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Mental health, financial, and social outcomes among older adults with probable COVID-19 infection: A longitudinal cohort study.

ABSTRACT: We investigated the immediate and longer-term impact (over 4-6 months) of probable COVID-19 infection on mental health, wellbeing, financial hardship, and social interactions among older people living in England. Data were analysed from 5146 older adults participating in the English Longitudinal Study of Ageing who provided data before the pandemic (2018-19) and at two COVID-19 assessments in 2020 (June-July and November-December). The associations of probable COVID-19 infection (first COVID-19 assessment) with depression, anxiety, poor quality of life (QoL), loneliness, financial hardship, and social contact with family/friends at the first and second COVID-19 assessments were tested using linear/logistic regression and were adjusted for pre-pandemic outcome measures. Participants with probable infection had higher levels of depression and anxiety, poorer QoL, and greater loneliness scores compared with those without probable infection at both the first (OR_depression = 1.62, P-value = 0.005; OR_anxiety = 1.59, P-value = 0.049; b_poorQoL = 1.34, P < 0.001; b_loneliness = 0.49, P < 0.001) and second (OR_depression = 1.56, P-value = 0.003; OR_anxiety = 1.55, P-value = 0.041; b_poorQoL = 1.38, P-value < 0.001; b_loneliness = 0.31, P-value = 0.024) COVID-19 assessments. Participants with probable infection also experienced greater financial difficulties than those without infection at the first assessment (OR = 1.50, P-value = 0.011). Probable COVID-19 infection is associated with longer-term deterioration of mental health and wellbeing and short-term increases in financial hardship among older adults. It is important to monitor the mental health of older people affected by COVID-19 and provide additional support to those in need.

SUBMITTER: Iob E

PROVIDER: S-EPMC9271189 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:ObjectivesThis study aimed to describe gait speed at admission and discharge from inpatient hospital rehabilitation among older adults recovering from orthopaedic trauma and factors associated with gait speed performance and discharge destination.DesignA longitudinal cohort study was conducted.SettingAustralian tertiary hospital subacute rehabilitation wards.ParticipantsPatients aged ?60 years recovering from orthopaedic trauma (n=746, 71% female) were eligible for inclusion.InterventionsUsual care (multidisciplinary inpatient hospital rehabilitation).Primary and secondary outcome measuresGait speed was assessed using the timed 10 m walk test. The proportion of patients exceeding a minimum gait speed threshold indicator (a priori 0.8 m/s) of community ambulation ability was calculated. Generalised linear models were used to examine associations between patient and clinical factors with gait speed performance and being discharged to a residential aged care facility.ResultsAt discharge, 18% of patients (n=135) exceeded the 0.8 m/s threshold indicator for community ambulation ability. Faster gait speed at discharge was found to be associated with being male (B=0.43, 95%?CI -0.01 to 0.87), admitted with pelvic (B=0.76, 95%?CI 0.14 to 1.37) or multiple fractures (B=1.13, 95%?CI 0.25 to 2.01) (vs hip fracture), using no mobility aids (B=-0.93, 95%?CI -1.89 to 0.01) and walking at a faster gait speed at admission (B=5.77, 95%?CI 5.03 to 6.50). Factors associated with being discharged to residential aged care included older age (OR 1.06, 95%?CI 1.03 to 1.10), longer length of stay (OR 1.01, 95%?CI 1.01 to 1.02), having an upper limb fracture (vs hip fracture) (OR 2.81, 95%?CI 1.32 to 5.97) and lower Functional Independence Measure cognitive score (OR 0.89, 95%?CI 0.86 to 0.92).ConclusionsPatients with a range of injury types, not only those presenting to hospital with hip fractures, are being discharged with slow gait speeds that are indicative of limited functional mobility and a high risk of further adverse health events.

Project description:IntroductionSocial networks play a role in slowing the development of dementia. However, there is a need for further investigation of the effects of improving social networks on health-related quality of life and cognitive performance. Targeted community aged care services are a central strategy for supporting older adults to initiate and maintain their social engagement with other individuals at all stages of later life. This protocol describes a prospective observational cohort study aimed at (1) characterising interpersonal relationships in older adults receiving community care services, (2) assessing the relationship social networks and health-related quality of life and cognition and (3) identifying the association between community care use, social networks and cognition. The findings will contribute to our understanding of how specific social network structures and social support services can maintain cognitive function in community-dwelling older adults.Methods and analysisThis is a prospective, observational cohort study of 201 older Australians residing in the community and receiving care services from one of three aged care organisations. Clients with a history of neurological injury will be excluded. Participants will undergo baseline measures of social networks, health-related quality of life and cognitive function, and a follow-up at 6 months. Service use and sociodemographic variables will also be collected. The primary outcome is cognitive function, and secondary outcomes include social networks and health-related quality of life. Multivariable linear regression will test the hypothesis that increased social networks are associated with an increase in cognitive function.Ethics and disseminationApproval of the study by Macquarie University Research Ethics Committee (reference number 5201831394062) has been obtained. This work will be disseminated by publication of peer-reviewed manuscripts, presentations in abstract form at scientific meetings and results will be made available to home and community-based care older adults and care staff of the involved organisations.Trial registration numberACTRN12618001723279; Pre-results.

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Mental health, financial, and social outcomes among older adults with probable COVID-19 infection: A longitudinal cohort study.

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