UK Survey Research Articles

Confidence of UK Ophthalmology Registrars in Managing Posterior Capsular Rupture: Results from a National Trainee Survey.

IntroductionTo establish the level of confidence amongst UK ophthalmology specialist registrars (residents) in managing posterior capsule rupture (PCR) during cataract surgery.MethodsAn online nine-item questionnaire was distributed to all registrars, recruited nationwide via regional representatives. Data collected included stage of training, number of completed cataract operations, cumulative PCR rate, number of PCRs independently managed, understanding of vitrectomy settings and fluidic parameters and access to simulation. Respondents self-evaluated their confidence in managing PCR with vitreous loss.ResultsComplete responses were obtained from 248 registrars (35% response rate). Mean number of phacoemulsification procedures performed was 386. For senior registrars (OST 6–7), 35 out of 70 (50%) felt confident to manage PCR independently and 55 out of 70 (78.6%) were either quite confident or very confident at deciding when to implant an intraocular lens during PCR management. Lower confidence levels were noted for junior trainees (OST 1–2). Over 65% of survey respondents had access to relevant simulation.ConclusionsOur results represent the largest UK survey analysing the confidence of PCR management amongst registrars. Confidence improves with duration of training and increased exposure to management of PCR. However, 50% of senior registrars still lacked confidence to independently manage PCR and vitreous loss. A specific competency-based framework, potentially using a simulator or simulating a PCR event, incorporated into the curriculum may be desirable.

Management of sinonasal cancers: Survey of UK practice and literature overview

IntroductionSinonasal malignancy is a rare and heterogenous disease, with limited evidence to guide management. This report summarises the findings of a UK survey and expert workshop discussion which took place to inform design of a proposed UK trial to assess proton beam therapy versus intensity-modulated radiation therapy. MethodA multidisciplinary working group constructed an online survey to assess current approaches within the UK to surgical and non-surgical practice. Head and neck clinical oncologists, ear nose and throat (ENT) and oral-maxillofacial (OMF) surgeons were invited to participate in the 42-question survey in September 2020. The Royal College of Radiologists Consensus model was adopted in establishing categories to indicate strength of response. An expert panel conducted a virtual workshop in November 2020 to discuss areas of disagreement. ResultsA survey was sent to 140 UK-based clinicians with 63 responses (45% response rate) from 30 centres, representing a broad geographical spread. Participants comprised 35 clinical oncologists (56%) and 29 surgeons (44%; 20 ENT and 9 OMF surgeons). There were variations in preferred sequence and combination of treatment modalities for locally advanced maxillary squamous cell carcinoma and sinonasal undifferentiated carcinoma. There was discordant surgical management of the orbit, dura, and neck. There was lack of consensus for radiotherapy in post-operative dose fractionation, target volume delineation, use of multiple dose levels and treatment planning approach to organs-at-risk. ConclusionThere was wide variation across UK centres in the management of sinonasal carcinomas. There is need to standardise UK practice and develop an evidence base for treatment.

Adapting to the COVID-19 pandemic: A survey of UK and European hand surgery units

Hand surgery services had to rapidly adapt to the coronavirus disease 2019 (COVID-19) pandemic. The aim of the Reconstructive Surgery Trials Network #RSTNCOVID Hand Surgery survey was to document the changes made in the UK and Europe and consider which might persist.A survey developed by the Reconstructive Surgery Trials Network, in association with the British Association of Hand Therapists, was distributed to hand surgery units across the UK and Europe after the first wave of COVID-19. It was completed by one consultant hand surgeon at each of the 44 units that responded.Adult and paediatric trauma were maintained but elective services stopped. Consultations were increasingly virtual, and surgery was more likely to be under local anaesthetic and in a lower resource setting.Many of the changes are viewed as being beneficial. However, it is important to establish that they are clinically and cost effective. These survey results will help prioritise and support future research initiatives.

A survey of UK and Irish surgeons' attitudes, behaviours and barriers to change for environmental sustainability.

