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JAMA Health Forum ; 1(12): e201539, 2020 Dec 01.
Article in English | MEDLINE | ID: covidwho-2059097
JAMA ; 327(24): 2389-2390, 2022 06 28.
Article in English | MEDLINE | ID: covidwho-1929685
JAMA ; 327(22): 2248, 2022 06 14.
Article in English | MEDLINE | ID: covidwho-1888459
Innov Aging ; 5(3): igab031, 2021.
Article in English | MEDLINE | ID: covidwho-1462345


BACKGROUND AND OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic poses new challenges for caregivers of adults with chronic or disabling conditions. This study uses nationally representative data to examine the prevalence of pandemic care challenges and supports and their associations with caregiver mental health and interpersonal well-being. RESEARCH DESIGN AND METHODS: Participants include 311 caregivers aged 50-80 in the United States who were providing care for an adult with a chronic or disabling condition from the June 2020 National Poll on Healthy Aging. Five care challenges (e.g., confusion on public health guidelines) and 2 supports (e.g., physician offered information on care during COVID-19) are treated as predictors of caregiver mental health (care-related stress, self-reported mental health, and depressive symptoms) and interpersonal well-being (interpersonal conflicts, lack of companionship, and isolation). RESULTS: Each care challenge/support was endorsed by 13%-23% of caregivers. In adjusted models, difficulty getting needed medical care was associated with greater caregiver stress, depressive symptoms, and lower interpersonal well-being. All care challenges universally predicted greater caregiver stress. Caregiving supports were not independently associated with caregiver' mental health and interpersonal well-being. DISCUSSION AND IMPLICATIONS: Care challenges were associated with caregivers' mental health and interpersonal well-being during the early months of the pandemic. Some of these challenges may be attributed to changing public health guidelines and practices as the pandemic unfolded, whereas others are relevant to all care contexts (e.g., less support from family). Tools and supports for caregivers must consider both changing policies and care needs.

JAMA ; 2021 Aug 13.
Article in English | MEDLINE | ID: covidwho-1427016
J Am Geriatr Soc ; 70(1): 49-59, 2022 01.
Article in English | MEDLINE | ID: covidwho-1429915


BACKGROUND: Physical function worsens with older age, particularly for sedentary and socially isolated individuals, and this often leads to injuries. Through reductions in physical activity, the COVID-19 pandemic may have worsened physical function and led to higher fall-related risks. METHODS: A nationally representative online survey of 2006 U.S. adults aged 50-80 was conducted in January 2021 to assess changes in health behaviors (worsened physical activity and less daily time spent on feet), social isolation (lack of companionship and perceived isolation), physical function (mobility and physical conditioning), and falls (falls and fear of falling) since March 2020. Multivariable logistic regression was used to assess relationships among physical activity, social isolation, physical function, falls, and fear of falling. RESULTS: Among respondents, 740 (36.9%) reported reduced physical activity levels, 704 (35.1%) reported reduced daily time spent on their feet since March 2020, 712 (37.1%) reported lack of companionship, and 914 (45.9%) social isolation. In multivariable models, decreased physical activity (adjusted risk ratio, ARR: 2.92, 95% CI: 2.38, 3.61), less time spent on one's feet (ARR: 1.95, 95% CI: 1.62, 2.34), and social isolation (ARR: 1.51, 95% CI: 1.30, 1.74) were associated with greater risks of worsened physical conditioning. Decreased physical activity, time spent daily on one's feet, and social isolation were similarly associated with worsened mobility. Worsened mobility was associated with both greater risk of falling (ARR: 1.70, 95% CI: 1.35, 2.15) and worsened fear of falling (ARR: 2.02, 95% CI: 1.30, 3.13). Worsened physical conditioning and social isolation were also associated with greater risk of worsened fear of falling. CONCLUSION: The COVID-19 pandemic was associated with worsened physical functioning and fall outcomes, with the greatest effect on individuals with reduced physical activity and social isolation. Public health actions to address reduced physical activity and social isolation among older adults are needed.

Accidental Falls/statistics & numerical data , COVID-19 , Health Status , Independent Living , Sedentary Behavior , Aged , Aged, 80 and over , Exercise/statistics & numerical data , Female , Humans , Male , Middle Aged , Social Isolation , Surveys and Questionnaires
JAMA Health Forum ; 1(9): e201089, 2020 Sep 01.
Article in English | MEDLINE | ID: covidwho-756223
JAMA ; 2020 Aug 13.
Article in English | MEDLINE | ID: covidwho-713888