COVID-19 lockdowns' effects on the quality of life, perceived health and well-being of healthy elderly individuals: A longitudinal comparison of pre-lockdown and lockdown states of well-being

The impact of health risk communication on self-perceived health and worry of targeted groups: Lessons from the Swedish COVID-19 response

BACKGROUND

The Swedish COVID-19 strategy aimed to protect vulnerable groups through targeted measures, categorizing individuals aged 70 and above as high-risk. This study examines the impact of such group-based risk assessments on subjective health and virus-related concerns among older adults.

METHODS

We analyzed survey data from the SOM Institute for 68- to 71-year-olds in 2019 (N = 684) and 2020 (N = 726). Using ordered logit regression, we compared perceived health and virus-related concerns between individuals just below (68-69 years) and just above (70-71 years) the high-risk age threshold, controlling for demographic factors.

RESULTS

In 2020, 70-year-olds reported significantly lower perceived health compared to their 69-year-old peers, a difference not observed in 2019. Furthermore, 70-year-olds exhibited significantly higher virus-related concerns than their slightly younger counterparts. These patterns persisted when expanding the analysis to include individuals aged 68 and 71.

CONCLUSION

Our findings suggest that the Swedish COVID-19 strategy, while aimed at protecting individuals aged 70 and over, may have inadvertently increased perceived vulnerability and health concerns within this group. Conversely, those just below the high-risk age threshold reported better health and lower virus-related concerns, highlighting potential unintended psychological consequences of age-based risk communication.

Unveiling the Impact of Moderate and Severe Atopic Dermatitis: Insights on Burden, Clinical Characteristics, and Healthcare Resource Utilization in Adult Greek Patients from the APOLO Cross-Sectional Study

Background: Moderate to severe (M2S) atopic dermatitis (AD) is a chronic condition impacting individuals, society, and healthcare systems. Considering the changing M2S-AD treatment landscape, this study assesses the M2S-AD burden in patients reaching referral centers in Greece. Methods: This was a multicenter, cross-sectional study. Patients aged 12 years or older with clinically diagnosed M2S-AD were enrolled. Data collected included clinical practice assessments and the following validated patient-reported instruments: Dermatology Life Quality Index (DLQI); EuroQol-5 Dimensions-3 Level scale (EQ-5D-3L); Patient Oriented Eczema Measure (POEM); Peak Pruritus Numerical Rating Scale (PP-NRS); and Work Productivity and Activity Impairment: General Health (WPAI:GH). A pain frequency/intensity/cause questionnaire and a sleep disturbance scale were also used. Results: Outcomes of 184 adults (51.1% female) with M2S-AD based on the Eczema Area and Severity Index (EASI) are presented (n = 117 moderate; n = 67 severe). Among the patients, 14.8% were obese, 59.2% had allergic comorbidities, and 88.0% were receiving AD-specific therapy (systemic: 38.6%). The median age, disease duration, body surface area, and total EASI scores were 38.8 years, 11.8 years, 30.0%, and 16.9, respectively. The median DLQI score was 12.0, with 'symptoms/feelings' being the most affected domain. EQ-5D dimensions 'anxiety/depression' and 'pain/discomfort' were also affected (65.2% and 64.1% reporting problems, respectively). The median POEM score was 17.0. Pain, severe pruritus (PP-NRS ≥ 7), and sleep disturbance were reported by 80.4%, 62.0%, and 88.5%, respectively. The median WPAI:GH 'work productivity loss' and 'activity impairment' scores were 23.8% and 30.0%, respectively. Conclusions: Both moderate and severe AD patients reaching Greek specialized centers experience significant symptom burden and impairments in quality of life, sleep, work, and daily activities.