Surgery is a major contributor to the large environmental impact of healthcare, demanding urgent attention. To date there are no data on the attitudes and behaviours of surgeons towards climate change, or perceived barriers towards sustainable practice. We invited surgeons and surgical trainees in the UK and Ireland to participate in an online survey (developed in accordance with the CHERRIES checklist) conducted between June and November 2020 and disseminated via the Royal College of Surgeons of England, Edinburgh and Ireland, the Association of Surgeons in Training and through local communication. We received 130 responses, across 14 surgical specialties. The majority of respondents (122/130; 94%) were concerned about the threat of climate change. Most respondents had instigated more sustainable practices in their personal lives (113/130; 87%) and, to a lesser extent, at work (73/130; 56%). Surgeons were willing to make changes to their clinical practice (107/130; 82%), but the main perceived barrier to improving sustainability was a lack of leadership (92/130; 70%). Surgeons welcomed greater leadership and guidance from national bodies (118/130; 91%) and more monitoring and regulation (113/130; 87%). The surgeons who responded to our survey are concerned about climate change and willing to engage in efforts to transition to more sustainable practice, but would welcome greater support, guidance and leadership.

A UK Survey Examining the Experience of Adults With Mastocytosis Receiving COVID-19 Vaccination.

A UK Survey Examining the Experience of Adults With Mastocytosis Receiving COVID-19 Vaccination.

A physiological model of human mobility: A global study

The movement of people has led to several challenges in terms of traffic congestion, energy consumption, emissions and climate change. Human mobility modelling is currently described mainly through socio-economic variables, such as travel time, travel costs, income and car-ownership. The overall objective of this paper is to relate mobility behaviour based on measurable entities of travel time and distance and the entities of speed. A simple underlying mechanism of human mobility is presented based on the human energy expended. The energy is related firstly to the average values of travel modes. Explicit formulas for the distribution within each travel mode are developed and the concept is also shown to apply to multi-modal mobility. The approach is described in its most basic and fundamental form, but opens up perspectives for new applications and analyses approaches to transport modelling, planning and appraisals. The approach shows that travel time and distance are consistently inversely proportional and limited by the physiological power consumption. The basic hypothesis and the related verifications is shown on all modal combinations of daily mobility with a median R2 of around 0.8. The approach is validated using national travel surveys of Germany, Switzerland, UK and US, spanning over five decades to 2018.

Electrochemotherapy for the palliative management of non-skin-origin head and neck cancer: case series and UK national survey.

Electrochemotherapy uses electric fields to facilitate the influx of chemotherapy into cancer cells, producing a targeted effect. For head and neck cancer, it is mainly used for palliation of non-skin-origin metastases. It is used infrequently in the UK. This paper presents our experience and a UK survey to identify its frequency of use. Between 2016 and 2019, a prospective database was created and reviewed. Only patients with non-skin-origin metastatic head and neck cancer, with no other palliative options, were included. Survival length, complications and symptomatic benefit were assessed. The survey was conducted via e-mail. Five patients were included: three with squamous cell carcinoma, one with esthesioneuroblastoma and one with hepatocellular carcinoma. Survival ranged from 1 month to over 20 months. Minor complications were seen. Only 15 out of 69 UK head and neck multidisciplinary teams offer electrochemotherapy. Electrochemotherapy is a well-tolerated adjunct to standard palliation of metastatic head and neck cancer, and is offered by a limited number of UK multidisciplinary teams.

How do ophthalmologists manage functional visual symptoms? A UK survey of ophthalmologists\u2019 experience

Background/aimsFunctional visual symptoms are relatively common symptoms seen by ophthalmologists. However, there are no consensus guidelines on ophthalmological management of this condition, and there is a paucity of knowledge about the collective challenges experienced in treating patients with functional visual symptoms. In order to establish an ophthalmological perspective on this condition, we undertook the first national survey of experience, knowledge and management of functional visual symptoms amongst ophthalmologists.MethodsAn online survey was disseminated to ophthalmologists in the UK via all Royal College of Ophthalmology college tutors.ResultsOne hundred nineteen ophthalmologists completed the survey. Functional visual symptoms accounted for 3% of all new referrals. Forty per cent of respondents felt they had a good understanding of functional visual symptoms. Two-thirds reported a need for further training in this area. Respondents estimated two-thirds of patients’ symptoms improved, but a third experienced severe or extreme disability. Following diagnosis, a minority of patients were referred to mental health or neurology services. The majority of respondents described difficulty discussing psychological factors, with a lack of time or space in a clinic preventing a holistic approach. Free text comments highlighted a lack of access to dedicated psychological support for patients.ConclusionFunctional visual symptoms are disabling and are seen relatively frequently by ophthalmologists. This preliminary survey suggests that care pathways for patients with functional visual symptoms could be optimised. Fostering links between ophthalmology and existing services with expertise in functional disorders could improve patient care and clinician education and ultimately encourage research in this area.

