Changes in activity levels, physical functioning, and fall risk during the COVID-19 pandemic
Changes in activity levels, physical functioning, and fall risk during the COVID-19 pandemic
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DOI：
10.1111/jgs.17477
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发表时间：
2021-09-24
影响因子：
6.3
通讯作者：
Kullgren, Jeffrey T.
中科院分区：
文献类型：
--
作者：
Hoffman, Geoffrey J.;Malani, Preeti N.;Kullgren, Jeffrey T.
背景随着年龄的增长，身体功能会恶化，特别是对于久坐不动和与世隔绝的人来说，这往往会导致伤害。通过减少体力活动，新冠肺炎大流行可能恶化了身体机能，导致与跌倒相关的风险增加。方法于2021年1月对2006名50-80岁的美国成年人进行了一项具有全国代表性的在线调查，以评估自2020年3月以来健康行为(体力活动恶化，每天花在脚上的时间减少)、社会孤立(缺乏陪伴和感觉到的孤立)、身体功能(活动能力和身体调理)和摔倒(摔倒和害怕摔倒)的变化。使用多变量Logistic回归来评估身体活动、社会隔离、身体功能、跌倒和对跌倒的恐惧之间的关系。结果在受访者中，740人(36.9%)报告体力活动减少，704人(35.1%)报告自2020年3月以来每天减少站立时间，712人(37.1%)报告缺乏陪伴，914人(45.9%)表示社交孤立。在多变量模型中，较少的体力活动(调整后的风险比，ARR：2.92，95%CI：2.38，3.61)、较少的站立时间(ARR：1.95，95%CI：1.62，2.34)和社交隔离(ARR：1.51，95%CI：1.30，1.74)与身体机能恶化的风险增加。体力活动减少、每天站立的时间和社交孤立都同样与行动不便有关。活动能力恶化与跌倒风险增加(ARR：1.70，95%CI：1.35，2.15)和跌倒恐惧加重(ARR：2.02，95%CI：1.30，3.13)有关。身体条件的恶化和社会孤立也与更大的跌倒恐惧恶化的风险有关。结论新冠肺炎大流行与身体功能和跌倒结局恶化有关，以体力活动减少和社会孤立的个体影响最大。需要采取公共卫生行动，解决老年人体力活动减少和社会孤立的问题。
Background Physical function worsens with older age, particularly for sedentary and socially isolated individuals, and this often leads to injuries. Through reductions in physical activity, the COVID-19 pandemic may have worsened physical function and led to higher fall-related risks. Methods A nationally representative online survey of 2006 U.S. adults aged 50-80 was conducted in January 2021 to assess changes in health behaviors (worsened physical activity and less daily time spent on feet), social isolation (lack of companionship and perceived isolation), physical function (mobility and physical conditioning), and falls (falls and fear of falling) since March 2020. Multivariable logistic regression was used to assess relationships among physical activity, social isolation, physical function, falls, and fear of falling. Results Among respondents, 740 (36.9%) reported reduced physical activity levels, 704 (35.1%) reported reduced daily time spent on their feet since March 2020, 712 (37.1%) reported lack of companionship, and 914 (45.9%) social isolation. In multivariable models, decreased physical activity (adjusted risk ratio, ARR: 2.92, 95% CI: 2.38, 3.61), less time spent on one's feet (ARR: 1.95, 95% CI: 1.62, 2.34), and social isolation (ARR: 1.51, 95% CI: 1.30, 1.74) were associated with greater risks of worsened physical conditioning. Decreased physical activity, time spent daily on one's feet, and social isolation were similarly associated with worsened mobility. Worsened mobility was associated with both greater risk of falling (ARR: 1.70, 95% CI: 1.35, 2.15) and worsened fear of falling (ARR: 2.02, 95% CI: 1.30, 3.13). Worsened physical conditioning and social isolation were also associated with greater risk of worsened fear of falling. Conclusion The COVID-19 pandemic was associated with worsened physical functioning and fall outcomes, with the greatest effect on individuals with reduced physical activity and social isolation. Public health actions to address reduced physical activity and social isolation among older adults are needed.