Department of Epidemiology and Public Health, University College London, London, UK.
Department of Epidemiology and Public Health, University College London, London, UK.
Lancet Public Health. 2021 Jun;6(6):e365-e373. doi: 10.1016/S2468-2667(21)00069-4. Epub 2021 Apr 21.
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.
COVID-19 大流行影响了心理健康、心理幸福感和社会互动。身体残疾者可能特别容易受到负面影响，但证据很少。我们的目的是评估英格兰 COVID-19 大流行早期身体残疾老年人的情绪和社会体验。
在这项纵向队列研究中，我们分析了 2018-19 年和 2020 年 6-7 月期间从年龄在 52 岁及以上、居住在英格兰的参与者中收集的英国老龄化纵向研究的数据。身体残疾定义为日常生活活动（ADL）基本和工具性活动受损以及行动不便。通过在线或计算机辅助电话访谈评估抑郁、焦虑、孤独、生活质量、睡眠质量以及实时和书面社会联系的数量。对有和没有身体残疾的人的 COVID-19 大流行期间的经历进行了统计学调整，以调整大流行前的结果测量、年龄、性别、财富、种族、是否有配偶或伴侣、家庭人数和慢性疼痛。对两次调查都有完整数据的所有参与者均纳入分析。
在 2020 年 6 月 3 日至 7 月 26 日期间，有 5820 名参与者做出了回应，其中 4887 名参与者有完整的大流行前措施和 COVID-19 调查数据，被纳入分析。在 COVID-19 大流行期间，ADL 受损的人出现临床显著抑郁症状（比值比 1.78 [95%CI 1.44-2.19]；p<0.0001）、焦虑症（2.23 [1.72-2.89]；p<0.0001）和孤独感（1.52 [1.26-1.84]；p<0.0001）的人数明显多于 ADL 未受损的人。ADL 受损的人睡眠质量也明显较差（1.44 [1.20-1.72]；p<0.0001），生活质量较差，与 ADL 未受损的人相比。当残疾定义为行动不便时，结果也是相似的。ADL 受损的人与家人的实时联系（0.70 [0.55-0.89]；p=0.0037）和书面社会联系（0.54 [0.45-0.64]；p<0.0001）较少。当残疾由行动不便定义时，社会接触的结果相似。
身体残疾者在 COVID-19 大流行期间可能面临更大的情绪困扰、生活质量差和幸福感低的风险，这凸显了对额外支持和有针对性的心理健康服务的需求。
经济和社会研究委员会/英国研究与创新、美国国家老龄化研究所、美国国立卫生研究院。
