended consequences of NPIs, with a particular emphasis on mental health and on lifestyle risk factors for non-communicable diseases (NCD): physical activity (PA), overweight and obesity, alcohol consumption, and tobacco smoking. We reviewed the scientific literature using combinations of search terms such as 'COVID-19', 'pandemic', 'lockdowns', 'mental health', 'physical activity', and 'obesity'. NPIs were found to have considerable adverse consequences for mental health, physical activity, and overweight and obesity. The impacts on alcohol and tobacco consumption varied greatly within and between studies. The variability in consequences for different groups implies increased health inequalities by age, sex/gender, socioeconomic status, pre-existing lifestyle, and place of residence. In conclusion, a proper assessment of the use of NPIs in attempts to control the spread of the pandemic should be weighed against the potential adverse impacts on other aspects of public health. Our findings should also be of relevance for future pandemic preparedness and pandemic response teams.

Resilience characterized and quantified from physical activity data: A tutorial in R

Consistent physical activity is key for health and well-being, but it is vulnerable to stressors. The process of recovering from such stressors and bouncing back to the previous state of physical activity can be referred to as resilience. Quantifying resilience is fundamental to assess and manage the impact of stressors on consistent physical activity. In this tutorial, we present a method to quantify the resilience process from physical activity data. We leverage the prior operationalization of resilience, as used in various psychological domains, as area under the curve and expand it to suit the characteristics of physical activity time series. As use case to illustrate the methodology, we quantified resilience in step count time series (length = 366 observations) for eight participants following the first COVID-19 lockdown as a stressor. Steps were assessed daily using wrist-worn devices. The methodology is implemented in R and all coding details are included. For each person's time series, we fitted multiple growth models and identified the best one using the Root Mean Squared Error (RMSE). Then, we used the predicted values from the selected model to identify the point in time when the participant recovered from the stressor and quantified the resulting area under the curve as a measure of resilience for step count. Further resilience features were extracted to capture the different aspects of the process. By developing a methodological guide with a step-by-step implementation, we aimed at fostering increased awareness about the concept of resilience for physical activity and facilitate the implementation of related research.

Work from home and the association with sedentary behaviors, leisure-time and domestic physical activity in the ELSA-Brasil study

BACKGROUND

Work from home (WFH) can impact workers´ sedentary behaviors and levels of physical activity. The aim of this study was to estimate the association between WFH and workers´ sedentary behaviors, leisure-time and domestic physical activities during the COVID-19 pandemic and verify whether age and sex may act as effect modifiers.

METHODS

We conducted a cross-sectional study of 2544 participants in the supplementary study on COVID-19 in the Longitudinal Study of Adult Health (ELSA-Brasil) from July 2020 to February 2021. We assessed screen time (≤ 8 h/day versus > 8 h/day), accumulated sitting time (≤ 8 h/day versus > 8 h/day) as sedentary behaviors on a typical day, and leisure-time (active versus inactive, according to World Health Organization recommendations) and domestic (low versus high, according to median) physical activity, using the International Physical Activity Questionnaire (IPAQ), before and during social distancing. Logistic regression models were used.

RESULTS

Participants that were working from home during social distancing showed increased odds of screen time and sitting time greater than 8 h/day (OR = 3.12; 95%CI: 2.32-4.20 and OR = 2.68; 95%CI: 2.02-3.56, respectively) and higher odds of high domestic physical activity (OR = 1.29; 95%CI: 0.99-1.67) when compared to those not working from home. There was no association between WFH and leisure-time physical activity (OR = 0.99, 95%CI: 0.75,1.31). Age was an effect modifier in the association between WFH and leisure-time physical activity and domestic activity. Older people working from home showed higher odds of physical inactivity (OR = 1.84, 95%CI: 1.07,3.16) and high domestic physical activity (OR = 1.92, 95%CI: 1.12,3.27) compared to older people not working from home.

CONCLUSION

WFH was associated with sedentary behavior > 8 h/day and high domestic physical activity. In the older people, WFH was associated with physical inactivity and high domestic physical activity. As sedentary behavior and physical inactivity are consistently negatively associated with health, it is important to discuss policies to manage WFH that allow pauses from physical activities and performance of hours of work within preestablished limits to reduce sedentary behavior. In addition, individuals working from home, especially the older people, should be encouraged to engage in leisure-time physical activity as a form of health promotion.

The Relationship Between Exercise Habits and Stress Among Individuals With Access to Internet-Connected Home Fitness Equipment: Single-Group Prospective Analysis

BACKGROUND

Physical activity (PA) confers numerous benefits to health and health care costs, yet most adults are not meeting recommended PA guidelines. Stress may be a factor that influences PA behavior. Research investigating the impact of stress on PA has yielded inconsistent findings. Most studies find that stress negatively impacts PA, but there is some evidence that habitual exercising buffers this association.

