Unintended Consequences of COVID-19 Social Distancing Among Older Adults With Kidney Disease.
Unintended Consequences of COVID-19 Social Distancing Among Older Adults With Kidney Disease.
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COVID-19的意外后果在患有肾脏疾病的老年人中的社会疏远。
DOI：
10.1093/gerona/glab211
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发表时间：
2022-04-01
期刊：
影响因子：
--
通讯作者：
Olsen MK
中科院分区：
文献类型：
--
作者：
Bowling CB;Berkowitz TSZ;Smith B;Whitson HE;DePasquale N;Wang V;Maciejewski ML;Olsen MK
虽然社交距离政策可以保护患有晚期慢性肾病 (CKD) 的老年人免于接触 COVID-19，但社交互动的减少也可能会产生意想不到的后果。为了确定因社交疏远而面临意外健康后果风险的患者亚组，我们对患有晚期 CKD 的老年退伍军人 (n = 223) 的全国队列研究的数据进行了横断面分析。特征包括日常生活活动 (ADL)、工具性 ADL (IADL)、认知评分、抑郁评分、社会支持、经济压力、症状负担和慢性病数量。社交距离的意外后果包括生活空间流动性受限、视频远程医疗意愿低、与护理人员的面对面接触减少以及粮食不安全。我们使用基于模型的递归分区 (MoB) 确定了面临意外后果风险的患者亚组。参与者的平均年龄为 77.9 岁，64.6% 是白人，96.9% 是男性。总体而言，22.4% 的参与者生活空间受到限制，33.9% 的参与者表示视频远程医疗的意愿较低，19.0% 的参与者表示减少了与护理人员的接触，3.2% 的参与者表示粮食不安全。对于生活空间限制，确定了按 IADL 难度、认知得分和 ADL 难度划分（即分割）的 4 个子组。在 IADL 困难大于 3 的参与者亚组中，生活空间受限的比例最高为 54.7%。对于远程医疗意愿低和护理人员接触减少的情况，单独的模型确定了分别按认知评分和抑郁评分划分的 2 个亚组。功能、认知和抑郁症状的测量可以识别患有晚期 CKD 的老年人，他们因社交距离而遭受意外健康后果的风险更高。
While social distancing policies protect older adults with advanced chronic kidney disease (CKD) from exposure to COVID-19, reduced social interaction may also have unintended consequences. To identify subgroups of patients at risk for unintended health consequences of social distancing, we conducted a cross-sectional analysis of data from a national cohort study of older veterans with advanced CKD (n = 223). Characteristics included activities of daily living (ADLs), instrumental ADLs (IADLs), cognition score, depression score, social support, financial stress, symptom burden, and number of chronic conditions. Unintended consequences of social distancing included restricted Life Space mobility, low willingness for video telehealth, reduced in-person contact with caregivers, and food insecurity. We identified subgroups of patients at risk of unintended consequences using model-based recursive partitioning (MoB). Participants had a mean age of 77.9 years, 64.6% were white, and 96.9% were male. Overall, 22.4% of participants had restricted Life Space, 33.9% reported low willingness for video telehealth, 19.0% reported reduced caregiver contact, and 3.2% reported food insecurity. For Life Space restriction, 4 subgroups partitioned (ie, split) by IADL difficulty, cognition score, and ADL difficulty were identified. The highest rate of restricted Life Space was 54.7% in the subgroup of participants with >3 IADL difficulties. For low willingness for telehealth and reduced caregiver contact, separate models identified 2 subgroups split by cognition score and depression score, respectively. Measures of function, cognition, and depressive symptoms may identify older adults with advanced CKD who are at higher risk for unintended health consequences of social distancing.
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影响因子：
1.2
作者：
Seibold, Heidi;Zeileis, Achim;Hothorn, Torsten
通讯作者：
Hothorn, Torsten
影响因子：
13.2
作者：
Bowling, C. Barrett;Muntner, Paul;Allman, Richard M.
通讯作者：
Allman, Richard M.
影响因子：
6.3
作者：
Hall, Rasheeda K.;Haines, Carol;Bowling, C. Barrett
通讯作者：
Bowling, C. Barrett
DOI：
10.1093/gerona/glz248
发表时间：
2020-03-01
影响因子：
5.1
作者：
Hall, Rasheeda K.;Zhou, Hui;Bowling, C. Barrett
通讯作者：
Bowling, C. Barrett
影响因子：
5.5
作者：
Levin, Adeera;Stevens, Paul E.
通讯作者：
Stevens, Paul E.