Evaluating changes in the well-being of older adults during the COVID-19 pandemic: a longitudinal cohort study

The COVID-19 pandemic affected the lives of older adults. Yet, little is known about changes in well-being among older adults during the pandemic, especially when COVID-19 measures were relaxed. Therefore, we aimed to assess changes in the well-being of older adults during multiple turning points of the pandemic. This longitudinal study included data from Dutch older adults (≥65 years old) participating in the Lifelines COVID-19 cohort. Data consisted of seven questionnaires, administered every 2-4 months between May 2020 and October 2021. The outcomes were quality of life (n = 14 682), physical fitness (n = 14 761), and feelings of isolation (n = 14 611), all graded on a scale from 0 to 10. Changes in well-being were analysed by multivariable linear mixed-effects models. The context of measures was described using the Government Stringency Index. Quality of life and feelings of isolation decreased when measures were tightened and increased when measures were relaxed. For example, when measures relaxed after the first lockdown in May 2020, quality of life increased by 0.23 [95% confidence interval (CI): 0.16-0.29] towards July 2020. Physical fitness decreased by 0.26 [95% CI: 0.15-0.37] during the study period. Differences between subsamples were not found, except for sex in feelings of isolation, which differences diminished after a period of relaxed measures. Changes in quality of life and feelings of isolation improved after periods of stringent COVID-19 measures. Physical fitness did not improve after measures were relaxed, suggesting a possible negative effect of the pandemic on the physical fitness of older adults.

Psychological Wellbeing and Life Satisfaction among Chinese Older Immigrants in Canada across the Early and Late Stages of the COVID-19 Pandemic

OBJECTIVES

This study compared the psychological wellbeing, life satisfaction, and perceived social support in Chinese older immigrants living in Canada between the early (i.e., Wave 1: September-November 2020) and late (i.e., Wave 2: January-February 2023) stages of the COVID-19 pandemic. Additionally, it assessed perceived social support from family, friends, or others as predictors for psychological wellbeing and life satisfaction in this population.

METHODS

These questions were addressed with a cross-sectional survey design with two independent samples at Wave 1 (n = 171) and Wave 2 (n = 191), respectively.

RESULTS

The results revealed lower levels of psychological wellbeing, life satisfaction, and perceived social support in Wave 2 compared to Wave 1. The hierarchical regression models identified social support from friends (but not from family or others) as a significant predictor for psychological wellbeing and life satisfaction. Additionally, a higher level of income and being a male predicted better psychological wellbeing. A higher level of income and a lower level of education predicted greater life satisfaction.

CONCLUSIONS

The findings suggest a deterioration in psychological wellbeing and life satisfaction from the early to late stages of the pandemic and highlight the protective effect of social support from friends among Chinese older immigrants.

Pilot testing the Engaging Generations (eGen) Program to address social well-being among lower-income older adults

Introduction

Throughout the COVID-19 pandemic, the need to address digital inclusion and social well-being for older adults was particularly apparent for those from disadvantaged communities. This pilot program provided access to technology and intergenerational mentorship to older adult participants interested in receiving and learning how to utilize an iPad. Pre/post-changes were examined for social well-being in the areas of quality of life, social isolation, and loneliness.

Methods

This study conducted pre- and post-surveys with older participants (n = 145) from five disadvantaged communities in the United States utilizing standardized measures. One-on-one interviews were conducted post-program (n = 98) to examine participants' perceptions of the program and evaluate its impact on social measures.

Results

The study sample included older adults (Mean age = 72.3) who were mostly lower income (82.3%) and self-reported as Black (13.6%), Hispanic (21.7%), and White (56.5%). Significant differences were identified in participant pre/post-survey scores for social isolation, loneliness, and a global measure of quality of life. Qualitative analyses suggest improvements in various aspects of social well-being. Themes showed that participants believed the program contributed to (1) enhanced mood and mental health, (2) improved quality of life, (3) sense of purpose and feelings of being less alone, (4) ability to use video calling to connect with others; and (5) ability to more freely use email, texting, and messaging to communicate with others.

Discussion

This research demonstrates that this pilot program seemed to contribute to reduced social isolation and loneliness for participants, and participants stated more positive social well-being following program participation. However, future research with larger samples is needed to expand upon these findings. Future studies will examine the pathways between technology improvements and social well-being and examine group differences.