OBJECTIVE

This study aims to examine the relationship between stress and exercise habits among habitual exercisers with internet-connected home fitness equipment (Peloton Bike) during the COVID-19 lockdown.

METHODS

Participants were recruited through Facebook (N=146) and asked to complete an internet-based survey that assessed COVID-19-related stressors, perceived stress associated with those stressors, and general perceived stress. Self-reported exercise was assessed on the survey using the Godin Leisure-time Exercise Questionnaire (GLTEQ). Participants were also asked for consent to access their Peloton usage data through the Peloton platform. From their usage data, the frequency and duration of cycling classes was calculated for 4 weeks prior to and 12 weeks following the survey. Hierarchical regression equations tested the association between stress reported on the survey and subsequent exercise participation. Exercise participation was quantified both as the frequency and duration of Peloton cycling over the 12 weeks following the survey and as self-reported moderate to vigorous activity on a second survey completed by a subset of participants 12 weeks after the initial survey.

RESULTS

There were 146 participants in our Peloton analysis sample and 66 in the self-reported exercise analysis. Peloton user data showed that study participants cycled frequently (mean 5.9 times per week) in the month prior to the initial survey, and that presurvey Peloton use was a strong predictor of exercise frequency (R²=0.57; F_2,143=95.27; P<.001) and duration (R²=0.58; F_2,143=102.58; P<.001) for the 12 subsequent weeks. Self-reported overall exercise likewise showed that this sample was very active, with an average of more than 8 times per week of moderate to vigorous exercise at the initial survey. Self-reported exercise on the initial survey was a strong predictor of self-reported exercise 12 weeks later (R²=0.31; F_1,64=29.03; P<.001). Perceived stress did not impact Peloton cycling duration or frequency (P=.81 and .76, respectively) or self-reported exercise (P=.28).

CONCLUSIONS

The results suggest that stress did not negatively impact exercise participation among habitually active adults with access to internet-connected home fitness equipment. Habitual exercise may buffer the impact of stress on participation in regular moderate to vigorous activity. Future research should examine the role that the availability of home-based internet-connected exercise equipment may play in this buffering.

Joys or Sorrows of Parenting During the COVID-19 Lockdown: A Scoping Review

Objectives: The aim of this scoping review was to map out the existing evidence of the impact of the COVID-19 lockdown on parents of children and adolescents. We sought to: 1) identify parenting domains that were particularly affected by lockdown measures, 2) describe the challenges and opportunities of lockdown measures in these domains, and 3) define protective and exacerbating factors modulating the effect of lockdown measures on parents. Methods: We identified five main domains investigated in the context of parenting during the early COVID-19 lockdown derived from 84 studies: health and wellbeing, parental role, couple functioning, family and social relationships, and paid and unpaid work. For each domain, we listed challenges and opportunities, as well as discriminant factors. Results: The lockdown impacted all five different but interconnected domains, introduced new roles in parents' lives, and particularly affected women and vulnerable populations. Conclusion: This scoping review highlights the importance of approaching public health policymaking from a social justice perspective. Such an approach argues for social and public health policies to promote health accounting for its social, economic, political, and commercial determinants.

Factors Influencing Mobility During the COVID-19 Pandemic in Community-Dwelling Older Adults

OBJECTIVE

To describe and identify factors influencing mobility among older adults during the first 5 months of the COVID-19 pandemic.

DESIGN

A cross-sectional telesurvey.

SETTING

Community dwelling older adults, situated within the first 5 months of the COVID-19 pandemic, in Hamilton, Canada.

PARTICIPANTS

A random sample of 2343 older adults were approached to be in the study, of which 247 completed the survey (N=247). Eligible participants were aged ≥65 years.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Mobility was measured using global rating of change items and the Late Life Function Instrument (LLFI). Multivariate linear regression models were used to examine the association between mobility and related factors based on Webber's model.

RESULTS

247 older adults (29% male, mean age 78±7.3 years) completed surveys between May and August 2020. Respectively, 26%, 10%, and 9%, rated their ability to engage in physical activity, housework, and move around their home as worse compared with the start of the pandemic. The mean LLFI score was 60.9±13.4. In the model, walking volume (β=0.03 95% confidence interval 0.013, 0.047), fall history (β=-0.04, 95% confidence interval -0.08, -0.04), male sex (β=0.06, 95% confidence interval 0.02, 0.09), unpleasant neighborhood (β=-0.06, 95% confidence interval -0.11, -0.02), musculoskeletal pain (β=-0.07, 95% confidence interval -0.11, -0.03), and self-reported health (β=0.08, 95% confidence interval 0.03, 0.13) had the strongest associations with LLFI scores and explained 64% of the variance in the LLFI score.

