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2.
Med Sci Monit ; 27: e935496, 2021 Dec 21.
Article in English | MEDLINE | ID: covidwho-1599426

ABSTRACT

BACKGROUND The COVID-19 pandemic can affect the elderly population's general health. This study aimed to compare the effects of a remote home-based exercise program to improve the mental state, balance, and physical function and to prevent falls in adults aged 65 years and older during the COVID-19 pandemic in Seoul, Korea. MATERIAL AND METHODS Seventy participants were randomly assigned to an experimental group of 35 participants who underwent a remote home-based fall prevention exercise program and a control group of 35 participants. The experimental group performed an exercise program twice weekly for 8 weeks from June 2 to July 21, 2021. The Geriatric Depression Scale, 5 times sit to stand test, grip strength, 10-m walk test, gait analysis, Timed Up and Go test, and static balance test were assessed before and after the 8-week program. RESULTS The group-by-time interaction effect was statistically significant for the Geriatric Depression Scale, five times sit to stand test, grip strength, 10-meter walk, gait speed, step length, stride length, Timed Up and Go test, and static balance test (P<0.05). Compared with the control group, the experimental group showed a significant effect in all dependent variables except dynamic balance (P<0.05). CONCLUSIONS In this population, the remote home-based fall prevention exercise program resulted in a significant improvement in physical function, psychological factors, and balance during the COVID-19 pandemic. The findings may have implications for community public health measures to protect the vulnerable during future epidemics and pandemics of infectious disease.


Subject(s)
Accidental Falls/prevention & control , Telemedicine , Aged , Aged, 80 and over , COVID-19/epidemiology , Exercise , Exercise Therapy , Female , Geriatric Assessment , Hand Strength , Health Services for the Aged , Humans , Male , Postural Balance , Seoul/epidemiology , Walking Speed
3.
Annu Int Conf IEEE Eng Med Biol Soc ; 2021: 2180-2185, 2021 11.
Article in English | MEDLINE | ID: covidwho-1566220

ABSTRACT

The Center for Eldercare and Rehabilitation Technology, at University of Missouri, has researched the use of smart, unobtrusive sensors for older adult residents' health monitoring and alerting in aging-in-place communities for many years. Sensors placed in the apartments of older adult residents generate a deluge of daily data that is automatically aggregated, analyzed, and summarized to aid in health awareness, clinical care, and research for healthy aging. When anomalies or concerning trends are detected within the data, the sensor information is converted into linguistic health messages using fuzzy computational techniques, so as to make it understandable to the clinicians. Sensor data are analyzed at the individual level, therefore, through this study we aim to discover various combinations of patterns of anomalies happening together and recurrently in the older adult's population using these text summaries. Leveraging various computational text data processing techniques, we are able to extract relevant analytical features from the health messages. These features are transformed into a transactional encoding, then processed with frequent pattern mining techniques for association rule discovery. At individual level analysis, resident ID 3027 was considered as an exemplar to describe the analysis. Seven combinations of anomalies/rules/associations were discovered in this resident, out of which rule group three showed an increased recurrence during the COVID lockdown of facility. At the population level, a total of 38 associations were discovered that highlight the health patterns, and we continue to explore the health conditions associated with them. Ultimately, our goal is to correlate the combinations of anomalies with certain health conditions, which can then be leveraged for predictive analytics and preventative care. This will improve the current clinical care systems for older adult residents in smart sensor, aging-in-place communities.


Subject(s)
Electronic Health Records , Linguistics , Unsupervised Machine Learning , Aged , COVID-19 , Health Services for the Aged , Home Care Services , Humans , Independent Living
6.
PLoS Med ; 18(10): e1003779, 2021 10.
Article in English | MEDLINE | ID: covidwho-1463302

