Woźniak Anna, Misiąg Weronika, Leśnik Patrycja, Janc Jarosław, Chabowski Mariusz
Division of Internal Medicine Nursing, Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Poland.
Student research group No. K180, Faculty of Medicine, Wroclaw Medical University, Poland.
Dent Med Probl. 2025 Jul-Aug;62(4):609-618. doi: 10.17219/dmp/177329.
Coronavirus disease 2019 (COVID-19) quickly reached the pandemic status, with 765.22 million confirmed cases of COVID-19 and 6.92 million COVID-19 deaths reported worldwide by May 2023. Due to its sudden and global nature, the COVID-19 pandemic has had a significant impact on the emotional and mental health of many people. A group of COVID-19 patients who frequently require intensive care are geriatric patients. The cognitive performance of these patients and their independence in instrumental activities of daily living (IADL) may be crucial to their prognosis and risk of in-hospital death.
The present study aimed to assess the level of independence in activities of daily living (ADL), mental fitness, the level of fear of COVID-19, and cognitive functions to determine their impact on in-hospital mortality in geriatric COVID-19 patients.
A total of 300 intensive care unit (ICU) patients with COVID-19 were included in the cross-sectional study, using the following questionnaires: the Lawton IADL scale, the Katz ADL index of independence, the fear of COVID-19 scale (FCV-19S), the abbreviated mental test score (AMTS), and the 15-item geriatric depression scale (GDS15).
Patients aged 64 or below reported significantly greater independence on the IADL scale and the basic ADL scale, and showed a significantly higher level of mental fitness (Mann-Whitney U test; p = 0.001). Patient survival and in-hospital mortality were influenced by independence in basic and complex ADL.
The level of independence is an important prognostic indicator for in-hospital mortality in geriatric COVID-19 patients. The higher the level of mental fitness, the higher the level of independence in basic and instrumental activities of daily living. Patients aged ≥65 years are less independent in basic and instrumental activities of daily living. Moreover, they show a significantly lower level of cognitive functions.
2019冠状病毒病（COVID-19）迅速发展成为大流行病，截至2023年5月，全球报告的COVID-19确诊病例达7.6522亿例，死亡692万例。由于其突发性和全球性，COVID-19大流行对许多人的情绪和心理健康产生了重大影响。一类经常需要重症监护的COVID-19患者是老年患者。这些患者的认知表现及其在日常生活工具性活动（IADL）中的独立性可能对其预后和院内死亡风险至关重要。
本研究旨在评估老年COVID-19患者的日常生活活动（ADL）独立性水平、心理适应能力、对COVID-19的恐惧程度以及认知功能，以确定它们对院内死亡率的影响。
共有300例COVID-19重症监护病房（ICU）患者纳入横断面研究，使用以下问卷：洛顿IADL量表、卡茨ADL独立性指数、COVID-19恐惧量表（FCV-19S）、简易精神状态检查表（AMTS）和15项老年抑郁量表（GDS15）。
64岁及以下患者在IADL量表和基本ADL量表上的独立性显著更高，心理适应能力水平也显著更高（曼-惠特尼U检验；p = 0.001）。患者的生存和院内死亡率受基本和复杂ADL独立性的影响。
独立性水平是老年COVID-19患者院内死亡率的重要预后指标。心理适应能力越高，在基本和日常生活工具性活动中的独立性水平越高。65岁及以上患者在基本和日常生活工具性活动中的独立性较低。此外，他们的认知功能水平显著较低。
