The Impact of Frailty on the Relationship between Life-Space Mobility and Quality of Life in Older Adults during the COVID-19 Pandemic.
J Nutr Health Aging
; 25(4): 440-447, 2021.
Article
in English
| MEDLINE | ID: covidwho-1160647
ABSTRACT
BACKGROUND:
The COVID-19 pandemic has led to abrupt restrictions of life-space mobility. The impact of shelter-in-place orders on older adults' health and well-being is still unclear.OBJECTIVE:
To investigate the relationship between life-space mobility and quality of life (QoL) in older adults with and without frailty during the COVID-19 pandemic.DESIGN:
Multicenter prospective cohort study based on structured telephone interviews.SETTING:
Four geriatric outpatient clinics in the metropolitan area of Sao Paulo, Brazil.PARTICIPANTS:
557 community-dwelling adults aged 60 years and older. MEASUREMENTS The Life-Space Assessment was used to measure community mobility before and during the COVID-19 pandemic, and a previously validated decrease of ≥ 5 points defined restricted life-space mobility. Frailty was assessed through the FRAIL (fatigue, resistance, ambulation, illnesses, and loss of weight) scale. The impact of shelter-in-place orders on QoL was evaluated with the question «How is the COVID-19 pandemic affecting your QoL?¼, to which participants could respond «not at all¼, «to some extent¼, or «to a great extent¼. We used ordinal logistic regressions to investigate the relationship between restricted life-space mobility and impact on QoL, adjusting our analyses for demographics, frailty, comorbidities, cognition, functionality, loneliness, depression, and anxiety. We explored whether frailty modified the association between life-space mobility and impact on QoL.RESULTS:
Participants were on average 80±8 years old, 65% were women, and 33% were frail. The COVID-19 quarantine led to a restriction of community mobility in 79% of participants and affected the QoL for 77% of participants. We found that restricted life-space mobility was associated with impact on QoL in older adults during the pandemic, although frailty modified the magnitude of the association (P-value for interaction=0.03). Frail participants who experienced restricted life-space mobility had twice the odds of reporting an impact on QoL when compared with non-frail individuals, with respective adjusted odds ratios of 4.20 (95% CI=2.36-7.50) and 2.18 (95% CI=1.33-3.58).CONCLUSION:
Older adults experienced substantial decreases in life-space mobility during the COVID-19 pandemic, and this unexpected change impacted their QoL. Providers should be particularly watchful for the consequences of abrupt life-space restrictions on frail individuals.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Quality of Life
/
Geriatric Assessment
/
Frail Elderly
/
Frailty
/
COVID-19
Type of study:
Cohort study
/
Experimental Studies
/
Observational study
/
Prognostic study
/
Qualitative research
/
Randomized controlled trials
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
South America
/
Brazil
Language:
English
Journal:
J Nutr Health Aging
Journal subject:
Nutritional Sciences
/
Geriatrics
Year:
2021
Document Type:
Article
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