Prior Engagement in Physical Activity Correlates with Enhanced Quality of Life Perceptions among Older Adults during COVID-19 Lockdown

BACKGROUND

This longitudinal study aimed to evaluate whether prior engagement in a physical exercise program correlated with enhanced perceptions of quality-of-life components among older adults during the COVID-19 lockdown period.

METHODS

The cohort comprised elderly individuals (aged ≥ 65 years) who had previously partaken in a 12-week randomized controlled trial investigating the effects of a mixed aerobic-anaerobic, moderate-intensity exercise program. Participants' health-related quality of life was assessed using the Short Form Health Survey-12 item (SF-12) at the beginning of the initial trial and, again, one year later during the COVID-19 lockdown. In the exercise group, 44 participants were included, while the control group consisted of 49 participants, with computer-based, double-blind randomization conducted in Cagliari, Italy. The differences in scores for each SF-12 item between the two groups from T0 to T1 were compared using one-way ANOVA with Bonferroni corrections. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 27.

RESULTS

No statistically significant differences were observed on average by age (exercise group vs. control group 72.20 ± 4.78 vs. 72.91 ± 4.77; F = 0.513, p = 0.476). A decrease from T0 to T1 towards a better score on the SF-12 was observed in the exercise group compared to the control group in item 1 (F = 67.463, p < 0.0001); in item 5 (F = 4.319, p = 0.041); item 8 (F = 4.269, p = 0.041); item 9 (F = 10.761, p = 0.001); item 10 (F = 170.433, p < 0.001); and item 11 (F = 4.075, p = 0.046).

CONCLUSIONS

The results suggest that participation in a moderate physical exercise program one year prior may have equipped older adults with better coping mechanisms to navigate the stress and isolation imposed by the COVID-19 lockdown, as reflected by their enhanced scores on quality-of-life components pertaining to mental well-being. Exercise may confer a protective effect against the adverse psychological impacts of stressful events like the pandemic, even among older adults with chronic conditions. This study underscores the potential benefits of exercise interventions for promoting quality of life and preventing mood disorders in the elderly population.

Correlates of Loneliness and Social Isolation among Older Adults during the COVID-19 Outbreak: A Comprehensive Assessment from a National United States Sample

This study examined the correlates of loneliness and social isolation among older adults in the United States (U.S.) during the COVID-19 outbreak. We analyzed data from the 2020 National Health and Aging Trends Study, a nationally representative sample of 3257 U.S. older adults aged 65 years and older. We analyzed and identified the sociodemographic, health, social support, and community correlates of loneliness, higher loneliness during versus before the COVID-19 outbreak, and social isolation using weighted multiple logistic regression models. About 35.2% of U.S. older adults reported loneliness during the COVID-19 outbreak, 21.9% reported higher loneliness compared to before the COVID-19 outbreak, and 32.8% were socially isolated during the outbreak. Correlates for increased odds of loneliness included female gender, higher education, physical activity, depression, anxiety, functional limitations, and virtual communication access (only for higher loneliness during COVID-19 outbreak). Correlates for increased odds of social isolation included higher age, non-Hispanic Black, Hispanic, higher number of household children, and metropolitan residence. Our findings provide insights into evidence-based approaches to address social disconnection among U.S. older adults. The wide range of sociodemographic, health, social support, and community correlates identified in this study warrants multifaceted interventions that traverse individual, community, and societal levels to address the loneliness and social isolation epidemic.

More Adult Women than Men at High Cardiometabolic Risk Reported Worse Lifestyles and Self-Reported Health Status in the COVID-19 Lockdown

BACKGROUND

The COVID-19 lockdown represented an immense impact on human health, which was characterized by lifestyle and dietary changes, social distancing and isolation at home. Some evidence suggests that these consequences mainly affected women and altered relevant ongoing clinical trials. The aim of this study was to evaluate the status and changes in diet, physical activity (PA), sleep and self-reported health status (SRH) as perceived by older adult men and women with metabolic syndrome during the COVID-19 lockdown.

METHODS

We analyzed data from 4681 Spanish adults with metabolic syndrome. We carried out a telephone survey during May and June 2020 to collect information on demographics, dietary habits, PA, sleep, SRH and anthropometric data.

