Frailty among Older People during the First Wave of the COVID-19 Pandemic in The Netherlands.

Restrictive measures due to the COVID-19 pandemic may cause problems in the physical, social, and psychological functioning of older people, resulting in increased frailty. In this cross-sectional study, we aimed to assess the prevalence and characteristics of frailty, to examine differences in perceived COVID-19-related concerns and threats between frail and non-frail people and to identify variables associated with frailty in the first wave of the COVID-19 pandemic, in Dutch older people aged ≥ 65 years. We used data from the Lifelines COVID-19 Cohort Study. The Groningen Frailty Indicator (GFI) was used, with a score ≥ 4 indicating frailty. Frailty was described per domain (i.e., physical, cognitive, social, and psychological). The association between demographic, health and lifestyle variables and frailty was determined with logistic regression analyses. Frailty was present in 13% of the 11,145 participants that completed the GFI. Most items contributing to a positive frailty score were found within the social domain, in the frail (51%) and the non-frail (59%) persons. For items related to concerns and threats, a significantly higher proportion of frail people reported being worried or feeling threatened. In conclusion, during Corona restrictions, prevalence of frailty was considerable in older people from the Northern Netherlands, with one in eight being frail. Frailty was characterized by social problems and frail people were more often worried and felt threatened by the COVID-19 pandemic.

Can Use of Digital Technologies by People with Dementia Improve Self-Management and Social Participation? A Systematic Review of Effect Studies.

There is increasing interest in the use of technology to support social health in dementia. The primary objective of this systematic review was to synthesize evidence of effectiveness of digital technologies used by people with dementia to improve self-management and social participation. Records published from 1 January 2007 to 9 April 2020 were identified from Pubmed, PsycInfo, Web of Science, CINAHL, and the Cochrane Central Register of Controlled Trials. Controlled interventional studies evaluating interventions based on any digital technology were included if: primary users of the technology had dementia or mild cognitive impairment (MCI); and the study reported outcomes relevant to self-management or social participation. Studies were clustered by population, intervention, and outcomes, and narrative synthesis was undertaken. Of 1394 records identified, nine met the inclusion criteria: two were deemed to be of poor methodological quality, six of fair quality, and one of good quality. Three clusters of technologies were identified: virtual reality, wearables, and software applications. We identified weak evidence that digital technologies may provide less benefit to people with dementia than people with MCI. Future research should address the methodological limitations and narrow scope of existing work. In the absence of strong evidence, clinicians and caregivers must use their judgement to appraise available technologies on a case-by-case basis.