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T. Shinohara1, K. Saida1, S. Tanaka1, A. Murayama2, D. Higuchi1
1Takasaki University of Health and Welfare, Department of Physical Therapy, Faculty of Health Care, Takasaki, Japan, 2Gunma University of Health and Welfare, Department of Physical Therapy, Faculty of Rehabilitation, Maebashi, Japan
Background: Coronavirus disease 2019 (COVID-19) countermeasures like social distancing have resulted in changes in physical or psychological conditions among community-dwelling older adults. Worsening conditions will likely result in increased frailty rates or worsened frailty in older adults. We call this frailty “corona-frailty” (BMJ, 2020).
Purpose: We studied the effects of COVID-19 countermeasures on the lifestyle and physical or psychological conditions of community-dwelling older adults, and the association between frailty and these conditions.
Methods: This cross-sectional study was conducted between May 8 and June 18, 2020, in Takasaki City, Gunma Prefecture, Japan. The questionnaire survey was administered to 1,953 older adults, who returned the responses by post. The Frailty Screening Index was used for frailty evaluation. The Questionnaire for Older Adults (QO), developed by Japan’s Ministry of Health, Labour and Welfare in 2019, was used to assess physical and psychological conditions. The QO has 15 items divided into 10 domains. To assess changes in lifestyle and physical or psychological subjective conditions, we developed the Questionnaire for Change of Life (QCL), comprising five items along three dimensions of frailty: physical, cognitive, and social. Cronbach’s α was calculated as a measure of the internal consistency of the QO and QCL. Chi-square tests and Cramér’s V were used to measure the strength of the associations with frailty.
Results: Of the 1,110 (53.5%) participants who responded, 994 who answered all the questions were included. Women comprised 74.9% of the study population, and the mean age was 78.5 years. Ninety-nine participants (10.0%) had frailty, and 520 participants (52.3%) had pre-frailty. Cronbach’s α for QO and QCL was 0.060 and 0.573, respectively. An increase in frailty was associated with worsening daily movement, leg muscle strength, meal size, and anxiety as assessed by QCL (p < 0.001, Cramér’s V: 0.174, 0.352, 0.214, and 0.107, respectively). Eight of the 10 domains of QO had a significant association with frailty, and the participants’ conditions were so poor that they were considered frail (p < 0.05). The items for health condition, mental health, oral function, falls, cognitive function, and habit of going out were associated with frailty in particular (Cramér’s V: 0.343, 0.208, 0.231, 0.209, 0.203, and 0.204, respectively).
Conclusion(s): The internal consistency of the QCL was poor, and the intercorrelations of the items of the QO or QCL were low because they were developed with a comprehensive perspective for older adults. We suggest that each individual QO or QCL item should be used in analysis. Subjective daily movement, leg muscle strength, and meal size decreased and anxiety increased because of the COVID-19 countermeasures. In terms of the COVID-19 countermeasures requested, frailty had significant associations with various physical or psychological conditions. The association between frailty and health condition was particularly strong.
Implications: The effects of COVID-19 are long-lasting. It is important to prevent corona-frailty. Physical therapists and policy makers should intervene in lifestyles and check for physical or psychological conditions associated with frailty among community-dwelling older adults.
Funding, acknowledgements: A part of this work was supported by the Japanese Society for the Promotion of Science KAKENHI (Grant 19K19712).
Keywords: frailty, older adult, COVID-19
Topic: COVID-19
Did this work require ethics approval? Yes
Institution: Takasaki University of Health and Welfare
Committee: the Research Ethics Committee
Ethics number: 2009
All authors, affiliations and abstracts have been published as submitted.
