Mental health and social interactions of older people with physical disabilities in England during the COVID-19 pandemic: a longitudinal cohort study.
Mental health and social interactions of older people with physical disabilities in England during the COVID-19 pandemic: a longitudinal cohort study.
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DOI：
10.1016/s2468-2667(21)00069-4
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发表时间：
2021-06
期刊：
影响因子：
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通讯作者：
Di Gessa G
中科院分区：
文献类型：
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作者：
Steptoe A;Di Gessa G
COVID-19大流行影响了心理健康、心理健康和社会交往。身体残疾的人可能特别容易受到负面影响，但证据很少。我们的目标是评估英格兰2019冠状病毒病大流行最初几个月内身体残疾老年人的情感和社会体验。在这项纵向队列研究中，我们分析了2018-19年和2020年6月至7月收集的英国老龄化纵向研究的数据，这些数据来自年龄在52岁及以上并居住在英格兰的参与者。身体残疾被定义为日常生活的基本和工具性活动（ADL）受损和活动能力受损。抑郁，焦虑，孤独，生活质量，睡眠质量，以及实时和书面的社会接触量进行了评估在线或计算机辅助电话采访。在COVID-19大流行期间，对有和没有身体残疾的人的经历进行了统计学调整，包括大流行前的结果指标、年龄、性别、财富、种族、配偶或伴侣的存在、家庭人数和慢性疼痛。所有参与者都有完整的数据，可用于两项调查被纳入分析。2020年6月3日至7月26日期间，5820名参与者作出回应，其中4887人拥有疫情前措施和COVID-19调查的完整数据，并被纳入分析。在COVID-19大流行期间，明显更多的ADL受损患者出现临床显著的抑郁症状（比值比1.78 [95%CI 1.44 - 2.19]; p<0.0001），焦虑（2·23 [1·72-2·89]; p<0·0001）和孤独感（1·52 [1·26-1·84]; p<0·0001）。与没有ADL障碍的人相比，ADL障碍的人也有显著更多的睡眠质量受损（1.44 [1.20 - 1.72]; p<0.0001）和生活质量差。当残疾被定义为行动不便时，结果也是类似的。与没有ADL障碍的人相比，ADL障碍的人与家人的实时联系（0.70 [0.55 - 0.89]; p= 0.0037）和书面社交联系（0.54 [0.45 - 0.64]; p<0.0001）较少。当残疾被定义为行动不便时，社会接触的结果相似。在COVID-19大流行期间，身体残疾的人可能特别容易出现情绪困扰、生活质量差和健康状况不佳，这突出表明需要额外的支持和有针对性的心理健康服务。经济和社会研究理事会/联合王国研究和创新、国家老龄问题研究所、国家健康研究所。
The COVID-19 pandemic has affected mental health, psychological wellbeing, and social interactions. People with physical disabilities might be particularly likely to be negatively affected, but evidence is scarce. Our aim was to evaluate the emotional and social experience of older people with physical disabilities during the early months of the COVID-19 pandemic in England. In this longitudinal cohort study, we analysed data from the English Longitudinal Study of Ageing collected in 2018–19 and June–July, 2020, from participants aged 52 years and older and living in England. Physical disability was defined as impairment in basic and instrumental activities of daily living (ADL) and impaired mobility. Depression, anxiety, loneliness, quality of life, sleep quality, and amount of real-time and written social contact were assessed online or by computer-assisted telephone interviews. Comparisons of experiences during the COVID-19 pandemic of people with and without a physical disability were adjusted statistically for pre-pandemic outcome measures, age, sex, wealth, ethnicity, presence of a spouse or partner, number of people in the household, and chronic pain. All participants with full data available for both surveys were included in the analyses. Between June 3 and July 26, 2020, 5820 participants responded, 4887 of whom had full data available for both the pre-pandemic measures and the COVID-19 survey and were included in the analysis. During the COVID-19 pandemic, significantly more people with ADL impairment had clinically significant symptoms of depression (odds ratio 1·78 [95% CI 1·44–2·19]; p<0·0001), anxiety (2·23 [1·72–2·89]; p<0·0001), and loneliness (1·52 [1·26–1·84]; p<0·0001) than people without ADL impairment. Significantly more people with ADL impairment also had impaired sleep quality (1·44 [1·20–1·72]; p<0·0001) and poor quality of life than people without ADL impairment. The results were similar when disability was defined by impaired mobility. People with ADL impairment had less frequent real-time contact (0·70 [0·55–0·89]; p=0·0037) and written social contact (0·54 [0·45–0·64]; p<0·0001) with family than people without ADL impairment. Results for social contact were similar when disability was defined by impaired mobility. People with physical disability might be at particular risk for emotional distress, poor quality of life, and low wellbeing during the COVID-19 pandemic, highlighting the need for additional support and targeted mental health services. Economic and Social Research Council/UK Research and Innovation, National Institute on Aging, National Institute for Health Research.