Zhang Xiaochen, Hery Chloe, McLaughlin Eric M, Woods Nancy F, Neuhouser Marian L, Harris Holly, Gower Emily W, Wactawski-Wende Jean, Shadyab Aladdin H, Wallace Robert B, Paskett Electra D
Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, USA.
Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, Washington, USA.
J Am Geriatr Soc. 2025 Jun;73(6):1711-1721. doi: 10.1111/jgs.19434. Epub 2025 Mar 10.
The impact of COVID-19 on physical function (PF) outcomes among older adults remains unclear. We examined the long-term association between COVID, PF, and Activities of Daily Living (ADLs) among women from the Women's Health Initiative (WHI).
Participants from the WHI who completed the COVID-19 survey (2021-2022) and annual survey (2022) were included. Self-reported data on COVID-19 testing and symptoms (2021-2022) were used. PF score and ADLs were evaluated pre- and post-COVID-19 survey by the 36-Item Short Form Survey PF subscale, the Lawton Instrumental Activities of Daily Living, and the Katz Index of Independence in ADL. Multivariable linear regression and logistic regression were used and adjusted for pre-COVID functioning to examine the association between COVID status, PF, and ADLs. The interaction between pre-COVID functioning and COVID status was tested.
Among the 13,933 WHI participants, 71.4% were aged ≥ 80 years, and 88.6% were Non-Hispanic White. Only 8.7% tested positive for COVID-19 (n = 1210), with 35.1% having long COVID (n = 425). The most common long COVID symptoms were fatigue (18.2%), malaise (12.2%), memory problems (12.1%), and brain fog (11.2%). Women who tested COVID+ had lower PF scores (60 vs. 65, p = 0.045) and were less likely to be able to do all ADLs without help (74% vs. 79.2%, p = 0.015) compared to those who never tested COVID+. After controlling for covariates, post-COVID PF scores did not differ by COVID status (p = 0.30), although pre-COVID PF scores were significantly linked to post-COVID scores (p < 0.001). Similarly, the odds of being able to do all ADLs without any help did not differ by COVID status (p = 0.31), with pre-COVID ADLs significantly associated with post-COVID ADLs (p < 0.001).
In older women, after accounting for pre-COVID functional status, the association between long COVID and lower functioning became nonsignificant. Our findings highlight the importance of preserving physical functioning among older women.
2019冠状病毒病（COVID-19）对老年人身体功能（PF）结局的影响仍不明确。我们研究了来自女性健康倡议（WHI）的女性中COVID、PF和日常生活活动（ADL）之间的长期关联。
纳入来自WHI且完成了COVID-19调查（2021 - 2022年）和年度调查（2022年）的参与者。使用了关于COVID-19检测和症状的自我报告数据（2021 - 2022年）。通过36项简短调查问卷PF子量表、Lawton日常生活工具性活动量表和Katz日常生活活动独立性指数在COVID-19调查前后评估PF得分和ADL。使用多变量线性回归和逻辑回归，并对COVID前的功能状态进行调整，以研究COVID状态、PF和ADL之间的关联。对COVID前功能状态和COVID状态之间的相互作用进行了检验。
在13933名WHI参与者中，71.4%年龄≥80岁，88.6%为非西班牙裔白人。只有8.7%的人COVID-19检测呈阳性（n = 1210），其中35.1%患有长期新冠症状（n = 425）。最常见的长期新冠症状是疲劳（18.2%）、不适（12.2%）、记忆问题（12.1%）和脑雾（11.2%）。与从未检测出COVID-19阳性的女性相比，检测出COVID-19阳性的女性PF得分较低（60对65，p = 0.045），且在没有帮助的情况下能够完成所有ADL的可能性较小（74%对79.2%，p = 0.015）。在控制协变量后，COVID后PF得分在不同COVID状态下没有差异（p = 0.30），尽管COVID前PF得分与COVID后得分显著相关（p < 0.001）。同样，在没有任何帮助的情况下能够完成所有ADL的几率在不同COVID状态下没有差异（p = 0.31），COVID前ADL与COVID后ADL显著相关（p < 0.001）。
在老年女性中，在考虑了COVID前的功能状态后，长期新冠与功能降低之间的关联变得不显著。我们的研究结果强调了保持老年女性身体功能的重要性。