RESULTS

The mean age of participants was 64.9 years at recruitment, and 52% of participants were men. Most participants (64.1%) perceived a decrease in their PA during confinement. Regarding gender-specific differences, a higher proportion of women than men perceived a decrease in their PA (67.5% vs. 61.1%), Mediterranean diet adherence (20.9% vs. 16.8%), sleep hours (30.3% vs. 19.1%), sleep quality (31.6% vs. 18.2%) and SRH (25.9% vs. 11.9%) (all p < 0.001).

CONCLUSIONS

The COVID-19 lockdown affected women more negatively, particularly their self-reported diet, PA, sleep and health status.

Social Isolation of Older Adults, Family, and Formal Caregivers During the COVID-19 Pandemic: Stories and Solutions Through Participatory Action Research

This participatory action research (PAR) aimed to understand the health implications of guidelines impacting social isolation among frail community-dwelling older adults and their family and formal caregivers during the coronavirus disease (COVID-19) pandemic. Reflexive thematic analysis (RTA) of data collected from 10 policy/procedural documents revealed four themes: valuing principles, identifying problem(s), setting priorities, and making recommendations. Interviews with 31 participants from Peterborough, Ontario, also revealed four themes: sacrificing social health, diminishing physical health, draining mental health, and defining supports. Recommendations to decision makers were finalized at a knowledge exchange event involving participants and members of Age-friendly Peterborough. Key findings demonstrate the need for Canadian governments and health and social service agencies to enhance access to technology-based interventions, and educational and financial resources for caregivers. Meaningful communication and collaboration between older adults, caregivers, and decision makers are also needed to reduce the gap between policy and practice when addressing social isolation.

An in-person survey of the influence of the COVID-19 pandemic on physical function, functional capacity, cognitive function, and mental health among community-dwelling older adults in Japan from 2016 to 2022

BACKGROUND

The COVID-19 outbreak might have had several effects on older adults; however, much of the previous research only included self-report, cross-sectional, and online-survey data in the early stage of the pandemic. We conducted a face-to-face survey before and after the COVID-19 pandemic and investigated the influence of the pandemic on several functions to distinguish between changes due to aging and changes due to the pandemic using a linear mixed model.

METHODS

A total of 8 longitudinal surveys were conducted from 2016 to 2022. Physical function was assessed by weight, body mass index, body fat percentage, skeletal muscle mass index, calf circumference, grip strength, knee extension strength, the 5-times chair stand test, the timed up & go test and 5-m walking test. Functional capacity was measured using the Tokyo Metropolitan Institute of Gerontology index of competence, cognitive function was measured using the Trail Making Test - A, and mental health was measured using the Geriatric Depression Scale.

RESULTS

Of a total of 73 participants, 51 (69.9%) were female. The mean age at first participation was 71.82 years (SD = 4.64). The results of the linear mixed model showed that lower-limb muscle strength and body fat percentage and cognitive function changed significantly before and after the pandemic, while grip strength, functional capacity, and mental health did not.

CONCLUSIONS

The changes in these functions between before and after the pandemic might be attributed to the diminished opportunities for the independent older individuals to go out and engage in activities. Although functional capacity did not change, lower-limb muscle strength is important for functional independence. This decline might influence the functional capacity of these individuals in the future.

Clear as a bell? Policy stringency and elderly health during Covid-19

This paper investigates how restriction policies have impacted elderly self-assessed health (SAH) in Europe during the pandemic, and how the Covid-19 infection interacts with policy stringency to modulate the SAH deterioration. Using the Survey of Health, Aging and Retirement in Europe (SHARE) between October 2019 and August 2021, including 9,034 adults aged 50 years and above, alongside with a stringency index from the Oxford's Coronavirus Government Response Tracker (OxCGRT), we design both an adjusted probit model and a recursive bivariate probit model to test for endogeneity of Covid-19 infection. Estimations results show a bell curve between stringency and SAH degradation: a deleterious effect of restrictions at low levels of stringency up to a tipping point after which more stringent policies become protective. Covid-19 infection moderates this association. Depending on individuals' initial health, the effect of restrictions is uneven: highly stringent policies become damaging for individuals most likely to enter a vulnerabilization path, for whom the bell curve is thus inverted. Overall, this study shows clear patterns of association between policy stringency and perceived health among older Europeans, and highlights the potential trade-off between targeting as many people as possible, those in poor health or those on the edge of vulnerability.

