Longitudinal Aging Study Amsterdam COVID-19 exposure index: a cross-sectional analysis of the impact of the pandemic on daily functioning of older adults

  1. Emiel O Hoogendijk
  2. Noah A Schuster
  3. Theo G van Tilburg
  4. Laura A Schaap
  5. Bianca Suanet
  6. Sascha De Breij
  7. Almar AL Kok
  8. Natasja M Van Schoor
  9. Erik J Timmermans
  10. Renate T de Jongh
  11. Marjolein Visser
  12. Martijn Huisman

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Abstract

The aim of this study was to develop an index to measure older adults’ exposure to the COVID-19 pandemic and to study its association with various domains of functioning.

Design

Cross-sectional study.

Setting

The Longitudinal Aging Study Amsterdam (LASA), a cohort study in the Netherlands.

Participants

Community-dwelling older adults aged 62–102 years (n=1089) who participated in the LASA COVID-19 study (June–September 2020), just after the first wave of the pandemic.

Primary outcome measures

A 35-item COVID-19 exposure index with a score ranging between 0 and 1 was developed, including items that assess the extent to which the COVID-19 situation affected daily lives of older adults. Descriptive characteristics of the index were studied, stratified by several sociodemographic factors. Logistic regression analyses were performed to study associations between the exposure index and several indicators of functioning (functional limitations, anxiety, depression and loneliness).

Results

The mean COVID-19 exposure index score was 0.20 (SD 0.10). Scores were relatively high among women and in the southern region of the Netherlands. In models adjusted for sociodemographic factors and prepandemic functioning (2018–2019), those with scores in the highest tertile of the exposure index were more likely to report functional limitations (OR: 2.24; 95% CI: 1.48 to 3.38), anxiety symptoms (OR: 3.14; 95% CI: 1.82 to 5.44), depressive symptoms (OR: 2.49; 95% CI: 1.55 to 4.00) and loneliness (OR: 2.97; 95% CI: 2.08 to 4.26) than those in the lowest tertile.

Conclusions

Among older adults in the Netherlands, higher exposure to the COVID-19 pandemic was associated with worse functioning in the physical, mental and social domain. The newly developed exposure index may be used to identify persons for whom targeted interventions are needed to maintain or improve functioning during the pandemic or postpandemic.

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  1. Version published to 10.1136/bmjopen-2022-061745
  2. ScreenIT

    SciScore for 10.1101/2022.02.02.22270309: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: 17,20,21 The LASA study, including the COVID-19 study, received approval by the medical ethics committee of VU University medical centre.
    Consent: Written informed consent was provided by all respondents.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    All analyses were done in SPSS 26 (IBM Corp, Armonk, NY, USA).
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    However, the study also has limitations. First, our results should be interpreted with caution. Because of the cross-sectional design of the study, we have to be careful with drawing conclusions on the direction of the observed associations. We partly addressed this by controlling the analyses on the associations between the COVID-19 exposure index and various indicators of functioning for pre-pandemic functioning. This adjustment was needed, because it is possible that people who already had health problems before the pandemic have a higher chance to experience changes in healthcare or homecare, and therefore score higher on the COVID-19 exposure index 9. However, it is still possible that levels of functioning partly determine how people respond to certain items included in the exposure index. For example, mental health problems may result in a more negative evaluation of the impact of the pandemic on daily life. Second, our data covered the first wave of the pandemic in the Netherlands. We do not know to what extent these findings are generalizable to later stages of the pandemic and to other geographical areas. This will become more clear when follow-up data from the LASA study become available, as well as data from cohort studies in older populations across Europe, such as the SHARE study.30,31 Third, we created the exposure index with an existing dataset, so we were limited to variables available in this dataset. We missed consequences of the pandemic in some domains, s...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

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  3. Version published to 10.1101/2022.02.02.22270309 on medRxiv