ABSTRACT

BACKGROUND: Older adults, including those with long-term conditions (LTCs), are vulnerable to social isolation. They are likely to have become more socially isolated during the Coronavirus Disease 2019 (COVID-19) pandemic, often due to advice to "shield" to protect them from infection. This places them at particular risk of depression and loneliness. There is a need for brief scalable psychosocial interventions to mitigate the psychological impacts of social isolation. Behavioural activation (BA) is a credible candidate intervention, but a trial is needed. METHODS AND FINDINGS: We undertook an external pilot parallel randomised trial (ISRCTN94091479) designed to test recruitment, retention and engagement with, and the acceptability and preliminary effects of the intervention. Participants aged ≥65 years with 2 or more LTCs were recruited in primary care and randomised by computer and with concealed allocation between June and October 2020. BA was offered to intervention participants (n = 47), and control participants received usual primary care (n = 49). Assessment of outcome was made blind to treatment allocation. The primary outcome was depression severity (measured using the Patient Health Questionnaire 9 (PHQ-9)). We also measured health-related quality of life (measured by the Short Form (SF)-12v2 mental component scale (MCS) and physical component scale (PCS)), anxiety (measured by the Generalised Anxiety Disorder 7 (GAD-7)), perceived social and emotional loneliness (measured by the De Jong Gierveld Scale: 11-item loneliness scale). Outcome was measured at 1 and 3 months. The mean age of participants was aged 74 years (standard deviation (SD) 5.5) and they were mostly White (n = 92, 95.8%), and approximately two-thirds of the sample were female (n = 59, 61.5%). Remote recruitment was possible, and 45/47 (95.7%) randomised to the intervention completed 1 or more sessions (median 6 sessions) out of 8. A total of 90 (93.8%) completed the 1-month follow-up, and 86 (89.6%) completed the 3-month follow-up, with similar rates for control (1 month: 45/49 and 3 months 44/49) and intervention (1 month: 45/47and 3 months: 42/47) follow-up. Between-group comparisons were made using a confidence interval (CI) approach, and by adjusting for the covariate of interest at baseline. At 1 month (the primary clinical outcome point), the median number of completed sessions for people receiving the BA intervention was 3, and almost all participants were still receiving the BA intervention. The between-group comparison for the primary clinical outcome at 1 month was an adjusted between-group mean difference of -0.50 PHQ-9 points (95% CI -2.01 to 1.01), but only a small number of participants had completed the intervention at this point. At 3 months, the PHQ-9 adjusted mean difference (AMD) was 0.19 (95% CI -1.36 to 1.75). When we examined loneliness, the adjusted between-group difference in the De Jong Gierveld Loneliness Scale at 1 month was 0.28 (95% CI -0.51 to 1.06) and at 3 months -0.87 (95% CI -1.56 to -0.18), suggesting evidence of benefit of the intervention at this time point. For anxiety, the GAD adjusted between-group difference at 1 month was 0.20 (-1.33, 1.73) and at 3 months 0.31 (-1.08, 1.70). For the SF-12 (physical component score), the adjusted between-group difference at 1 month was 0.34 (-4.17, 4.85) and at 3 months 0.11 (-4.46, 4.67). For the SF-12 (mental component score), the adjusted between-group difference at 1 month was 1.91 (-2.64, 5.15) and at 3 months 1.26 (-2.64, 5.15). Participants who withdrew had minimal depressive symptoms at entry. There were no adverse events. The Behavioural Activation in Social Isolation (BASIL) study had 2 main limitations. First, we found that the intervention was still being delivered at the prespecified primary outcome point, and this fed into the design of the main trial where a primary outcome of 3 months is now collected. Second, this was a pilot trial and was not designed to test between-group differences with high levels of statistical power. Type 2 errors are likely to have occurred, and a larger trial is now underway to test for robust effects and replicate signals of effectiveness in important secondary outcomes such as loneliness. CONCLUSIONS: In this study, we observed that BA is a credible intervention to mitigate the psychological impacts of COVID-19 isolation for older adults. We demonstrated that it is feasible to undertake a trial of BA. The intervention can be delivered remotely and at scale, but should be reserved for older adults with evidence of depressive symptoms. The significant reduction in loneliness is unlikely to be a chance finding, and replication will be explored in a fully powered randomised controlled trial (RCT). TRIAL REGISTRATION: ISRCTN94091479.