Quality of life of patients with hip fracture was better during the COVID-19 period than before, an ancillary study from the HiFIT multicenter study

Background

The COVID-19 pandemic had a global impact on people life, notably because of lockdown periods. This could particularly affected patients suffering from hip fracture, who could have been more isolated during these periods. We aim at evaluating the impact of the COVID-19 period (including lockdown periods) on quality of life (QOL) in older adult patients 90 days after a surgery for a hip fracture.

Subject and methods

Ancillary study of the prospective randomized controlled HiFIT study. We compared the QOL measured at 90 days after a hip fracture surgery using the EuroQOL-5 dimensions 3 levels (EQ-5D), the Perceived Quality of life (PQOL) and the Instrumental Activities of Daily Living (IADL) in patients included in the Hifit study before and during the COVID-19 pandemic.

Results

The characteristics of the 161 patients included before and of the 213 included during the COVID period (including 122 (57%) during COVID with containment periods and 91 (43%) during COVID without containment periods) were similar (mean age 84 ± 10 years; 282 (75%) women). The majority (81%) of the patients alive at 90 days had returned to their previous place of residence in both periods. During the COVID period, EQ-5D showed better patient pain/discomfort and anxiety/depression levels. The PQOL happiness was not different, with around 81% of the patient being "happy" or "very happy" during the two periods and the IADL was also similar during the two periods. In the multivariate analysis odd ratios of having poorer outcomes were increased before COVID for pain/discomfort (OR 2.38, 95%CI [1.41-4.15], p = 0.001), anxiety (OR 1.89 [1.12-3.21], p = 0.017) and mobility (1.69 [1.02-2.86], p = 0.044).

Conclusion

Patient's quality of life measured using different scales was not altered during the COVID period compared to before COVID, 90 days after a hip fracture. Surprisingly, the Pain/Discomfort and Anxiety dimensions of the EQ-5D questionnaires were even better during the COVID period.Clinical trial registration:https://clinicaltrials.gov/ (NCT02972294).

V. Confirmatory factor analysis of the effect of daily-living on the happiness of community-dwelling older adults in Chile

This study examined the effect of the human-functioning dimension on happiness among community-dwelling older adults (OAs) in Chile. Questionnaires were used for data collection from a sample of 785 OAs of both sexes attending healthcare institutions. Exploratory factor analysis was performed using parallel analysis and oblique rotation. Confirmatory factor analysis and structural equation modeling were conducted using the maximum likelihood and unweighted least squares methods. Goodness-of-fit analyses were performed by considering absolute and respective incremental fit indices. The relationships between the functioning and happiness factors were all significant at the 1% level, indicating that functioning impacts happiness. The ratios of the variances between both constructs were identical to those of the covariances, indicating consistency between the models, with similarities and equalities in the estimation of their parameters. The modeling confirms a direct relationship between activities of daily living functioning and happiness. Given that a lack of functioning significantly affects OAs' happiness and quality of life, this relationship is consistent with the available theory. These findings may contribute to the formulation of social and health policies regarding OAs in Chile and other Latin American countries.

Productive art engagement in a hybrid format: effects on emotions of older adults during COVID-19 pandemic

Introduction

Previous studies have shown benefits of productive art-activity on frail older adults' mental and physical health. In this study, we investigated the effects of art-producing activities in a hybrid format (in-person and online) in a context of lockdown compared with previous studies taking place in museums and their effects on wellbeing, quality of life, physical frailty, and apathy in older adults.

