Department of Preventive Medicine, Rush University Medical Center, 1700 W. Van Buren St., Suite 470, Chicago, IL, 60612, USA.
Department of Child, Family, and Population Health Nursing, University of Washington, Box 357262, Seattle, WA, 98195, USA.
Int J Behav Med. 2021 Dec;28(6):813-819. doi: 10.1007/s12529-021-09974-0. Epub 2021 Mar 2.
Executive functions (EF) support engagement in goal-directed behaviors, including several health behaviors. Stressful and cognitively demanding events can disrupt EFs and interfere with health behavior, possibly to a greater extent in those with preexisting EF deficits. This study examined the association between preexisting EF deficits and subsequent negative changes in eating patterns, physical activity, sedentariness, and alcohol/substance use during the COVID-19 pandemic.
Participants were 374 young adults in a follow-up study of the longitudinal, multisite Study of Early Child Care and Youth Development (SECCYD). Preexisting EF deficits were assessed with the Barkley Deficits in Executive Function Scales-Short Form, and personally impactful negative changes in four health behaviors (physical activity, unhealthy eating, sedentary time, alcohol/substance use) during the COVID-19 pandemic were subsequently assessed with the Epidemic-Pandemic Impacts Inventory.
In ordered logistic regression models, higher preexisting total EF deficits were associated with greater negative impactful changes in physical activity and unhealthy eating, independent of sociodemographic variables, obesity, and (as relevant) accelerometer-based physical activity and pre-COVID-19 diet quality. Socioeconomic status moderated the association between total EF deficits and impactful change in alcohol/substance use, with EF deficits linked to greater impactful change in alcohol/substance use only in higher socioeconomic strata.
Individuals with preexisting EF deficits appear more vulnerable to the negative impact of the COVID-19 pandemic on several key health behaviors. As the pandemic unfolds, strategies may be needed to identify those with EF deficits (e.g., screening tools) and provide them with tailored support for chronic disease risk reduction.
执行功能（EF）支持参与有目的的行为，包括几种健康行为。有压力和认知要求的事件会破坏 EF，并干扰健康行为，在那些原本 EF 有缺陷的人身上可能会更大程度地干扰健康行为。本研究探讨了在 COVID-19 大流行期间，预先存在的 EF 缺陷与随后的饮食模式、身体活动、久坐行为和酒精/物质使用的负面变化之间的关系。
参与者是在纵向、多地点早期儿童保育和青年发展研究（SECCYD）的后续研究中招募的 374 名年轻成年人。预先存在的 EF 缺陷使用 Barkley 执行功能缺陷量表-短式进行评估，在 COVID-19 大流行期间，四项健康行为（身体活动、不健康饮食、久坐时间、酒精/物质使用）的个人影响负面变化随后使用大流行影响清单进行评估。
在有序逻辑回归模型中，较高的预先存在的总 EF 缺陷与身体活动和不健康饮食的更大负面影响变化相关，独立于社会人口统计学变量、肥胖以及（如相关）基于加速度计的身体活动和 COVID-19 前的饮食质量。社会经济地位调节了总 EF 缺陷与酒精/物质使用的有影响力的变化之间的关系，EF 缺陷与酒精/物质使用的有影响力的变化仅在较高的社会经济阶层中相关。
预先存在 EF 缺陷的个体似乎更容易受到 COVID-19 大流行对几项关键健康行为的负面影响。随着大流行的发展，可能需要制定策略来识别那些有 EF 缺陷的人（例如，筛查工具），并为他们提供针对慢性病风险降低的个性化支持。