CONCLUSIONS

Physical and environmental factors may help explain poorer mobility during lockdowns. Future research should examine these associations longitudinally to see if factors remain consistent over time and could be targeted for rehabilitation.

Digital literacy during the coronavirus pandemic in older adults: Literature Review and Research Agenda

Demographic change in the developed world is leading to a higher proportion of older adults and longer life expectancy. Measures to control the coronavirus disease have affected older adults the most. Social isolation and access to remote health services has been a problem for many people. We have used the method of scientific literature review. The selection of articles was made in accordance with the following inclusion criteria: accessibility, scientificity, content relevance and topicality. After selection, the results were analysed by qualitative content analysis. With the content analysis of twenty scientific articles, we gained an insight into digital literacy of older adults during the COVID-19 pandemic. Three content categories were identified: (1) poor digital literacy of older adults, (2) inequality in ICT access, (3) use of ICT reduces the negative impact of social isolation. We note that there is a large digital divide in digital literacy and competences among older adults which expanded during the coronavirus disease pandemic. Several factors, including socio-economic status, internet access and the poor adaptation of ICT for older adults affect digital literacy. Rapid development of remote health and social care, poor digital literacy of older adults and the poor adaptation of ICT for older adults dictate that the problem must be tackled systemically.

Bounce Forward Better: Geriatric and Gerontological Research in the Post-pandemic Future

In recent years, we have faced challenges in managing coronavirus disease 2019 (COVID-19), especially in older adults. The pandemic has precipitated a global health crisis that impeded older adults from maintaining their health. Disruption of the routine management of chronic diseases, physical inactivity deteriorating physical function and quality of life, malnutrition, and mental disorders have been suggested as major threats to the health of older adults. To address these problems and facilitate reactivation of normal care activities, this article summarizes the contents of a webinar held by the Annals of Geriatric Medicine and Research (AGMR) regarding the future directions of geriatric medicine and research in the post-COVID-19 era.

Sedentary behaviour, physical activity, and sleep among office workers during the COVID-19 pandemic: a comparison of Brazil and Sweden

BACKGROUND

The COVID-19 pandemic has affected the physical behaviours of office workers worldwide, but studies comparing physical behaviours between countries with similar restrictions policies are rare. This study aimed to document and compare the 24-hour time-use compositions of physical behaviours among Brazilian and Swedish office workers on working and non-working days during the pandemic.

METHODS

Physical behaviours were monitored over 7 days using thigh-worn accelerometers in 73 Brazilian and 202 Swedish workers. Daily time-use compositions were exhaustively described in terms of sedentary behaviour (SED) in short (< 30 min) and long (≥30 min) bouts, light physical activity (LPA), moderate-to-vigorous physical activity (MVPA), and time-in-bed. We examined differences between countries using MANOVA on data processed according to compositional data analysis. As Swedish workers had the possibility to do hybrid work, we conducted a set of sensitivity analyses including only data from days when Swedish workers worked from home.

RESULTS

During working days, Brazilian office workers spent more time SED in short (294 min) and long (478 min) bouts and less time in LPA (156 min) and MVPA (50 min) than Swedish workers (274, 367, 256 and 85 min, respectively). Time spent in bed was similar in both groups. Similar differences between Brazilians and Swedes were observed on non-working days, while workers were, in general, less sedentary, more active and spent more time-in-bed than during working days. The MANOVA showed that Brazilians and Swedes differed significantly in behaviours during working (p <  0.001, ηp2 = 0.36) and non-working days (p <  0.001, ηp2 = 0.20). Brazilian workers spent significantly more time in SED relative to being active, less time in short relative to long bouts in SED, and more time in LPA relative to MVPA, both during workdays and non-workdays. Sensitivity analyses only on data from days when participants worked from home showed similar results.

CONCLUSIONS

During the COVID-19 pandemic Brazilian office workers were more sedentary and less active than Swedish workers, both during working and non-working days. Whether this relates to the perception or interpretation of restrictions being different or to differences present even before the pandemic is not clear, and we encourage further research to resolve this important issue.

Mixed-methods evaluation of Daily Moves, a community-based physical activity program for older adults

Background

Although the health benefits of physical activity are well documented, most older adults are not sufficiently active. There is a need to explore approaches to physical activity promotion amongst older adults that meet the personal preferences and needs of participants, and that can be implemented on a large scale in community-based settings. The current study evaluates Daily Moves, a community-based physical activity program for older adults living in Adelaide, Australia. 

Methods

The Daily Moves program, which ran almost entirely during the COVID-19 pandemic, provided participants with personalized plans and information about suitable physical activity promoting activities available in their local area. This study used an explanatory sequential mixed-methods approach to evaluate associations between participation in the Daily Moves program and physical activity engagement, physical function and psychosocial wellbeing, and to explore the experiences of Daily Moves participants through qualitative interviews, with a particular focus on the impact of the COVID-19 pandemic on program participation and enjoyment.