Methods

We conducted a randomized unicentric control trial on a sample of 126 seniors older than 65 years (mean age 71.9 ± 2.3, 81% women) living in Nice (France). Participants were randomized in two parallel groups (intervention group with n = 62 vs. control group with n = 64) conducted during pandemic, between March and May 2021. The intervention group involved participatory art-based activities conducted in a hybrid format, either in-person or online, once a week for 2 h over a 12-week period. No specific intervention was proposed to the control group. The main aim was to evaluate how this hybrid format would impact the wellbeing, quality of life, and physical frailty of participants. The secondary aim was to compare our results with the previous studies conducted by Beauchet et al., and the third aim was to evaluate the impact of the intervention on apathy. Validated scales were implemented in RedCap and administered at baseline (M0) and at the end of the third month (M3).

Results

The intervention group showed significant improvement in their quality of life (p = 0.017) and their level of apathy (p = 0.016) after intervention. Emotional blunting increased significantly in the control group (p = 0.016) while it remained stable in the intervention group. No significant improvement was observed on the frailty, and wellbeing scores remained constant in both groups.

Conclusion

This randomized control trial confirmed emotional effects on seniors practicing an art-based activity in a hybrid format during pandemic on a weekly basis for 3 months.

Clinical Trial Registration

ClinicalTrials.gov, identifier: NCT04570813.

What is well-being? A scoping review of the conceptual and operational definitions of occupational well-being

Well-being is a multifaceted construct that is used across disciplines to portray a state of wellness, health, and happiness. While aspects of well-being seem universal, how it is depicted in the literature has substantial variation. The aim of this scoping review was to identify conceptual and operational definitions of well-being within the field of occupational health. Broad search terms were used related to well-being and scale/assessment. Inclusion criteria were (1) peer-reviewed articles, (2) published in English, (3) included a measure of well-being in the methods and results section of the article, and (4) empirical paper. The searches resulted in 4394 articles, 3733 articles were excluded by reading the abstract, 661 articles received a full review, and 273 articles were excluded after a full review, leaving 388 articles that met our inclusion criteria and were used to extract well-being assessment information. Many studies did not define well-being or link their conceptual definition to the operational assessment tool being used. There were 158 assessments of well-being represented across studies. Results highlight the lack of a consistent definitions of well-being and standardized measurements.

Prevalence of Long-term Symptoms Varies When Using Different Post-COVID-19 Definitions in Positively and Negatively Tested Adults: The PRIME Post-COVID Study

Background

Long-term symptoms after a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (ie, post-coronavirus disease 2019 [COVID-19] condition or long COVID) constitute a substantial public health problem. Yet, the prevalence remains currently unclear as different case definitions are used, and negatively tested controls are lacking. We aimed to estimate post-COVID-19 condition prevalence using 6 definitions.

Methods

The Prevalence, Risk factors, and Impact Evaluation (PRIME) post-COVID-19 condition study is a population-based sample of COVID-19-tested adults. In 2021, 61 655 adults were invited to complete an online questionnaire, including 44 symptoms plus a severity score (0-10) per symptom. Prevalence was calculated in both positively and negatively tested adults, stratified by time since their COVID-19 test (3-5, 6-11, or ≥12 months ago).

Results

In positive individuals (n = 7405, 75.6%), the prevalence of long-term symptoms was between 26.9% and 64.1% using the 6 definitions, while in negative individuals (n = 2392, 24.4%), the prevalence varied between 11.4% and 32.5%. The prevalence of long-term symptoms potentially attributable to COVID-19 ranged from 17.9% to 26.3%.

Conclusions

There is a (substantial) variation in prevalence estimates when using different post-COVID-19 condition definitions, as is current practice; there is limited overlap between definitions, indicating that the essential post-COVID-19 condition criteria are still unclear. Including negatives is important to determine long-term symptoms attributable to COVID-19.

Trial registration

ClinicalTrials.gov Identifier: NCT05128695.

