Differences in Unfavorable Lifestyle Changes during the COVID-19 Pandemic between People with and without Disabilities in Finland: Psychological Distress as a Mediator.

ABSTRACT

We investigated whether people with disabilities-cognition, vision, hearing, mobility, or at least one of these disabilities-report more COVID-19-related negative lifestyle changes than those without disabilities, and whether psychological distress (MHI-5) mediates the association between disabilities and negative lifestyle changes. Information about COVID-related lifestyle changes among people with disabilities is scarce. We analyzed population-based data from the 2020 FinSote survey carried out between September 2020 and February 2021 in Finland (n = 22,165, aged 20+). Logistic regressions were applied to investigate the effect of the COVID-19 pandemic and related restrictions on negative lifestyle changes-sleeping problems or nightmares, daily exercise, vegetable consumption, and snacking. To test for a mediation effect of psychological distress, the Karlson-Holm-Breen method was used. People with all disability types reported increased sleeping problems or nightmares, and decreased vegetable consumption during the pandemic more frequently than those without. People with mobility and cognitive disabilities more frequently reported decreased daily exercise. People with cognitive disabilities more often reported increased snacking. Psychological distress mediated associations between disabilities and negative lifestyle changes, with the highest association between cognitive disabilities and increased sleeping problems or nightmares (B = 0.60), and the lowest between mobility disabilities and decreased daily exercise (B = 0.08). The results suggest that strategies to promote healthy lifestyles should consider people with disabilities. Alleviating their psychological distress during crisis situations could be one approach.