Management of C2 odontoid peg fragility fractures – A UK survey of spinal surgeons

PurposePatients sustaining fragility fractures of the C2 odontoid peg have 30-day mortality rates as high as 10% rising up to 34.1% at 1 year. Substantial controversy exists regarding optimal management of these fractures and there is a lack of national guidance to inform best practice.The aim of this study was to determine current practice in the management of these fractures throughout the United Kingdom. MethodsA UK wide, cross sectional survey was conducted, asking 10 questions regarding the initial management, imaging and follow-up of an elderly patient with a type 2 fragility odontoid peg fracture. This was publicised through the British Orthopaedic Association website and sent to all members of the Society of British Neurological Surgeons (SBNS) via email. Results107 Responses were received. 56% from orthopaedic consultants, 29% from neurosurgical consultants and 15% from senior spine fellows.86% (92) of respondents choose treatment with a cervical orthosis, with 84% (77) of these opting for a semi rigid Aspen or Philadelphia collar compared to 16% (15) opting for a soft cervical collar. Three (3%) opted for operative intervention with a further three (3%) choosing Halo fixation. Nine respondents (8%) opted for no orthosis and treatment with analgesia alone.Length of immobilisation in cervical orthosis ranged from 6 to 12 weeks. Initial follow-up ranged from 1 week to 6 weeks, with 6% (6) discharged without follow up.There was also marked variation in the use of follow-up imaging with 17% (18) using plain radiographs, 62% (66) requesting lateral flexion / extension radiographs, 10% (11) using CT and 11% (12) not performing any imaging at final follow up.In 60% (64) of cases respondents did not change subsequent management as a result of imaging. ConclusionType-2 fragility peg fractures have high morbidity and mortality. There is marked variation in the treatment modalities used, follow-up regime and use of imaging throughout the UK.Given the rapidly increasing incidence of these injuries and the associated mortality this should be a high priority field for further research. Further large scale studies are urgently required to inform best practice and standardise management of these injuries.

Motivation and willingness to increase physical activity for dementia risk reduction: Cross-Sectional UK survey with people aged 50 and over

Objective:Tackling modifiable risk factors such as physical inactivity currently represents the only way to reduce the increasing prevalence of dementia worldwide. This study aimed to investigate attitudes to increasing physical activity to reduce risk of dementia in people over 50. Methods Attitudes to increasing physical activity to reduce risk of dementia were assessed in a national online survey promoted via online forums and public adverts. The Motivation to Change Behaviour for Dementia Risk Reduction (MOCHAD-10) scale examined motivation for lifestyle change. Multivariable logistic regression was used to identify the predictors of willingness and motivation to increase physical activity. Results Data from 3,948 individuals showed most people were moderately/very physically active (80%). People more likely to be physically active had better health and education, were older, male, and had a partner. People willing to increase physical activity (73%) were more likely to be younger, non-White, underweight, had better health and lifestyles, and had experience caring for someone with dementia. People with higher levels of motivation to change lifestyle (MOCHAD-10 subscales) were more likely to be female, younger, in poorer physical/mental health, had lower perceived mental activity, and were a carer for someone with dementia. Conclusion Men and those with better health status were more physically active. Those who exercised less and those who were more motivated to increase physical activity were not necessarily able to be physically active. Multisectoral public health strategies should seek to use the high motivation levels among this group to mitigate the barriers related to physical activity for dementia risk reduction.

Weight-related perceptions in male adults: Preliminary findings from a cross-sectional survey in Czech Republic, Lebanon, Singapore and UK.

Weight-related perceptions in male adults: Preliminary findings from a cross-sectional survey in Czech Republic, Lebanon, Singapore and UK.