Results

The research evaluation included 69 older adults (mean age at baseline = 73.9 ± 5.6 years; 19 male). Following Daily Moves, participants reported an increase in self-report physical activity levels (mean increase = 1.8 days, p < 0.001), improvements on several measures of physical function (left grip strength (mean increase = 1.8 kg, p < 0.001); right grip strength (mean increase = 1.3 kg, p = 0.03); Timed Up and Go (mean decrease = 1.3 s, p < 0.001)), and no significant changes in measures of psychosocial wellbeing. Qualitative interviews revealed that participants valued the supportive and flexible nature of Daily Moves, and that they felt connected with staff and other participants despite the onset of the pandemic.

Conclusions

This evaluation demonstrates that physical activity programs embedded within the community can provide flexible and tailored recommendations to participants, and that this approach can promote positive change in important indicators of health in older adults.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-022-03567-6.

The Influence of Easing COVID-19 Restrictions on the Physical Activity Intentions and Perceived Barriers to Physical Activity in UK Older Adults

COVID-19 has had profound effects on physical activity behaviours of older adults, and understanding this impact is essential to driving public health policies to promote healthy ageing. The present study aimed to determine; (1) intended physical activity behaviours of older adults following the easing of UK COVID-19 restrictions; (2) the relationship between self-reported physical activity and intended physical activity behaviour; (3) perceived barriers to achieving the intended physical activity goal. Ninety-six participants (74.8 ± 4.4 years; 52 female) from a longitudinal study examining the impact of COVID-19 on physical activity were recruited. Participants outlined their future physical activity intentions and completed the COM-B Self Evaluation Questionnaire. Participants were split into groups based on their intention to 'Maintain' (n = 29), 'Increase' (n = 38) or 'Return' (n = 29) to pre-COVID-19 physical activity. Self-reported physical activity undulated over the pandemic but was mostly equivalent between groups. Intended physical activity behaviour was independent of self-report physical activity. Capability and motivation factors were the most frequently cited barriers to the intended physical activity behaviour, with a greater number of capability barriers in the 'Return' group. Such barriers should be considered in the COVID-19 recovery public health physical activity strategy for promoting healthy ageing.

Global evidence on falls and subsequent social isolation in older adults: a scoping review

BACKGROUND

Falls are a leading cause of injury-related hospitalizations among adults aged 65 years and older and may result in social isolation.

OBJECTIVE

To summarise evidence on falls and subsequent social isolation and/or loneliness in older adults through a scoping review.

ELIGIBILITY CRITERIA

Studies were eligible for inclusion if the population had a mean age of 60 years or older, they examined falls and subsequent social isolation, loneliness, fear of falling or risk factors and were primary studies (eg, experimental, quasi-experimental, observational and qualitative).

SOURCES OF EVIDENCE

MEDLINE, CINAHL, Embase, Ageline and grey literature from inception until 11 January 2021.

CHARTING METHODS

A screening and charting form was developed and pilot-tested. Subsequently, two reviewers screened citations and full-text articles, and charted the evidence.

RESULTS

After screening 4993 citations and 304 full-text articles, 39 studies were included in this review. Participants had a history of falling (range: 11% to 100%). Most studies were conducted in Europe (44%) and North America (33%) and were of the cross-sectional study design (66.7%), in the community (79%). Studies utilised 15 different scales. Six studies examined risk factors for social isolation and activity restriction associated with fear of falling. Six studies reported mental health outcomes related to falls and subsequent social isolation.

CONCLUSIONS

Consistency in outcome measurement is recommended, as multiple outcomes were used across the included studies. Further research is warranted in this area, given the ageing population and the importance of falls and social isolation to the health of older adults.

SCOPING REVIEW REGISTRATION NUMBER

10.17605/OSF.IO/2R8HM.

COVID-Inconfidentes: how did COVID-19 and work from home influence the prevalence of leisure-time physical inactivity? An analysis of before and during the pandemic

BACKGROUND

The COVID-19 pandemic has brought drastic changes to the lives of the global population. The restrictions imposed by government agencies impacted the daily lives of citizens, influencing several health behaviors, such as physical activity (PA). Thus, the present study aimed to assess the prevalence of physical inactivity (PI) and its associated factors before and during the COVID-19 pandemic.

METHODS

A population-based household seroepidemiological survey was conducted in two Brazilian municipalities located in the state of Minas Gerais, in which 1750 volunteers were interviewed between October and December 2020. Face-to-face interviews were conducted using a structured questionnaire in an electronic format. The moments considered for the PI analysis were M0 (before the pandemic), M1 (from March to July 2020), and M2 (from October to December 2020). Descriptive statistics and univariate and multivariate logistic regression were used to examine the factors associated with PI before (M0) and during the pandemic (M1 and M2).

