ABSTRACT
BackgroundNursing home (NH) residents are prioritized for COVID-19 vaccination. We report monthly mortality, hospitalizations, and emergency department (ED) visit incidence rates (IRs) during 2010-2020 to provide context for COVID-19 vaccine safety assessments. MethodsWe observed outcomes among NH residents using administrative databases. IRs were calculated by month, sex, and age group. Comparisons between months were assessed using one-sample t-tests; comparisons by age and sex were assessed using chi-squared tests. ResultsFrom 2010-2019, there were 83,453 (SD: 652.4) NH residents per month, with an average of 2.3 (SD: 0.28) deaths, 3.1 (SD: 0.16) hospitalizations, and 3.6 (SD: 0.17) ED visits per 100 residents per month. From March to December 2020, mortality IRs were increased, but hospitalization and ED visit IRs were reduced (p<0.05). ConclusionWe identified consistent monthly mortality, hospitalization, and ED visit IRs during 2010-2019. Marked differences in these rates were observed during 2020, coinciding with the COVID-19 pandemic.
ABSTRACT
ObjectivePhysical distancing and stay-at-home measures implemented to slow transmission of novel coronavirus disease (COVID-19) may intensify feelings of loneliness in older adults, especially those living alone. Our aim was to characterize the extent of loneliness in a sample of older adults living in the community and assess characteristics associated with loneliness. DesignOnline cross-sectional survey between May 6 and May 19, 2020 SettingOntario, Canada ParticipantsConvenience sample of the members of a national retired educators organization. Primary outcome measuresSelf-reported loneliness, including differences between women and men. Results4879 respondents (71.0% women; 67.4% 65-79 years) reported that in the preceding week, 43.1% felt lonely at least some of the time, including 8.3% that felt lonely always or often. Women had increased odds of loneliness compared to men, whether living alone (adjusted Odds Ratio (aOR) 1.52 [95% Confidence Interval (CI) 1.13-2.04]) or with others (2.44 [95% CI 2.04-2.92]). Increasing age group decreased the odds of loneliness (aOR 0.69 [95% CI 0.59-0.81] 65-79 years and 0.50 [95% CI 0.39-0.65] 80+ years compared to <65 years). Living alone was associated with loneliness, with a greater association in men (aOR 4.26 [95% CI 3.15-5.76]) than women (aOR 2.65 [95% CI 2.26-3.11]). Other factors associated with loneliness included: fair or poor health (aOR 1.93 [95% CI 1.54-2.41]), being a caregiver (aOR 1.18 [95% CI 1.02-1.37]), receiving care (aOR 1.47 [95% CI 1.19-1.81]), high concern for the pandemic (aOR 1.55 [95% CI 1.31-1.84]), not experiencing positive effects of pandemic distancing measures (aOR 1.94 [95% CI 1.62-2.32]), and changes to daily routine (aOR 2.81 [95% CI 1.96-4.03]). ConclusionsWhile many older adults reported feeling lonely during COVID-19, several characteristics - such as being female and living alone - increased the odds of loneliness. These characteristics may help identify priorities for targeting interventions to reduce loneliness. Strengths and limitations of this studyO_LIThis survey study leveraged a strong community-based partnership to obtain timely data from a large sample of older Canadians on the impacts of COVID-19. C_LIO_LIThis study identified several characteristics that increased the odds of loneliness, which may help to identify priorities for targeted interventions to reduce loneliness. C_LIO_LIThe data were based on a convenience sample of retired, educational staff, who are not fully representative of the Canadian population. The perspectives of vulnerable groups who may be at greater risk for loneliness (e.g. those with severe mental health illness, low income, no home internet access, etc.) are likely underrepresented in this sample. C_LI
