Depressive Symptoms, Fatigue and Social Relationships Influenced Physical Activity in Frail Older Community-Dwellers during the Spanish Lockdown due to the COVID-19 Pandemic.

Laura M Pérez,Luis Soto-Bagaria,Jordi Vilaró,Joan Ars,Sonia Baró,Paula Espí-Valbé,Carmina Castellano-Tejedor,Fabricio Zambom-Ferraresi,Francisco Díaz-Gallego,María B Enfedaque,Matteo Cesari,Marco Inzitari

doi:10.3390/ijerph18020808

Abstract

Due to the dramatic impact of the COVID-19 pandemic, Spain underwent a strict lockdown (March–May 2020). How the lockdown modified older adults’ physical activity (PA) has been poorly described. This research assesses the effect of the lockdown on PA levels and identifies predictors of sufficient/insufficient PA in frail older community-dwellers. Community-dwelling participants from the +ÀGIL Barcelona frailty intervention program, suspended during the pandemic, underwent a phone-assessment during the lockdown. PA was measured before and after the lockdown using the Brief Physical Activity Assessment Tool (BPAAT). We included 98 frail older adults free of COVID-19 (mean age = 82.7 years, 66.3% women, mean Short Physical Performance Battery = 8.1 points). About one third of participants (32.2%) were not meeting sufficient PA levels at the end of the lockdown. Depressive symptoms (OR = 0.12, CI95% = 0.02–0.55) and fatigue (OR = 0.11, CI95% = 0.03–0.44) decreased the odds of maintaining sufficient PA, whereas maintaining social networks (OR = 5.07, CI95% = 1.60–16.08) and reading (OR = 6.29, CI95% = 1.66–23.90) increased it. Living alone was associated with the reduction of PA levels (b = −1.30, CI95% = −2.14–−0.46). In our sample, pre-lockdown mental health, frailty-related symptoms and social relationships were consistently associated with both PA levels during-lockdown and pre-post change. These data suggest considering specific plans to maintain PA levels in frail older community-dwellers.

Highlights

The COVID-19 global pandemic has had a dramatic impact on the population’s health, especially for older adults [1]
We describe physical activity (PA) changes due to mobility restrictions in communitydwelling, frail older persons who had not been diagnosed with COVID-19 from a running program, to delay or revert frailty in community-dwelling older adults of Barcelona
Taking advantage of the extensive comprehensive geriatric assessment (CGA) pre-lockdown, which included a standardized measure of PA, we explored factors associated with the improvement or maintenance of sufficient PA levels during the lockdown

Summary

Introduction

The COVID-19 global pandemic has had a dramatic impact on the population’s health, especially for older adults [1]. In order to promote a more comprehensive and life-course assessment of older adults, the World Health Organization (WHO) introduced the concept of functional ability (i.e., having the capabilities that enable all people to be and do what they value), which is determined by the interaction between intrinsic capacity (i.e., composite of all physical and mental capacities) and the environment [3]. This latter was clearly altered by the COVID-19 pandemic, and the consequent preventative restrictions. Lockdowns and mobility restrictions are crucial public health countermeasures, these caused a radical and sudden change in people’s lifestyles, in particular regarding physical activity (PA) levels [6,7]

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Conclusion