RESULTS

The prevalence of PI was higher in the first months of the pandemic (M1) (67.3%; 95% confidence interval (CI): 62.4-71.9) than in the months from October to December 2020 (M2) (58.7%; 95% CI: 52.8-64.3); however, at both times (M1 and M2), PI was more prevalent than in the period before the pandemic started (M0) (39.7%; 95% CI: 35.6-43.8). Individuals who were overweight, obese, and had low educational levels were more likely to be physically inactive. At both M1 and M2, individuals who worked at a work from home were less likely to have PI.

CONCLUSIONS

The results suggest that the COVID-19 pandemic negatively influenced PA, substantially increasing the prevalence of PI. The determinants associated with PI were education, body mass index, and work from home.

Parental Perspectives of the Impact of COVID-19 Lockdown on Food-Related Behaviors: Systematic Review

Home confinement during the COVID-19 pandemic has been accompanied by dramatic changes in household food dynamics that can significantly influence health. This systematic literature review presents parental perspectives of the impact of COVID-19 lockdown (up to 30 June 2022) on food preparation and meal routines, as well as other food-related behaviors, capturing both favorable and unfavorable changes in the household food environment. Themes and trends are identified and associations with other lifestyle factors are assessed. Overall, families enjoyed more time together around food, including planning meals, cooking, and eating together. Eating more diverse foods and balanced home-cooked meals (e.g., fresh fruit and vegetables) was combined with overeating and increased snacking (e.g., high-calorie snacks, desserts, and sweets), as parents became more permissive towards food; however, food insecurity increased among families with the lowest income. Adoption of meal planning skills and online shopping behavior emerged alongside behaviors aimed at self-sufficiency, such as bulk purchasing and stockpiling of non-perishable processed foods. These results are an important first step in recognizing how this pandemic may be affecting the family food environment, including low-income families. Future obesity prevention and treatment initiatives, but also ongoing efforts to address food management, parental feeding practices, and food insecurity, can account for these changes moving forward.

How has the COVID-19 Pandemic Affected Diabetes Self-Management in People With Diabetes? - A One-Year Follow-Up Study

BACKGROUND AND AIM

In Denmark, the COVID-19 pandemic resulted in two lockdowns, one from March to May 2020 and another from December 2020 to April 2021, which had severe impact on everyday life. The aim of this study was to explore changes in diabetes self-management behaviors during the pandemic and to examine how specific population characteristics were associated with changes in diabetes management.

METHODS AND PARTICIPANTS

In a cohort study from March 2020 to April 2021, two online questionnaires were collected from a total of 760 people with diabetes. Descriptive statistics were used to assess the proportion of participants experiencing improvements, deterioration, and status quo in diabetes self-management during the pandemic. Using logistic regressions, baseline characteristics were explored as potential predictors of change.

RESULTS

Approximately half of the participants reported that they experienced lower physical activity in April 2021 compared to before the pandemic, approximately one fifth reported diabetes self-management to be more difficult than prior to the pandemic, and one fifth reported eating more unhealthily than before the pandemic. Some participants reported higher frequency of high blood glucose levels (28%), low blood glucose levels (13%) and more frequent blood glucose variability (33%) compared to before. Easier diabetes self-management was reported by relatively few participants, however, 15% reported eating more healthily, and 20% reported being more physically active. We were largely unable to identify predictors of change in exercise activities. The few baseline characteristics identified as predictors of difficulties in diabetes self-management and adverse blood glucose levels due to the pandemic were sub-optimal psychological health, including high diabetes distress levels.

CONCLUSION

Findings indicate that many people with diabetes changed diabetes self-management behaviors during the pandemic, mostly in a negative direction. Particularly high diabetes distress levels in the beginning of the pandemic was a predictor of both positive and negative change in diabetes self-management, indicating that people with high diabetes distress levels could potentially benefit from increased support in diabetes care during a period of crisis.

A double-blinded, randomized, parallel intervention to evaluate biomarker-based nutrition plans for weight loss: The PREVENTOMICS study

BACKGROUND & AIMS

Growing evidence suggests that biomarker-guided dietary interventions can optimize response to treatment. In this study, we evaluated the efficacy of the PREVENTOMCIS platform-which uses metabolomic and genetic information to classify individuals into different 'metabolic clusters' and create personalized dietary plans-for improving health outcomes in subjects with overweight or obesity.

