Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine, New York, NY, USA.
Division of Geriatrics, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
J Gen Intern Med. 2022 Apr;37(5):1177-1182. doi: 10.1007/s11606-021-07361-9. Epub 2022 Feb 15.
Homebound older adults have heightened risks for isolation and negative health consequences, but it is unclear how COVID-19 has impacted them. We examine social contact and mood symptoms among previously homebound older adults during the COVID-19 pandemic.
DESIGN/SETTING: Cross-sectional analysis using data from the National Health and Aging Trends Study (NHATS), a nationally-representative longitudinal study of aging in the USA.
A total of 3,112 community-dwelling older adults in 2019 who completed the COVID-19 survey in the summer/fall of 2020.
Homebound status was defined via self-report as rarely/never leaving home or leaving the house with difficulty or help in the prior month. We measured limited social contact during COVID-19 (in-person, telephone, video or email contacts <once/week), as well as loneliness, anxiety, and depression.
Among homebound older adults, 13.2% experienced limited social contact during COVID-19 vs. 6.5% of the non-homebound. Differences in social contact were greatest for contacts via email/text/social media: 54.9% of the homebound used this <once/week vs. 28.4% of the non-homebound. In adjusted analyses of those without limited social contact prior to the pandemic, the homebound had higher but not significantly different odds (OR 1.83; 95% CI 0.95-3.52) of limited social contact during COVID-19, with increased risk among the older individuals, those with dementia, and those in assisted living facilities. Of the homebound, 13.2% felt lonely every/most days during the pandemic vs. 7.7% of non-homebound older adults. Homebound and non-homebound older adults reported similar rates of increased loneliness, anxiety, or depression during COVID-19. Fewer homebound older adults learned a new technology during the pandemic (16.3%) vs. non-homebound older adults (30.4%).
Isolation among homebound older adults increased during COVID-19, partially due to differences in technology use. We must ensure that homebound persons have the connection and care they need including new technologies for communication during and beyond COVID-19.
行动不便的老年人面临着更高的孤独和负面健康后果的风险，但目前尚不清楚 COVID-19 对他们的影响。我们研究了 COVID-19 大流行期间以前行动不便的老年人的社会联系和情绪症状。
设计/背景：这是一项使用美国全国健康老龄化趋势研究（NHATS）数据的横断面分析，这是一项针对美国老龄化的全国性纵向研究。
共有 3112 名居住在社区的老年人，他们在 2019 年完成了 COVID-19 调查，并于 2020 年夏季/秋季接受了调查。
通过自我报告将行动不便的状态定义为很少/从不离开家或在上个月离开家有困难或需要帮助。我们测量了 COVID-19 期间的社交接触受限（面对面、电话、视频或电子邮件联系<每周一次），以及孤独感、焦虑和抑郁。
在行动不便的老年人中，有 13.2%的人在 COVID-19 期间社交接触受限，而非行动不便的老年人中这一比例为 6.5%。社交接触方面的差异在电子邮件/短信/社交媒体方面最为明显：54.9%的行动不便者每周使用<一次，而非行动不便者中这一比例为 28.4%。在调整了疫情前社交接触不受限制的人群后，行动不便者的社交接触受限风险更高，但差异无统计学意义（OR 1.83；95%CI 0.95-3.52），且在年龄较大、患有痴呆症和居住在辅助生活设施的人群中风险更高。在行动不便的老年人中，有 13.2%的人在疫情期间每天/大部分时间感到孤独，而非行动不便的老年人中这一比例为 7.7%。行动不便和非行动不便的老年人在 COVID-19 期间报告的孤独感、焦虑或抑郁增加比例相似。在疫情期间，行动不便的老年人学习新技术的比例较低（16.3%），而非行动不便的老年人为 30.4%。
行动不便的老年人在 COVID-19 期间更加孤立，部分原因是技术使用的差异。我们必须确保行动不便的人能够获得他们所需要的联系和关怀，包括在 COVID-19 期间和之后用于沟通的新技术。
