Abstract
The association of COVID-19 not requiring hospitalization with functional mobility in community-dwelling adults above and beyond the impact of the pandemic control measures implemented in 2020 remains to be elucidated. To evaluate the association between a COVID-19 diagnosis and change in mobility and physical function of adults in Canada aged 50 years or older during the initial pandemic lockdown. This population-based cohort study used data from the Canadian Longitudinal Study on Aging (CLSA) COVID-19 study. This study was launched on April 15, 2020, and the exit questionnaires were completed between September and December 2020. Prepandemic data from the first CLSA follow-up (2015-2018) were also used. Respondents included middle-aged and older community-dwelling participants residing in Canadian provinces. Data were analyzed from February to May 2021. The assessment for self-reported COVID-19 status was adapted from the Public Health Agency of Canada and the Centers for Disease Control and Prevention case definition available at the time of data collection; cases were classified as confirmed or probable, suspected, or non-COVID-19. Changes in mobility since the start of the COVID-19 pandemic were assessed using global rating of change in mobility scales at the COVID-19 exit questionnaire. Participant-reported new onset of difficulty in 3 physical function tasks was also examined. Among 51 338 participants at baseline, 21 491 participants (41.9%) were 65 years or older and 26 155 participants (51.0%) were women and 25 183 (49.1%) were men. Of 2748 individuals with confirmed or probable or suspected COVID-19, 113 (94.2%) were not hospitalized. Individuals with confirmed or probable COVID-19 had higher odds of worsening mobility in terms of ability to engage in household activity (odds ratio [OR], 1.89; 95% CI, 1.11-3.22), physical activity (OR, 1.91; 95% CI, 1.32-2.76), and standing up after sitting in a chair (OR, 2.33; 95% CI, 1.06-5.11) compared with adults without COVID-19 during the same pandemic time period. Similar results were found for suspected COVID-19 status (eg, household activity: OR, 2.09; 95% CI, 1.82-2.41). This cohort study among older adults in Canada found that receiving a COVID-19 diagnosis was significantly associated with worse mobility and functioning outcomes even in the absence of hospitalization. These findings suggest that interventions may be needed for individuals with mild to moderate COVID-19 who do not require hospitalization.
Highlights
The World Health Organization (WHO) declared COVID-19 a pandemic on March 11, 2020, and as of December 2021, there have been more than 262 million confirmed cases and more than 5.2 million deaths globally.[1]
Individuals with confirmed or probable COVID-19 had higher odds of worsening mobility in terms of ability to engage in household activity, physical activity (OR, 1.91; 95% CI, 1.32-2.76), and standing up after sitting in a chair (OR, 2.33; 95% CI, 1.06-5.11) compared with adults without COVID-19 during the same pandemic time period
These findings suggest that interventions may be needed for individuals with mild to moderate COVID-19 who do not require hospitalization
Summary
The World Health Organization (WHO) declared COVID-19 a pandemic on March 11, 2020, and as of December 2021, there have been more than 262 million confirmed cases and more than 5.2 million deaths globally.[1]. Even less is known about mobility and function in nonhospitalized samples of community-dwelling older adults.[4,5]. The associations of preexisting sociodemographic and health characteristics in community-dwelling individuals with changes in mobility and functioning from COVID-19 remain to be elucidated. We hypothesized that individuals with confirmed or probable and suspected COVID-19 will be more likely to report worsening of mobility and physical function compared with those without COVID-19. The purpose of this study was to examine the association between a COVID-19 diagnosis and change in mobility and physical function among middle-aged and older adults who were enrolled in the Canadian Longitudinal Study on Aging (CLSA) COVID-19 study
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