METHODS

A 10-week parallel, double-blinded, randomized intervention was conducted in 100 adults (82 completers) aged 18-65 years, with body mass index ≥27 but <40 kg/m², who were allocated into either a personalized diet group (n = 49) or a control diet group (n = 51). About 60% of all food was provided free-of-charge. No specific instruction to restrict energy intake was given. The primary outcome was change in fat mass from baseline, evaluated by dual energy X-ray absorptiometry. Other endpoints included body weight, waist circumference, lipid profile, glucose homeostasis markers, inflammatory markers, blood pressure, physical activity, stress and eating behavior.

RESULTS

There were significant main effects of time (P < 0.01), but no group main effects, or time-by-group interactions, for the change in fat mass (personalized: -2.1 [95% CI -2.9, -1.4] kg; control: -2.0 [95% CI -2.7, -1.3] kg) and body weight (personalized: -3.1 [95% CI -4.1, -2.1] kg; control: -3.3 [95% CI -4.2, -2.4] kg). The difference between groups in fat mass change was -0.1 kg (95% CI -1.2, 0.9 kg, P = 0.77). Both diets resulted in significant improvements in insulin resistance and lipid profile, but there were no significant differences between groups.

CONCLUSION

Personalized dietary plans did not result in greater benefits over a generic, but generally healthy diet, in this 10-week clinical trial. Further studies are required to establish the soundness of different precision nutrition approaches, and translate this science into clinically relevant dietary advice to reduce the burden of obesity and its comorbidities.

CLINICAL TRIAL REGISTRY

ClinicalTrials.gov registry (NCT04590989).

Physical Activity and Diet in a Global Pandemic: An Investigation of the Impact of COVID-19 on Factors Relevant for Musculoskeletal Health at Two Different Stages of the Lifecourse

Background

Physical activity, nutrition and other lifestyle factors play important roles in maintaining musculoskeletal health. The coronavirus disease (COVID-19) originated in late 2019, spread globally to be declared a pandemic by the World Health Organisation in March 2020, and led to widespread behaviour change. The aim of this study was to use two existing cohorts, the Hertfordshire Cohort Study (HCS) and Health and Employment After Fifty Study (HEAF), to understand how wave one of the COVID-19 pandemic impacted lifestyle factors associated with musculoskeletal health in the UK.

Methods

125 eligible participants, 65 males and 60 females (drawn from the HCS study, median (IQR) age 84.3 (82.4-86.6) years, all Caucasian, and community dwelling) were contacted by telephone and asked to complete a questionnaire administered by a trained researcher. Data collection occurred over the period July 2020 to February 2021. 2469 participants, 1086 men and 1383 women (drawn from the HEAF study, median age 65.7 (62.0-69.3) years, mostly Caucasian and community dwelling) completed an online questionnaire in March 2021.

Results

In HCS, 47% respondents reported being less physically active than before the pandemic (and only 5% more so), 27% said they consumed less alcohol compared to pre-pandemic times (and only 3% more so), and 18% reported eating less than before, although quality of diet was generally unchanged over this timeframe surveyed. In HEAF, 44% participants said they were less active than before the pandemic, while 17% reported being more active. The majority of participants reported no changes in alcohol consumption and diet; however, 19% said they drank more than before (32% of which was above recommended levels), 16% said their diet was less healthy, and 19% reported eating more than before.

Conclusion

We have reported the experience of the first wave of the COVID-19 pandemic among participants of two Caucasian community dwelling UK cohorts, highlighting the impact of the pandemic on lifestyle factors associated with musculoskeletal health. Changed physical activity levels were reported in a high proportion of respondents in both studies; an investigation of reversibility of these changes is required.

Behavior changes and functional capacity Physical, social, and dietary behavioral changes during the COVID-19 crisis and their effects on functional capacity in older adults

Background

This two-year follow-up study aimed to identify factors associated with unhealthy behaviors during the COVID-19 pandemic and examine their impact on functional capacity in older adults.

Methods

Altogether, 536 adults aged ≥65 years participated in this study. The frequency of going out, exercise habits, face-to-face and non-face-to-face interactions, social participation, and eating habits were examined as behavioral factors before and after the first declaration of a state of emergency in Japan. Functional capacity was assessed using the Tokyo Metropolitan Institute of Gerontology Index of Competence.

Results

Using latent class analysis considering changes in the six behaviors, the participants were divided into healthy (n = 289) and unhealthy (n = 247) behavior groups. The male sex was associated with 2.36 times higher odds, diabetes with 2.19 times higher odds, depressive mood with 1.83 times higher odds, poor subjective economic status with 2.62 times higher odds, and living alone with 44% lower odds of being unhealthy. The unhealthy behavior group showed significantly decreased functional capacity (B =−1.56 [−1.98, −1.14]) than the healthy behavior group. For each behavior, negative changes in going out (B =−0.99 [−1.60, −0.37]), face-to-face interaction (B =−0.65 [−1.16, −0.13]), and non-face-to-face interactions (B =−0.80 [−1.36, −0.25]) were associated with a decline in functional capacity.