Lived experiences and meanings of the COVID-19 pandemic: A case of the elderly survivors

The extent of risk brought about by the COVID-19 pandemic on the well-being of the elderly has emphasized the need to investigate their experiences during these challenging times. This study was conducted to explore the elderly's lived experiences as COVID-19 patients and to understand how they make sense of and cope with what happened to them when infected with COVID-19. Using Husserl's descriptive phenomenology, 13 elderly from Naval, Biliran Province, Philippines were chosen as participants using purposive sampling. The total number of participants was determined through theoretical saturation. In-depth interviews and the writing of field notes were done to collect information on the participants' experiences. The transcripts were analyzed following Colaizzi's steps in descriptive phenomenological method of analysis. Four general themes emerged for the elderly's lived experiences during the pandemic. These included discrimination, social isolation, anxiety and stress, and fear. Findings revealed that despite the challenges the elderly encountered during the pandemic and when they tested positive for COVID-19, they had seen it as an opportunity to improve and change their practices. The strategies that the elderly employed to cope with the pandemic were all adaptive and have resulted in positive outcomes. Results of the study emphasize the need for more programs and policies to enhance the care and support provided to the elderly during a health crisis.

The longer-term impact of the COVID-19 pandemic on wellbeing and subjective cognitive functioning of older adults in Belgium

In earlier survey research, we observed a severe impact of the first peak of the COVID-19 pandemic on the subjective wellbeing, sleep and activity of adults aged 65 years or older in Flanders, Belgium. The impact on subjective cognitive functioning, however, was limited. Since then, periods of lockdown and periods with less strict regulations alternated, but social distancing remained, especially for older adults. To study the longer-term impact of the pandemic on wellbeing and subjective cognitive functioning, we re-assessed the older adults from the first measurement moment (May-June 2020) in a second (June-July 2020) and third (December 2020) wave of the survey (n = 371, M = 72 years old, range 65-97 years old). Results indicated that wellbeing fluctuated with the severity of the pandemic. Results for self-reported cognitive functioning were mixed. While participants indicated a slightly better general subjective cognitive functioning at the end of the study, experienced problems with most cognitive subdomains significantly increased over time. The presence of depressive and anxiety symptoms were related to the longer-term impact of the pandemic on wellbeing and subjective cognitive functioning. Our study shows the long-lasting impact of the pandemic on the wellbeing and subjective cognitive functioning of older adults, without full recovery from the first wave.

Non-rigorous versus rigorous home confinement differently impacts mental health, quality of life and behaviors. Which one was better? A cross-sectional study with older Brazilian adults during covid-19 first wave

BACKGROUND

The implementation of social distancing measures during covid-19 influenced health outcomes and population´s behaviors, and its rigidity was very different across countries. We aimed to verify the association between the rigidity of social distancing measures of covid-19 first wave with depression symptoms, quality of life and sleep quality in older adults.

METHODS

This is a cross-sectional study including 1023 older adults (90% women; 67.68 ± 5.92 years old) of a community-based program in Fortaleza (Brazil). Dependent variables (depression symptoms, sleep quality, and quality of life) were measured through phone calls along June 2020, during the first covid-19 wave. Confinement rigidity (non-rigorous and rigorous) was considered as independent variable. Sociodemographic characteristics (sex, marital status, scholarity, and ethnicity), number of health conditions, nutritional status, movement behavior (physical activity and sitting time), technological skills, and pet ownership were considered as confounding variables. A binomial logistic regression (odds ratio [OR]) was performed to verify the association of confinement rigidity and depression symptoms, sleep quality, and quality of life, adjusted by confounding variables.

RESULTS

Older adults who adopted a less rigid lockdown had a higher frequency of depression symptoms, worse perception of quality of life, and bad sleep quality (p < 0.001). Confinement rigidity was able to explain the probability of depression symptoms occurrence (OR: 2.067 [95% CI: 1.531-2.791]; p < 0.001), worse quality of life (OR: 1.488 [95% CI: 1.139-1.944]; p < 0.05), and bad sleep quality (OR: 1.839 [95% CI: 1.412-2.395]; p < 0.001). Even adjusted by confounding variables, confinement rigidity was able to explain the poor outcomes analyzed in older adults.

CONCLUSION

Our findings showed that less rigid lockdown was associated with a superior frequency of depression symptoms, worse sleep quality, and lower perception of quality of life in older adults. Therefore, our study could improve comprehension regarding the impact of social distancing measures rigidity in health-related conditions and in the context of covid-19 and other similar pandemic situations.