Physical and mental well-being, risk and protective factors among older lesbians /gay women in the United Kingdom during the initial COVID-19 2020 lockdown

ABSTRACT This article reports on a subset of findings from a recent UK survey of the impact of COVID-19 on older LGBT+ people in the UK. It considers the responses of 149 lesbian/gay women (137 cisgender, 12 trans) to questions relating to physical and mental health and wellbeing. Findings indicate that those women – in couples and singles – who were happy with their living circumstances pre-COVID showed stoicism, adaptability, and determined positivity in response to the pandemic and associated lockdown. Some even reported an improved quality of life, better personal relationships and increased neighborly support. By contrast, those women who were very unhappy with their circumstances prior to COVID-19 – generally women who lived alone and experienced a mismatch between their actual and desired social network – either remained unhappy or became more unhappy, due to its impact on fragile support systems. For trans women, formal support from trans/LGBT+ specific networks – online during COVID lockdown – were central to their wellbeing. Having access to, and being able to use, online technologies were essential to good mental health during lockdown. These findings reaffirm the diversity among older lesbians/gay women as well as highlighting how COVID-19 has acted as a magnifier to their preexisting circumstances. The narratives of those doing well – generally better-networked, intentionally positive and engaged in practices which promote their well-being – may offer insights for supporting those who find their lives more challenging, both during a public health crisis and more generally.

UK and Ireland survey of MPharm student and staff experiences of mental health curricula, with a focus on Mental Health First Aid

BackgroundOne in four people experience a mental health problem every year and improving mental health care is an international priority. In the course of their work, pharmacists frequently encounter people with mental health problems. The experience of mental health teaching, including Mental Health First Aid (MHFA) training, in undergraduate pharmacy (MPharm) students in the UK and Ireland is not well documented. Students’ viewpoints, contextualised with curricular overviews provided by staff, were analysed to understand their experience.MethodsAn anonymous, online questionnaire was distributed to MPharm students and staff in the UK and Ireland. Students were asked closed questions regarding their course and exposure to MHFA, which were analysed using descriptive statistics. Open questions were included to enable explanations and these data were used to contextualise the quantitative findings. One member of staff from each university was invited to answer a modified staff version of the questionnaire, to provide a curriculum overview and staff perspective.Results232 students and 13 staff, from 22 universities, responded. Three-quarters of students did not agree with the statement that ‘mental health was embedded throughout the MPharm’. Most students (80.6%) stated that they were taught neuropharmacology whilst 44.8% stated that their course included communicating with people about their mental health. One-third (33.2%) of students stated that their degree ‘adequately prepared them to help people with their mental health’. Twenty-six students (11.6%) had completed MHFA training of which 89% would endorse inclusion of this within the MPharm. Of those who had not completed the training, 81% expressed a desire to do so. Those who completed MHFA training self-reported greater preparedness than those who did not, but student numbers were small.ConclusionsMental health teaching for pharmacy undergraduates is more focussed on theoretical aspects rather than applied skills. MHFA was viewed by students as one way to enhance skill application. The association of the increased self-reported preparedness of those who completed MHFA could be confounded by a positive environmental cultural. MPharm programmes need sufficient focus on real-world skills such as communication and crisis response, to complement the fundamental science.

A Review of Circular Economy Research for Electric Motors and the Role of Industry 4.0 Technologies

The market for electric motors is experiencing a step-growth due to their adoption across a range of industrial sectors. This increased demand also highlights the importance of end-of-life management of electric motors and a requirement for appropriate strategies for the high value materials embedded in them. This paper aims to offer a holistic view on the circular economy research for electric motors and the role of Industry 4.0 technologies by presenting the state-of-the-art available in literature and comparing it with the industrial perspective. The literature review revealed the absence of a methodology for selecting the best end-of-life scenario for industrial electric motors. Recycling, which is an end-of-product-life strategy, was found to be the key focus area of research. Reuse, which is a better strategy in terms of waste hierarchy, was the least researched area due to lack of information about the condition and availability of returned products. In order to capture the current landscape within the UK for the repair, remanufacture and recycling of electrical machines, a structured survey of UK based companies was conducted. The survey revealed that nearly half of the companies do not undertake any repair strategies for electrical machine components; however, there was an aspiration from the respondents to migrate their companies towards more sustainable activities. The industry survey and the review of existing literature led to the identification of research trends, challenges and recommendations for future research.

UK survey demonstrates a wide range of impacts attributable to clinical librarian services

To understand the impact of the UK Clinical Librarian (CL) workforce and benchmark the results against a study undertaken in the North West region of the English National Health Service (NHS). An online survey was distributed by CLs to their service users regarding literature searches that had been carried out on their behalf in the 6months from April to October 2017. Interviews were later carried out in person with selected respondents to the questionnaires. CLs across the UK contribute to a wide range of outcomes, with 41% of search requests contributing to the choice of intervention, and 41% also to the advice offered by the clinician requester to a patient or their carer. These results are in line with the previous work undertaken in the North West. CLs provide diverse services to clinical teams. They support the continuing professional development and personal research needs of team members, service development needs of organisations, and the information provided contributes to improved quality and safety of patient care. The survey confirms the findings of the earlier NW study. It demonstrates the impact of services based around literature searching on patient care.