Conclusion

Our results showed four factors associated with engaging in unhealthy lifestyle behaviors and how behavioral changes affect functional capacity decline during the COVID-19 pandemic, which will help to develop public health approaches

Changes in Physical Activity and Sedentary Behavior before and during the COVID-19 Pandemic: A Swedish Population Study

Governments have enforced measures to limit the spread of COVID-19 with varying degrees of success, which could affect people's physical activity (PA) and sedentary behavior. This study aimed to examine changes in PA levels, types of PA, and sedentary behavior in the Swedish population before and during the COVID-19 pandemic. Associations between changed PA levels and demographical and behavioral determinants were also investigated. In December 2020, 1035 individuals (18-79 years old) completed a survey about their PA and sedentary behavior before and during the pandemic. Factors influencing their PA were also explored. Fifty-one percent of the sample reported reduced total PA, 18% had no change, and 31% increased their PA. Overall, organized PA decreased the most and sedentary behavior increased. The youngest and oldest age groups reported the greatest reduction in PA, while middle-aged groups reported the most increased PA. Men reported a larger increase in sedentary behavior than women. Mental and physical capability was associated with change in PA. In conclusion, this study indicates that, during the COVID-19 pandemic, the majority of the Swedish population have decreased PA levels with a concurrent increase in sedentary behavior, which may have negative health consequences. Interventions are recommended to address both PA and sedentary behavior, specifically to strengthen people's ability to perform PA and focusing on the youngest and oldest age groups.

A study of diet in older community-dwelling adults in the UK during the COVID-19 pandemic: Findings from the Southampton Longitudinal Study of Ageing (SaLSA)

Introduction

Adequate nutrition is important for health in later life. Older adults are especially vulnerable to adverse outcomes following infection by COVID-19 and have commonly spent a disproportionate time within their own homes to reduce risk of infection. There are concerns that advice to shield may have led to malnutrition as older adults may modify daily routines including usual shopping habits. The aims of this study were to report self-reported pandemic-related changes in diet and examine lifestyle and medical correlates of these changes in older UK community-dwelling adults.

Methods

We recruited 491 participants from the city of Southampton, UK. Participants completed a postal questionnaire in summer/autumn 2021, over a year after the first UK national lockdown was announced. The questionnaire ascertained demographic and lifestyle factors, in addition to number of comorbidities, nutrition risk scores, and presence of frailty. Associations between these participant characteristics in relation to self-reported changes in diet quality (lower, similar or higher when compared to before the first lockdown) were examined using ordinal logistic regression.

Results

Median (lower quartile, upper quartile) age was 79.8 (77.0, 83.7) years. Overall, 11 (4.9%) men and 25 (9.4%) women had poorer diet quality compared to before the first UK lockdown. The following participant characteristics were associated with increased risk of being in a worse category for change in diet quality after adjustment for sex: lower educational attainment (p = 0.009); higher BMI (p < 0.001); higher DETERMINE (a malnutrition assessment) score (p = 0.004); higher SARC-F score (p = 0.013); and self-reported exhaustion in the previous week on at least 3 days (p = 0.002).

Conclusions

Individuals at higher nutritional risk were identified as reporting increased risk of deterioration in diet quality during the pandemic. Further investigation of the factors leading to these changes, and an understanding of whether they are reversible will be important, especially for future pandemic management.

Understanding influences on physical activity participation by older adults: A qualitative study of community-dwelling older adults from the Hertfordshire Cohort Study, UK

BACKGROUND

The health benefits of physical activity (PA) participation in later life are widely recognised. Understanding factors that can influence the participation of community-dwelling older adults in PA is crucial in an ageing society. This will be paramount in aiding the design of future interventions to effectively promote PA in this population. The main aim of this qualitative study was to explore influences on PA among community-dwelling older people, and the secondary aim was to explore gender differences.

METHODS

Qualitative data were collected in 2014 by conducting focus group discussions using a semi-structured discussion guide with older people resident in Hertfordshire, UK. Discussions were audio-recorded, transcribed verbatim and transcripts analysed thematically.

RESULTS

Ninety-two participants were recruited to the study (47% women; 74-83 years) and a total of 11 focus groups were conducted. Findings indicated six themes that appeared to affect older adults' participation in PA: past life experiences; significant life events; getting older; PA environment; psychological/personal factors; and social capital. Overall, the findings emphasised the role of modifiable factors, namely psychological factors (such as self-efficacy, motivation, outcome expectancy) and social factors (such as social support and social engagement). These factors exerted their own influence on physical activity participation, but also appeared to mediate the effect of other largely non-modifiable background and ageing-related factors on participants' engagement with PA in later life.

