Even in mild cases, many older adults face mobility issues after COVID-19
Middle-aged and older adults with confirmed, probable or suspected COVID-19, even mild cases, experienced worsened mobility and functioning outcomes following infection, according to findings published in JAMA Network Open.
“The risk for mobility problems with COVID-19 was higher for older people, those with multiple chronic conditions, lower income, living in an apartment or condo (vs. a house), low physical activity and higher nutritional risk,” Marla K. Beauchamp, PhD, an assistant professor in the School of Rehabilitation Science at McMaster University in Canada, told Healio. “Although these factors alone did not account for the extent of mobility problems we observed, it does give us a sense of who we might need to target for rehabilitation and prevention.”
Beauchamp and colleagues conducted a population-based study using data from the Canadian Longitudinal Study on Aging. They extracted information from COVID-19-related questionnaires completed by 29,559 adults aged 45 to 85 years between September 2020 and December 2020. The researchers compared the data that were collected during this period with pre-pandemic data from 2015 to 2018.
At baseline, 63.4% of respondents were aged 65 years or older. Also, 52.45% were women and 93.51% were white. A majority of respondents (37.4%) had an annual household income between CAD $50,000 and $100,000 (37.4%) or at or above $100,000 (37.4%), while 25.2% reported an income of less than $50,000.
In total, 2,748 individuals had confirmed, probable or suspected COVID-19, according to Beauchamp and colleagues. Among these respondents, 94.2% were not hospitalized. Individuals with confirmed or probable COVID-19 were twice as likely to develop worsening ability to engage in household activities (OR = 1.89; 95% CI, 1.11-3.22), physical activity (OR = 1.91; 95% CI, 1.32-2.76) and standing up after sitting (OR = 2.33; 95% CI, 1.06-5.11) compared with adults without COVID-19, according to the researchers. Similar results were found for those with suspected COVID-19, the researchers observed.
Among the study cohort, more than one in four respondents (25.2%) reported worsening ability to engage in physical activity, 8.9% reported worsening ability to move around in their homes and 8.6% reported worsening ability to engage in housework during the pandemic. Also, compared with data collected before the pandemic, 15.2% of respondents reported new difficulty in standing up after sitting in a chair, 10.4% reported new difficulty walking up and down a flight of stairs without assistance and 11.1% reported new difficulty walking two to three neighborhood blocks, according to Beauchamp and colleagues.
“Based on our findings and that of others, there may be a need for rehabilitation, even among those with initially mild COVID-19 illness, to regain their mobility,” Beauchamp said.
The findings of this large population-based cohort study are important as they show an association between likely or confirmed COVID-19 illness with a reduced ability to engage in household activities and physical activity.
The COVID-19 pandemic has significantly impacted the health of many individuals throughout the world, and much emphasis has been placed on concerning impacts of the disease, including hospitalization rates and deaths from COVID-19. These findings illustrate COVID-19 illness has likely impacted the quality of life of many people, even those not requiring hospital admission, by contributing to limitations in physical activity and ability to care for oneself and function at home. Reduced physical function not only impacts the person infected by COVID-19 but can affect family and friends who may now have additional duties to support loved ones infected by COVID-19, which reduces their ability to work and provide for others who are dependent on them.
Based on these results, clinicians should assess for decline in physical function and ability to care for oneself in patients affected by COVID-19 who are homebound and offer access to supportive measures such as physical therapy or homemaker services for those who qualify.
Limitations of the study include incorporating people with probable or suspected COVID-19 in addition to those with a confirmed diagnosis, reducing the ability to associate the findings of this paper specifically with a COVID-19 diagnosis. In addition, as the study data were completed in December 2020, the impact on the delta and omicron COVID-19 variants on functional mobility cannot be assessed.