C. Astolphi Lima1, J. Amorim2, F. Trombini-Souza3, A. da Silva4, R. Barbosa dos Santos1, P. Parreira Batista5, E. Duim6, P. Pelicioni7, D. Pereira8, M.d.C. Correia de Lima9, M. Perracini1,9
1University City of Sao Paulo, Master’s and Doctoral Programs in Physical Therapy, São Paulo, Brazil, 2Instituto Federal do Rio de Janeiro, Rio de Janeiro, Brazil, 3University of Pernambuco, Pernambuco, Brazil, 4Faculdade de Medicina de Jundiaí, Departamento de Saúde Coletiva, Jundiaí, Brazil, 5Universidade Federal de Minas Gerais, Federal University of Minas Gerais, Belo Horizonte, Brazil, 6Hospital Israelita Albert Einstein, Department of Diagnostic and Ambulatory Medicine, São Paulo, Brazil, 7University of New South Wales, Sydney, Australia, 8Federal University of Minas Gerais, Department of Physical Therapy, Belo Horizonte, Brazil, 9Faculty of Medical Sciences, Universidade Estadual de Campinas, Master’s and Doctoral Programs in Gerontology, Campinas, Brazil
Background: The SARS-CoV-2 pandemic poses enormous challenges for society as a whole. Older people are the most affected, not only by Covid-19's high lethality, but also by the recommendations of social and spatial distancing. Restriction of life-space mobility, particularly outside the home, can lead to a declining spiral of decreased health and disability. However, the impact of the pandemic over time on the mobility of older people is unknown.
Purpose: To compare mobility during the first months after COVID-19 pandemic outbreak in Brazil in comparison with pre pandemic situational context, according to sociodemographic measures.
Methods: Cohort study with a follow-up of 12 months, with older people aged 60 and over living in the community. As part of this cohort study we used data from the baseline assessment. Participants living in long-term care facilities and those who are bedridden were excluded. Recruitment of participants was carried out for according to the snowball sampling methodology. Data were collected using a structured questionnaire that were carried out on a digital platform (SurveyMonkey®). The main outcome of this study was mobility in the living spaces assessed by the Life-Space Assessment (LSA), which evaluates individual mobility in five levels of space, frequency of movement and needed of assistance in five levels of life space often used by older adults. Independent variables used were gender, age groups, race, marital and educational status, living alone, income, occupation, receiving pension, behaviour during social isolation and reported comorbidities. Association between the LSA delta score (LSA score during pandemic minus LSA score previous pandemic) and categorical variables was made using student t-test. Multiple linear regression analysis was used to examine whether the sociodemographic variables were associated independently with the LSA delta score.
Results: A total of 1482 older adults, living in 22 states in Brazil, were included. The mean age was 70.0 (±8.14) years old and 73.9% were female. The mean LSA score previous SARS-CoV-2 pandemic was 64.0 (±26.0) and during the pandemic was 37.8 (±22.1) and the delta score was -26.1 (±25.0) points. After adjusted for all variables, our linear regression analyses identified that the characteristics retained were the being men (β=4.02, 95%=0.47; 7.57), age groups 70-79 years (β=-5.82, 95%=-10.82; -0.82), race black (β=-6.05, 95%=-11.27; -0.83), being illiterate or having four or less complete years of schooling (β=9.05, 95%= 4.77; 13.34), and having an low income (β=4.29, 95%=0.84; 7.74).
Conclusion(s): Those who experienced the worst reduction in life-space mobility were older men (on age groups 60-69 and 70-79), living alone, that are black, illiterate or with a low educational level and with a lower income level. Specific interventions appear to be important to mitigate the negative consequences of life-space restrictions for this population. Increase physical activity levels at home, avoid sedentary behavior and support for caregivers to engage and stimulate older relatives to be active.
Implications: Future results will help us to understand if the recovery of life-spaces mobility restriction will have different trajectories for subgroups of older people, according to their adherence to social distancing measures and biopsychosocial factors.
Funding, acknowledgements: No support
Keywords: mobility limitation, social isolation, older adults
Topic: COVID-19
Did this work require ethics approval? Yes
Institution: Universidade Cidade de São Paulo
Committee: UNICID
Ethics number: CAAE 31592220.6.0000.0064
All authors, affiliations and abstracts have been published as submitted.
