Physical Activity, Stress and Cognitive Concerns During the COVID‐19 Pandemic Among Older Adults in the United States

Background The COVID‐19 pandemic has increased psychological distress. Research shows that physical activity can reduce emotional distress and improve cognitive functioning. Yet, the pandemic has limited opportunities to engage in physical activity. In this study, we examined whether older adults who maintained physical activity during the pandemic perceived less subjective cognitive concerns and better emotional distress management compared to those who reduced or did not engage in activity. 8 Method 80 adults (ages 55‐94 years) from the community completed an online survey. Subjective cognitive concerns were measured using the Everyday Cognition Scale. Physical activity was measured with the question, "Have you maintained your physical activities during social isolation?” and answers were grouped into yes, no, or partially. Emotional distress was measured with the question, "How well you think you have been able to manage your emotions, worries and stress, and answers were grouped into good/very good, regular, or bad/very bad. Result 54% of participants reported having maintained or increased their physical activity levels, 33% partially maintained their usual levels, and 13% reduced or did not engage in activity. 64% reported that they were managing their emotions, worry and stress good/very good, 30% regular, and 6% bad/very bad. Participants who maintained or increased their physical activity levels reported less cognitive concerns and greater ability to manage their emotions, worry and stress, compared to those who reduced, partially or did not engage in physical activity. Conclusion Encouraging individuals and providing resources for increasing physical activity may help mitigate some of the pandemic's adverse effects on psychological well‐being.

Cognitive and brain reserve predict decline in adverse driving behaviors among cognitively normal older adults.

Daily driving is a multi-faceted, real-world, behavioral measure of cognitive functioning requiring multiple cognitive domains working synergistically to complete this instrumental activity of daily living. As the global population of older adult continues to grow, motor vehicle crashes become more frequent among this demographic. Cognitive reserve (CR) is the brain's adaptability or functional robustness despite damage, while brain reserve (BR) refers the structural, neuroanatomical resources. This study examined whether CR and BR predicted changes in adverse driving behaviors in cognitively normal older adults. Cognitively normal older adults (Clinical Dementia Rating 0) were enrolled from longitudinal studies at the Knight Alzheimer's Disease Research Center at Washington University. Participants (n = 186) were ≥65 years of age, required to have Magnetic Resonance Imaging (MRI) data, neuropsychological testing data, and at least one full year of naturalistic driving data prior to the beginning of COVID-19 lockdown in the United States (March 2020) as measured by Driving Real World In-vehicle Evaluation System (DRIVES). Findings suggest numerous changes in driving behaviors over time were predicted by increased hippocampal and whole brain atrophy, as well as lower CR scores as proxied by the Wide Range Achievement Test 4. These changes indicate that those with lower BR and CR are more likely to reduce their driving exposure and limit trips as they age and may be more likely to avoid highways where speeding and aggressive maneuvers frequently occur.

Driving, Social Distancing, Protective, and Coping Behaviors of Older Adults Before and During COVID-19.

A thorough understanding of individual characteristics of older adults during the COVID-19 pandemic is critical for managing the ongoing pandemic course and planning for the future pandemics. Here, we explore the impact of the COVID-19 pandemic on driving, social distancing, protective, and coping behaviors of older adults. This study reports data on participants aged above 65 whose driving behaviors are being monitored using Global Positioning System (GPS) devices. Participants completed a COVID-19 survey in May 2020. We found that older adults decreased their number of days driving, number of trips per day, as well as average driving speed, and had fewer speeding incidents following COVID-19 onset. We also show that female and African American older adults engaged in more positive coping and cleaning behaviors, and had greater decreases in the number of days driving during the pandemic. The findings highlight the importance of considering older adults' individual characteristics for an equitable response to the COVID-19 pandemic.

COVID-19 and preclinical Alzheimer disease: Driving, mobility, activity and experiences of older adults in the United States

Background As the world grapples with the COVID-19 pandemic, there have been widespread disruptions to everyday life due to social distancing. Older adults with Alzheimer disease (AD) are at increased risk of morbidity and mortality from COVID-19. It is unknown how COVID-19 affects the mobility patterns of older adults with preclinical AD. Since before the pandemic, we have been monitoring the driving behaviors of older adults, enabling us to evaluate the impact of the pandemic on individuals with and without preclinical AD. Method We used in-vehicle Global Positioning System (GPS) devices to study driving behaviors of 115 older adults enrolled in the DRIVES study (aged 65+) from 1/1/2019 to 31/12/2020. The cohort included 62 individuals with preclinical AD (PreAD) and 53 without preclinical AD (CTL), as determined by cerebrospinal fluid biomarkers. All participants completed an online survey about their overall experiences during the pandemic. Using the GPS data, we determined the average monthly distance travelled, and the number of visitations to destinations categorized as food shopping, place of worship, restaurant, leisure, or health. All measures were computed monthly. Result oth groups experienced an approximate 40% decline in average monthly distance travelled overall after the start of the pandemic (PreAD: 1287.92 to 783.38 km vs. CTL: 1751.26 to 1053.29 km). Visits to places of worship, restaurants, leisure and health places declined by 70%, 46%, 23%, and 23% for the PreAD group, and by 48%, 31%, 48%, and 22% for the CTL group, respectively. However, the pandemic did not result in a significant decline in Food Shopping among either of the groups. Overall, compared to the CTL group, the PreAD group experienced a higher level of stress in response to the recommendations for socially distancing (p<0.01), more uncertainty about their risk of COVID-19 (p<0.05), more decline in trips for worship (p<0.05) and less decline in trips for leisure (p<0.01). Conclusion Our findings indicate decreased mobility in all older adults during the pandemic, with the preclinical AD group exhibiting more decline in trips to places of worship, less decline in leisure activities, and increased stress and uncertainty in response to COVID-19.