The impact of SARS-CoV-2 vaccination in Dravet syndrome: A UK survey

BackgroundThe COVID-19 pandemic led to the urgent need for accelerated vaccine development. Approved vaccines have proved to be safe and well tolerated across millions of people in the general population. Dravet syndrome (DS) is a severe, early onset, developmental and epileptic encephalopathy. Vaccination is a precipitating factor for seizures. While there is no evidence that vaccine-precipitated seizures lead to adverse outcomes in people with DS, fear surrounding vaccination can remain for caregivers of people with DS, in some cases resulting in rejection of recommended vaccinations, leaving individuals more vulnerable to the relevant infections. A greater understanding of the safety profile of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination in this vulnerable group will help provide guidance for caregivers and clinicians when considering vaccination. MethodsA cross‐sectional survey regarding COVID-19 and SARS-CoV-2 vaccine, in people with DS, was conducted by Dravet Syndrome UK (DSUK). Concomitantly, a review of individuals with DS who had recently received the SARS-CoV-2 vaccine, and who are resident at the Chalfont Centre for Epilepsy (CCE), or attend epilepsy clinics at the National Hospital for Neurology and Neurosurgery (NHNN), was undertaken. ResultsThirty-eight people completed the DSUK survey. Thirty-seven percent of caregivers reported being concerned about someone with DS receiving the SARS-CoV-2 vaccine; with some reporting that they would decline a vaccine when offered. Seventy-seven percent had not received any advice from a healthcare professional about the SARS-CoV-2 vaccination. 18/38 were eligible for SARS-CoV-2 vaccination, of whom nine had received their first vaccine dose. Combining the results of the DSUK survey and the review of individuals monitored at CCE or NHNN, fifteen people with DS had received their first dose of the SARS-CoV-2 vaccine. 11/15 (73%) reported at least one side effect, the most common being fatigue (6/15; 40%) and fever (6/15; 40%). Three individuals (20%) reported an increase in seizure frequency after the first vaccine dose. No increase in seizure frequency or duration was reported after the second dose. ConclusionOverall, these results suggest that SARS-CoV-2 vaccines are safe and well tolerated in individuals with DS, as they are in most people without DS. In most people with DS, SARS-CoV-2 vaccine does not appear to be associated with an increase in the frequency or duration of seizures, even in those who develop fever post-vaccination. Many caregivers are concerned about a person with DS receiving a SARS-CoV-2 vaccine, with some reporting that they would decline a SARS-CoV-2 vaccine when offered. It is crucial that healthcare professionals are proactive in providing accurate information regarding the risks and benefits of vaccination in this population, given the potential for serious outcomes from infection.

An analysis of qualitative responses from a UK survey of the psychosocial wellbeing of people with skin conditions and their experiences of accessing psychological support.

Skin conditions have a large emotional, psychological and psychiatric impact on the individual. The All-Party Parliamentary Group on Skin (APPGS) commissioned a qualitative survey to further explore this relationship alongside the experiences of those accessing services in relation to these difficulties in the UK. To examine the experiences of UK individuals living with a skin condition, and their views of seeking and receiving psychological treatment. This survey formed part of the evidence collected in the preparation of the APPGS Mental Health and Skin Disease report. A free-text electronic survey was widely distributed by professional bodies and skin-related charities. Responses were analysed using descriptive thematic analysis and descriptive statistics. Data for each question were classified and labelled, leading to the development of a coding frame. Inter-rater reliability was assessed using Cohen kappa statistic. In total, 544 participants (84% female) completed the survey. The majority of respondents had inflammatory skin diseases such as eczema (43%) or psoriasis (33%). The thematic analysis revealed five key themes associated with impact on mood; impact of intimacy; impact on activities of daily living; lack of recognition from others of the impact; and lack of accessible services. The survey demonstrates that there is an urgent need to improve both awareness of the impact that skin conditions can have, and for the provision of psychological services to address this impact.

