Changes in Health Behaviors, Mental and Physical Health among Older Adults under Severe Lockdown Restrictions during the COVID-19 Pandemic in Spain

  1. Esther García-Esquinas
  2. Rosario Ortolá
  3. Iago Gine-Vázquez
  4. José A. Carnicero
  5. Asier Mañas
  6. Elvira Lara
  7. Alejandro Alvarez-Bustos
  8. German Vicente-Rodriguez
  9. Mercedes Sotos-Prieto
  10. Beatriz Olaya
  11. Francisco José Garcia-Garcia
  12. Narcis Gusi
  13. Jose R. Banegas
  14. Irene Rodríguez-Gómez
  15. Ellen A. Struijk
  16. David Martínez-Gómez
  17. Alberto Lana
  18. Josep María Haro
  19. José Luis Ayuso-Mateos
  20. Leocadio Rodríguez-Mañas
  21. Ignacio Ara
  22. Marta Miret
  23. Fernando Rodríguez-Artalejo

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Abstract

We used data from 3041 participants in four cohorts of community-dwelling individuals aged ≥65 years in Spain collected through a pre-pandemic face-to-face interview and a telephone interview conducted between weeks 7 to 15 after the beginning of the COVID-19 lockdown. On average, the confinement was not associated with a deterioration in lifestyle risk factors (smoking, alcohol intake, diet, or weight), except for a decreased physical activity and increased sedentary time, which reversed with the end of confinement. However, chronic pain worsened, and moderate declines in mental health, that did not seem to reverse after restrictions were lifted, were observed. Males, older adults with greater social isolation or greater feelings of loneliness, those with poorer housing conditions, as well as those with a higher prevalence of chronic morbidities were at increased risk of developing unhealthier lifestyles or mental health declines with confinement. On the other hand, previously having a greater adherence to the Mediterranean diet and doing more physical activity protected older adults from developing unhealthier lifestyles with confinement. If another lockdown were imposed during this or future pandemics, public health programs should specially address the needs of older individuals with male sex, greater social isolation, sub-optimal housing conditions, and chronic morbidities because of their greater vulnerability to the enacted movement restrictions.

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  1. Version published to 10.3390/ijerph18137067
  2. ScreenIT

    SciScore for 10.1101/2021.02.15.21251738: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Also, multinomial (both fully-adjusted and stepwise) regression was used for the following a-priori defined outcomes: Statistical analyses were performed with Stata version 14.1 (StataCorp LP, College Station, TX).
    StataCorp
    suggested: (Stata, RRID:SCR_012763)

    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:
    Now we have identified subgroups of older adults who are more vulnerable to mental health declines with confinement, including those who feel lonelier, perform less physical activity, have mobility limitations, low MMSE scores or a negative ageing experience. Also, we found that individuals who lacked a garden/yard, with poor sleep quality, hypertension, cardiovascular disease, cancer, depression or mobility limitations were at increased risk of deteriorating physical function during confinement. Finally, we observed that women with short sleep, worse overall health and lower overall life satisfaction, osteomuscular disease and depression, as well as those who suffered from mobility limitations were at increased risk of pain worsening. Study limitations and strengths: Among the limitations of the present study is that not all cohorts had information in all the studied variables and a lack of data on the longer-term (July-December) effects of isolation measures. Moreover, the study cohort did not include institutionalized older adults, so results may not be generalizable to them. However, ours is one of the very few studies that have evaluated the effects of the pandemic in non-COVID-19-infected older adults. Also, unlike most of the reviewed web-based surveys, it relied on telephone interviews and used pre-pandemic in-home collected information on participants’ health behaviors and health status, reducing the risk of information bias (i.e. people not accurately reporting thei...

    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.

    About SciScore

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  3. Version published to 10.1101/2021.02.15.21251738 on medRxiv