The impact of COVID-19 on the well-being and cognition of older adults living in the United States and Latin America

Background In the COVID-19 pandemic, older adults from vulnerable ethnoracial groups are at high risk of infection, hospitalization, and death. We aimed to explore the pandemic?s impact on the well-being and cognition of older adults within and outside of the United States (US). Method 1,747 (646 White, 991 Latino, 77 Black, 33 Asian;72% female) individuals from the US and 14 Latin American countries completed an online survey regarding well-being and cognition during the pandemic. Outcome variables (pandemic impact, discrimination, loneliness, purpose of life, subjective cognitive concerns) were compared across four US ethnoracial groups, and Latinos living in the US and Latin America. Result Mean age was 66·5 (SD = 7·70) years and mean education was 15·4 (SD = 2·76) years. We found no differences in the pandemic?s overall impact across US ethnoracial groups. Compared to Whites, Latinos reported greater economic impact (p < ·001, ?p2 = .031);while Blacks reported experiencing discrimination more often (p < ·001, ?p2 = .050). Blacks and Latinos reported more positive coping (p < ·001, ?p2 = 040). Latin American Latinos reported greater pandemic impact (p < ·001, ?p2 =.013 ), more positive coping (p =·006, ?p2 =.008 ), and less discrimination than US Latinos (p < ·001, ?p2 = .013 ). Conclusion The COVID-19 pandemic has differentially impacted the well-being of older ethnically diverse individuals in the US and Latin America. Future studies should examine how mediators like income and coping skills modify the pandemic?s impact.

The impact of COVID-19 on the well-being and cognition of older adults living in the United States and Latin America.

BACKGROUND: In the COVID-19 pandemic, older adults from vulnerable ethnoracial groups are at high risk of infection, hospitalization, and death. We aimed to explore the pandemic's impact on the well-being and cognition of older adults living in the United States (US), Argentina, Chile, Mexico, and Peru. METHODS: 1,608 (646 White, 852 Latino, 77 Black, 33 Asian; 72% female) individuals from the US and four Latin American countries aged ≥ 55 years completed an online survey regarding well-being and cognition during the pandemic between May and September 2020. Outcome variables (pandemic impact, discrimination, loneliness, purpose of life, subjective cognitive concerns) were compared across four US ethnoracial groups and older adults living in Argentina, Chile, Mexico, and Peru. FINDINGS: Mean age for all participants was 66.7 (SD = 7.7) years and mean education was 15.4 (SD = 2.7) years. Compared to Whites, Latinos living in the US reported greater economic impact (p < .001, ηp 2  = 0.031); while Blacks reported experiencing discrimination more often (p < .001, ηp 2  = 0.050). Blacks and Latinos reported more positive coping (p < .001, ηp 2  = 0.040). Compared to Latinos living in the US, Latinos in Chile, Mexico, and Peru reported greater pandemic impact, Latinos in Mexico and Peru reported more positive coping, Latinos in Argentina, Mexico, and Peru had greater economic impact, and Latinos in Argentina, Chile, and Peru reported less discrimination. INTERPRETATION: The COVID-19 pandemic has differentially impacted the well-being of older ethnically diverse individuals in the US and Latin America. Future studies should examine how mediators like income and coping skills modify the pandemic's impact. FUNDING: Massachusetts General Hospital Department of Psychiatry.

Reaction to a Pandemic: Social Distancing and Driving Among Older Adults During COVID-19.

Coronavirus disease 2019 (COVID-19) has produced considerable morbidity and mortality worldwide, and older adults are at especially high risk for developing severe COVID-19. A cohort study of driving behavior from January 1, 2019, to April 25, 2019, and January 1, 2020, to April 25, 2020, was conducted. We hypothesized that older adults would reduce the number of days driving and number of trips/day they make after COVID-19 case acceleration. Data from 214 adults aged 66.5 to 92.8 years were used. Women comprised 47.6% of the sample and 15.4% were African American. Participants reduced the proportion of days driven during the pandemic (.673 vs. .382 [p < .001]) compared with same period the year before (.695 vs. .749). Trips/day showed a similar decline (p < .001). Participants also took shorter trips (p = .02), drove slower (p < .001), had fewer speeding incidents (p < .001), and had different trip destinations (p < .001). These results indicate that older adults reduce their driving behavior when faced with a pandemic.