Subject(s)
COVID-19/psychology , Depression/prevention & control , Health Promotion/methods , Health Services for the Aged , Loneliness , Pandemics , Social Isolation , Aged , Exercise , Female , Health Behavior , Humans , Internet , Male , Pilot Projects , Program Evaluation , SARS-CoV-2 , Social Participation , State Medicine , United Kingdom
7.
J Gerontol Nurs ; 47(10): 3-5, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1444381
12.
J Alzheimers Dis ; 83(4): 1841-1848, 2021.
Article in English | MEDLINE | ID: covidwho-1369637

ABSTRACT

BACKGROUND: In a previous study, we assessed burnout in geriatric healthcare workers during the first lockdown that lasted from March to May 2020 in France, in response to the COVID-19 crisis. OBJECTIVE: We carried out a follow-up study to assess burnout in the same population during the second lockdown that was implemented at the end of October 2020. METHODS: We used an online survey to assess burnout in terms of exhaustion and disengagement in a sample of 58 geriatric healthcare workers. RESULTS: We found higher levels of exhaustion, disengagement, and burnout among geriatric healthcare workers during the second than during the first lockdown. We also found high levels of exhaustion but moderate disengagement and burnout during the second lockdown. CONCLUSION: The increased exhaustion, disengagement, and burnout during the second lockdown can be attributed to the increased workload in geriatric facilities throughout this crisis and during the second lockdown due to shortage in staff and increased number of shifts and allocated duties. The high levels of exhaustion reported among geriatric healthcare workers during the second lockdown can reflect their physical fatigue, as well as their feelings of being emotionally overextended and exhausted by their workload.


Subject(s)
Burnout, Professional , COVID-19 , Caregiver Burden , Health Personnel/psychology , Health Services for the Aged , Work Engagement , Adult , Burnout, Professional/diagnosis , Burnout, Professional/epidemiology , Burnout, Professional/etiology , Burnout, Professional/psychology , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/psychology , Caregiver Burden/epidemiology , Caregiver Burden/psychology , Communicable Disease Control/methods , Female , Follow-Up Studies , France/epidemiology , Health Services Needs and Demand , Health Services for the Aged/organization & administration , Health Services for the Aged/statistics & numerical data , Humans , Male , SARS-CoV-2 , Surveys and Questionnaires
14.
J Steroid Biochem Mol Biol ; 213: 105958, 2021 10.
Article in English | MEDLINE | ID: covidwho-1331009

ABSTRACT

BACKGROUND: The objective of this extension phase of the quasi-experimental GERIA-COVID study was to determine whether vitamin D3 supplementation taken prior to or during COVID-19 was associated with better 3-month survival in geriatric patients hospitalized for COVID-19. METHODS: Intervention group was defined as all participants supplemented with vitamin D3 prior to or during COVID-19 (n = 67). Supplements were either bolus vitamin D3 (ie, 50,000 IU per month, or 80,000 IU or 100,000 IU or 200,000 IU every 2-3 months), or daily supplementation with 800 IU. Comparator group involved those without vitamin D supplements (n = 28). Outcome was 3-month mortality. Covariables were age, sex, functional abilities, history of malignancies, cardiomyopathy, undernutrition, number of acute health issues, antibiotics use, systemic corticosteroids use, and 25(OH)D concentration. RESULTS: 76.1 % (n = 51) of participants survived at 3 months in Intervention group, compared to only 53.6 % (n = 15) in Comparator group (P = 0.03). The fully-adjusted hazard ratio for 3-month mortality was HR = 0.23 [95 %CI: 0.09;0.58](P = 0.002) in Intervention group compared to Comparator group. Intervention group had also longer survival time (log-rank P = 0.008). CONCLUSIONS: Vitamin D3 supplementation was associated with better 3-month survival in older COVID-19 patients.


Subject(s)
COVID-19/diet therapy , Cardiomyopathies/diet therapy , Cholecalciferol/administration & dosage , Dietary Supplements , Malnutrition/diet therapy , Neoplasms/diet therapy , Vitamin D Deficiency/diet therapy , Vitamin D/analogs & derivatives , Aged, 80 and over , COVID-19/blood , COVID-19/mortality , COVID-19/virology , Cardiomyopathies/blood , Cardiomyopathies/mortality , Cardiomyopathies/virology , Case-Control Studies , Comorbidity , Drug Administration Schedule , Female , Health Services for the Aged , Humans , Male , Malnutrition/blood , Malnutrition/mortality , Malnutrition/virology , Neoplasms/blood , Neoplasms/mortality , Neoplasms/virology , Proportional Hazards Models , SARS-CoV-2/pathogenicity , Vitamin D/blood , Vitamin D Deficiency/blood , Vitamin D Deficiency/mortality , Vitamin D Deficiency/virology
16.
Nihon Ronen Igakkai Zasshi ; 58(2): 312-314, 2021.
Article in Japanese | MEDLINE | ID: covidwho-1304574
17.
J Am Geriatr Soc ; 69(10): 2708-2715, 2021 10.
Article in English | MEDLINE | ID: covidwho-1301523

