Longitudinal Aging Study Amsterdam COVID-19 exposure index: a cross-sectional analysis of the impact of the pandemic on daily functioning of older adults.

OBJECTIVES: The aim of this study was to develop an index to measure older adults' exposure to the COVID-19 pandemic and to study its association with various domains of functioning. DESIGN: Cross-sectional study. SETTING: The Longitudinal Aging Study Amsterdam (LASA), a cohort study in the Netherlands. PARTICIPANTS: Community-dwelling older adults aged 62-102 years (n=1089) who participated in the LASA COVID-19 study (June-September 2020), just after the first wave of the pandemic. PRIMARY OUTCOME MEASURES: A 35-item COVID-19 exposure index with a score ranging between 0 and 1 was developed, including items that assess the extent to which the COVID-19 situation affected daily lives of older adults. Descriptive characteristics of the index were studied, stratified by several sociodemographic factors. Logistic regression analyses were performed to study associations between the exposure index and several indicators of functioning (functional limitations, anxiety, depression and loneliness). RESULTS: The mean COVID-19 exposure index score was 0.20 (SD 0.10). Scores were relatively high among women and in the southern region of the Netherlands. In models adjusted for sociodemographic factors and prepandemic functioning (2018-2019), those with scores in the highest tertile of the exposure index were more likely to report functional limitations (OR: 2.24; 95% CI: 1.48 to 3.38), anxiety symptoms (OR: 3.14; 95% CI: 1.82 to 5.44), depressive symptoms (OR: 2.49; 95% CI: 1.55 to 4.00) and loneliness (OR: 2.97; 95% CI: 2.08 to 4.26) than those in the lowest tertile. CONCLUSIONS: Among older adults in the Netherlands, higher exposure to the COVID-19 pandemic was associated with worse functioning in the physical, mental and social domain. The newly developed exposure index may be used to identify persons for whom targeted interventions are needed to maintain or improve functioning during the pandemic or postpandemic.

Self-Reported Impact of the COVID-19 Pandemic on Nutrition and Physical Activity Behaviour in Dutch Older Adults Living Independently.

The aim was to explore the self-reported impact of the COVID-19 pandemic on nutrition and physical activity behaviour in Dutch older adults and to identify subgroups most susceptible to this impact. Participants (N = 1119, aged 62-98 y, 52.8% female) of the Longitudinal Aging Study Amsterdam living independently completed a COVID-19 questionnaire. Questions on diagnosis, quarantine and hospitalization were asked, as well as impact of the pandemic on ten nutrition and physical activity behaviours. Associations of pre-COVID-19 assessed characteristics (age, sex, region, household composition, self-rated health, BMI, physical activity, functional limitations) with reported impact were tested using logistic regression analyses. About half of the sample (48.3-54.3%) reported a decrease in physical activity and exercise due to the pandemic. An impact on nutritional behaviour predisposing to overnutrition (e.g., snacking more) was reported by 20.3-32.4%. In contrast, 6.9-15.1% reported an impact on behaviour predisposing to undernutrition (e.g., skipping warm meals). Those who had been in quarantine (n = 123) more often reported a negative impact. Subgroups with higher risk of impact could be identified. This study shows a negative impact of the COVID-19 pandemic on nutrition and physical activity behaviour of many older adults, which may increase their risk of malnutrition, frailty, sarcopenia and disability.