新冠疫情之前及期间老年人心理困扰的变化：虚弱转变和多种疾病的影响
Changes in psychological distress before and during the COVID-19 pandemic among older adults: the contribution of frailty transitions and multimorbidity.
作者信息
Wang Yi, Fu Peipei, Li Jie, Jing Zhengyue, Wang Qiong, Zhao Dan, Zhou Chengchao
机构信息
Centre for Health Management and Policy, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.
NHC Key Laboratory of Health Economics and Policy Research, Shandong University, 44 Wen-hua-xi Road, Jinan, Shandong, 250012, China.
出版信息
Age Ageing. 2021 Jun 28;50(4):1011-1018. doi: 10.1093/ageing/afab061.
AIM
To investigate changes in psychological distress in community-dwelling older adults before and during the coronavirus disease 2019 (COVID-19) pandemic and the contribution of frailty transitions and multimorbidity in predicting the psychological distress.
METHODS
Prospective repeated-measures cohort study on a sample of participants aged 60 and over. A total of 2, 785 respondents at the baseline (May 2019) were followed during the COVID-19 (August 2020). The changes in psychological distress before and during the COVID-19 were assessed using generalised estimation equations with adjusting for sex, age, education, economic status, marital status, tea drinking status, smoking status, alcohol drinking status, sedentary time, sleep quality and activities of daily living.
RESULTS
The psychological distress of older people has significantly increased in August 2020 compared with May 2019. Both older adults who remained frail and transitioned into frail state reported more psychological distress during the COVID-19. Similarly, both pre-existing multimorbidity and emerging multimorbidity groups were associated with more psychological distress. The group of frailty progression who reported new emerging multimorbidity showed more increase in psychological distress in comparison with those who remained in the non-frail state who reported no multimorbidity.
CONCLUSION
Psychological distress has increased among the community-dwelling older adults during the COVID-19 pandemic, and sustained and progressive frail states as well as multimorbidity were all associated with a greater increase of psychological distress. These findings suggest that future public health measures should take into account the increased psychological distress among older people during the COVID-19 pandemic, and the assessment of frailty and multimorbidity might help in warning of psychological distress.
目的
调查2019年冠状病毒病（COVID-19）大流行之前及期间社区居住老年人心理困扰的变化，以及虚弱转变和多种疾病共病在预测心理困扰方面的作用。
方法
对60岁及以上参与者样本进行前瞻性重复测量队列研究。在COVID-19期间（2020年8月）对2785名基线（2019年5月）受访者进行随访。使用广义估计方程评估COVID-19之前及期间心理困扰的变化，并对性别、年龄、教育程度、经济状况、婚姻状况、饮茶状况、吸烟状况、饮酒状况、久坐时间、睡眠质量和日常生活活动进行调整。
结果
与2019年5月相比，2020年8月老年人的心理困扰显著增加。在COVID-19期间，保持虚弱状态和转变为虚弱状态的老年人都报告了更多的心理困扰。同样，既有的多种疾病共病组和新出现的多种疾病共病组都与更多的心理困扰相关。与未患多种疾病的非虚弱状态组相比，报告出现新的多种疾病共病的虚弱进展组心理困扰增加更多。
结论
在COVID-19大流行期间，社区居住老年人的心理困扰有所增加，持续和渐进的虚弱状态以及多种疾病共病都与心理困扰的更大增加相关。这些发现表明，未来的公共卫生措施应考虑到COVID-19大流行期间老年人心理困扰的增加，对虚弱和多种疾病共病的评估可能有助于预警心理困扰。
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