ABSTRACT

COVID-19 has exacted a disproportionate toll on the health of persons living in nursing homes. Healthcare providers and other decision-makers in those settings must refer to multiple evolving sources of guidance to coordinate care delivery in such a way as to minimize the introduction and spread of the causal virus, SARS-CoV-2. It is essential that guidance be presented in an accessible and usable format to facilitate its translation into evidence-based best practice. In this article, we propose the Haddon matrix as a tool well-suited to this task. The Haddon matrix is a conceptual model that organizes influencing factors into pre-event, event, and post-event phases, and into host, agent, and environment domains akin to the components of the epidemiologic triad. The Haddon matrix has previously been applied to topics relevant to the care of older persons, such as fall prevention, as well as to pandemic planning and response. Presented here is a novel application of the Haddon matrix to pandemic response in nursing homes, with practical applications for nursing home decision-makers in their efforts to prevent and contain COVID-19.


Subject(s)
COVID-19 , Civil Defense/organization & administration , Evidence-Based Practice , Homes for the Aged/organization & administration , Infection Control , Models, Organizational , Nursing Homes/organization & administration , Aged , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/transmission , Disease Transmission, Infectious/prevention & control , Evidence-Based Practice/methods , Evidence-Based Practice/trends , Health Services for the Aged/organization & administration , Health Services for the Aged/standards , Health Services for the Aged/trends , Humans , Infection Control/methods , Infection Control/organization & administration , Infection Control/standards , Organizational Innovation , SARS-CoV-2 , United States
20.
J Am Geriatr Soc ; 69(10): 2722-2731, 2021 10.
Article in English | MEDLINE | ID: covidwho-1268124

ABSTRACT

OBJECTIVE: To assess the association between SARS-CoV-2 infection and decreased hand grip strength (HGS). DESIGN: Longitudinal population-based study. SETTING: Community-dwelling older adults (aged ≥60 years) living in a rural Ecuadorian village struck by the SARS-CoV-2 pandemic. PARTICIPANTS: Of 282 enrolled individuals, 254 (90%) finished the study. MEASUREMENTS: HGS was measured 3 months before (January 2020) and 9 months after the introduction of the virus into the population (January 2021). SARS-CoV-2 antibody testing was performed in two rounds: in May-June (early) and September-November (late), 2020. An independent association between SARS-CoV-2 infection and HGS decline was assessed by fitting linear mixed models for longitudinal data. Changes in HGS scores in SARS-CoV-2 seropositive subjects, according to the time elapsed since seroconversion, were compared with those who remained seronegative. RESULTS: Overall, 149 (59%) individuals became seropositive for SARS-CoV-2. The mean HGS (in kg) was 25.3 ± 8.3 at baseline and 23.7 ± 8.1 at follow-up (p = 0.028), with 140 individuals having >5% HGS decline between both measurements. The follow-up HGS measurement decreased by 1.72 kg in seropositive individuals, and by 0.57 kg in their seronegative counterparts (p < 0.001). SARS-CoV-2 seropositive individuals were 2.27 times more likely (95% CI: 1.33-3.87) to have a lower HGS measurement at the time of follow-up than those who remained seronegative. When compared with seronegative subjects, seropositive patients with early seroconversion were 3.41 times (95% CI: 1.73-6.74) more likely to have >5% HGS decline at the time of the follow-up than those with later, i.e., more recent, infections. CONCLUSIONS: This study shows an independent deleterious impact of SARS-CoV-2 on HGS that is more marked among individuals with infections that occurred more than 8 months before follow-up HGS. Results suggest the possibility of chronic damage to skeletal muscles by SARS-CoV-2.


Subject(s)
COVID-19/complications , Geriatric Assessment , Hand Strength , SARS-CoV-2/isolation & purification , Aftercare/methods , Aftercare/statistics & numerical data , Aged , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/physiopathology , COVID-19 Serological Testing/methods , Ecuador/epidemiology , Female , Geriatric Assessment/methods , Geriatric Assessment/statistics & numerical data , Health Services for the Aged/statistics & numerical data , Humans , Independent Living/statistics & numerical data , Longitudinal Studies , Male , Rural Population
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