Returning to cataract surgery after a hiatus: a UK survey report.

ObjectivesCataract surgeons may periodically take time away from operating which can lead to skills fade. There is a paucity of research investigating the experiences of returning cataract surgeons and how different individual circumstances impact on their return. Our aim was to investigate the subjective experiences of UK ophthalmologists simultaneously returning to surgery following the nationwide elective surgical hiatus due to the Covid-19 pandemic.MethodsAn online survey was nationally distributed between 01/09/2020 and 29/10/2020 to registered UK ophthalmologists. Participants indicating a surgical hiatus of 8 weeks or more were included.Results232 of 264 responses were analysed. Covid-19 was the most frequent reason for a surgical hiatus (median 15 weeks). Perceived operating difficulties were found in 29.1%. Transient anxiety (51.7%), reduced confidence, and perceived increased surgical time were commonplace. Trainees and females were more likely to encounter negative experiences (p < 0.001) and barriers to resource accessibility. Eyesi® and online videos were the most available and accessed pre-return resources. Childcare was five times more likely to present as a barrier to resource access for females than males.ConclusionsTechnical skills fade such as capsulorhexis difficulties were commonly perceived by trainee surgeons in addition to transient anxiety, reported in more than half of all surgeons following a hiatus as short as 8 weeks.Eyesi® simulation offers the potential to negate technical de-skilling. Few had formal return plans or awareness of RCOphth guidance. We believe there is scope for more specialised and targeted support for future returning cataract surgeons thereby optimising patient care.

Cross-sectional UK survey of advanced practice physiotherapy: characteristics and perceptions of existing roles

Background/aims Few studies have investigated the characteristics of advanced practice physiotherapy in the UK to evaluate current context and implementation. The aim of this study was to understand how advanced practice physiotherapy is implemented in the UK. Methods A cross-sectional online descriptive national questionnaire was developed, using a previous survey and literature, comprising 33 closed, Likert-scale and open questions. Data analysis was undertaken using frequencies and thematic analysis. All 646 members of the Advanced Practice Physiotherapy Network were invited to participate. Results A total of 142 (22% response) reported 13 job titles; 40% had experienced ≥1 title change; most (50.7%) preferred ‘advanced practice physiotherapist’. High level job satisfaction was identified but barriers prevent fulfilment of the four advanced practice physiotherapy pillars: clinical practice, leadership and management, education and research. High level clinical skills and facilitating patient pathways were key to role differentiation. Problems included lack of support, inconsistency between responsibility and reward, and no consistent framework for advanced practice physiotherapy roles. Conclusions Advanced practice physiotherapists are largely satisfied, but significant variation exists in titles and implementation of roles. A consistent advanced practice physiotherapy framework is required.

The impact of the COVID-19 pandemic on the health of adults with intellectual impairment: evidence from two longitudinal UK surveys.

BackgroundPeople with an intellectual impairment experience high levels of social and health inequalities. We investigated the impact of COVID‐19 on the physical and mental health of people with intellectual impairment, controlling for demographic risk, socio‐economic circumstances and pre‐pandemic health levels.MethodData were drawn from two UK birth cohorts that surveyed their participants on the impact of COVID‐19 in May 2020: the Millennium Cohort Study (20‐year‐old participants) and the British Cohort Survey (50‐year‐old participants). Health outcomes (COVID‐19 infection, COVID‐19 symptoms, self‐reported physical health, mental health, health service use and impact on health behaviours) were compared between people with and without intellectual impairment, adjusting for gender and ethnicity. Differences were further adjusted for self‐reported health pre‐pandemic and the impact of COVID‐19 on socio‐economic circumstances.ResultsControlling for gender and ethnicity, poor health was reported less often by younger adults [relative risks (RR): 0.44 95% confidence interval (CI) 0.23, 0.86] and more often by older adults (RR: 1.99 95% CI 1.45, 2.73) with intellectual impairment compared with peers. Older adults were also more likely to experience fever and loss of taste/smell. Adjusting for pre‐pandemic health and socio‐economic circumstances eliminated some differences in the older cohort, but not in the younger one.ConclusionIn young adulthood, the impact of COVID‐19 on health outcomes was not negative. The pattern was reversed in later adulthood, although differences were mostly eliminated after adjustment suggesting a socio‐economic and age gradient of COVID‐19 impacts on intellectual impairment.