CONCLUSION

In view of these findings, intervention designers could usefully work with behavioural scientists for insight as to how to enhance psychological and social factors in older adults. Our data suggest that interventions that aim to build self-efficacy, motivation and social networks have the potential to indirectly promote PA participation in older adults. This would be best achieved by developing physical activity interventions through working with participants in an empowering and engaging way.

Impact of the COVID-19 pandemic on community-dwelling older adults: A longitudinal qualitative study of participants from the Hertfordshire Cohort Study

BACKGROUND

Older adults have been especially vulnerable to adverse effects from the COVID-19 pandemic including higher mortality and more severe disease complications. At the same time, social isolation, malnutrition and physical inactivity are serious concerns among older adults. The pandemic and associated restrictions may serve to exacerbate these issues, presenting increased risks to physical and mental health. The aims of this qualitative study were: i) to explore how community-living older people in the UK experienced the first wave of the COVID-19 pandemic, specifically how it impacted their well-being and associated health behaviours; ii) to explore how older people's experiences and behaviours changed over time throughout the first wave.

METHODS

Qualitative data were collected by conducting serial telephone interviews, with an interval of approximately three months. Participants were from the Hertfordshire Cohort Study, all aged over 80 years. Discussions were audio-recorded, information related to the COVID-19 pandemic was transcribed verbatim and transcripts analysed thematically. Interviews were conducted from March to October 2020.

RESULTS

Data for twelve participants (7 men and 5 women) from a total of 35 interviews were used, comprising two or three timepoints per participant. Analysis identified five overarching themes: 1) shopping strategies and food accessibility, 2) limitations on activities and going out, 3) disruption to healthcare, 4) social and psychological repercussions, and 5) coping strategies. Findings highlight challenges associated with accessing shops, healthcare, and usual activities due to pandemic-related restrictions. Longitudinal findings showed that for some, the ongoing pandemic and related restrictions appeared to aggravate mental health issues (low mood, anxiety) over time, as well as greater feelings of isolation or loneliness, reduced activity and functional limitations; this was despite some relaxation of restrictions later on. Coping strategies used by participants included finding ways to keep busy and to do physical activity safely, maintaining social contact remotely, and having an optimistic or positive outlook, a 'do what you can' attitude.

CONCLUSIONS

Interventions are likely to be needed in the wake of the COVID-19 pandemic to support health behaviours, such as increasing physical activity, social engagement and improving mental health among community-living older adults.

Changes to Physical Activity Levels in Adults Aged 50+ in the First Six Months of the COVID-19 Pandemic

The purpose of this study is to qualitatively explore the impact of the COVID-19 pandemic on older adults’ PA nearly 6 months into the pandemic. Approximately 230 interviews were conducted with a diverse sample of participants (22.1% Black and 10.8% Hispanic). Data were transcribed in fall 2020 and analyzed using NVivo 12. Overall, most older adults (54.6%) interviewed reported no change in their PA, often reporting that their work kept them active. Decreases in PA for older adults (42.7%) were attributed to little social connectedness and stay-at-home restrictions. The few reporting an increase in PA (2.6%) had more time available to be active, including setting goals while staying home. This data provides an insight on how COVID-19 impacted PA levels for older adults. These findings can inform tailored interventions to promote PA during the pandemic.

Impact of COVID-19 lockdown on physical activity behaviours of older adults who participated in a community-based exercise program prior to the lockdown

This study investigated the impact of the 2020 COVID-19 lockdown on community-dwelling older adults attending a community-based exercise program to seek strategies to keep them active during self-isolated situations. A two-phase mixed methods approach included a survey followed by in-person focus groups. Forty-eight participants, with 32 starting a community-based exercise program before the lockdown and 16 joining the program after the lockdown, completed a questionnaire survey about physical activities before and during the lockdown. This was followed by three focus groups (26 participants in total) to identify factors influencing physical activity behaviours found in the survey. The survey found that the COVID-19 lockdown had varied impact on exercise adherence of the older adults: 43% of the participants exercised less during the lockdown than pre-lockdown, but 26% exercised more. Interestingly, among the participants approximately 80% still achieved the recommended physical activity level by the WHO during the lockdown. The focus groups revealed that exercise behaviours before the lockdown directly affected the behaviours during the lockdown. Participants' recognition of the support from trustworthy people also influenced their motivation to perform exercises in an isolated environment. Remote exercise programs, such as digital and printed exercise materials, were found beneficial for the participants only when they came from the people the older adults trusted through their previous experience (i.e., the program). A sense of belonging to the exercise group was also essential for the participants to achieve self-managed exercise. It was concluded that older adults need connections to an exercise group and a trustworthy exercise instructor who could continuously support them to be physically active in isolated situations such as lockdowns, in addition to exercise knowledge and a better understanding of the benefits of exercise.