Does being stricter mean doing better? Different effects of environmental policy stringency on quality of life, green innovation, and international cooperation

Nowadays, when we are facing several strict regulations, the question arises - does higher strictness lead to the desired results? This study addresses the fact that less research attention has focused on the effects of environmental policy stringency (EPS) on perceived health expressing quality of life, and on green international cooperation. In addition, previous research has provided rather mixed results on the impact of EPS on green innovation. Therefore, we fill an interesting research gap and help better understand the relationship between market-based and non-market-based EPS, perceived health, green innovations, and green international cooperation in OECD (Organization for Economic Co-operation and Development) countries. Using three complementary databases provided by OECD, Eurostat, and the World Bank and the classical linear regression model, we confirm hypotheses that strong market-based EPS and green international cooperation have positive effects on perceived health. Surprisingly, contrary to the findings of prior research, we do not confirm the positive effects of market-based and non-market-based EPS on green international cooperation. This study contributes to the literature on the Porter hypothesis, technological collaborations in green technological development, and environmental innovation theory. In addition, this study provides several practical implications for policymakers across OECD countries.

Health-related quality of life before and during the COVID-19 pandemic in Switzerland: a cross-sectional study

INTRODUCTION

The COVID-19 pandemic forced people to give up their daily routines and adjust to new circumstances. This might have affected health-related quality of life (HRQOL). We aimed to compare HRQOL during the first COVID-19 wave in 2020 to HRQOL before the pandemic and to identify determinants of HRQOL during the pandemic in Switzerland.

METHODS

We conducted a cross-sectional online survey during the pandemic (between May and July 2020; CoWELL sample; convenience sample). Before the pandemic (2015-2016), we had conducted a cross-sectional paper-based survey among a representative random sample of the Swiss general population (SGP sample). In both samples, we assessed physical and mental HRQOL (Short Form-36) and socio-demographic characteristics. In the CoWELL sample, we additionally assessed health- and COVID-19-related characteristics. Data were analysed using linear regressions.

RESULTS

The CoWELL sample included 1581 participants (76% women; mean age = 43 years, SD = 14 years) and the SGP sample 1209 participants (58% women, mean age = 49 years, SD = 15 years). Adjusted for sex, age, and education, the CoWELL sample reported higher physical HRQOL (PCS, +5.8 (95% CI: 5.1, 6.6), p < 0.001) and lower mental HRQOL (MCS, -6.9 (-7.8, -6.0), p < 0.001) than the SGP sample. In the CoWELL sample, especially persons with lower health literacy, who had no support network or who have had COVID-19, reported lower HRQOL.

DISCUSSION

Aspects unique to the COVID-19 pandemic affected HRQOL. Vulnerable persons such as those having had COVID-19, less support opportunities, and with lower health literacy are especially prone to impaired HRQOL during the COVID-19 pandemic.

The Well-being of Brazilian Industry Workers on Returning to the Physical Workplace During the COVID-19 Pandemic

OBJECTIVE

Our aim was to assess the prevalence and predictors of well-being among Brazilian industry workers on returning to the physical workplace during the COVID-19 pandemic.

METHODS

Two thousand two hundred forty-one participants completed an online survey between October and November 2021. Well-being was assessed with the World Health Organization Well-being Index, and the questionnaire also addressed sociodemographic and occupational characteristics and the health of workers and their contacts. Associations were estimated with logistic regression models.

RESULTS

The prevalence of adequate well-being was 63.15%. The predictors of poor well-being included being female, younger, working exclusively from home or on a hybrid model, having comorbid disorders, and living with someone with any comorbidity.

CONCLUSIONS

The identification of vulnerable groups with poor well-being may help organizations to direct efforts to the unmet psychological needs of these employees and develop well-being programs during this transition.

The effect of volunteer-led activities on the quality of life of volunteers, residents, and employees of a long-term care institution: a cohort study

BACKGROUND

The COVID-19 pandemic primarily impacted long-term care facilities by restricting visiting and circulation of visitors, affecting the quality of life (QoL) of older adults living in these institutions. Volunteer activities, essential for older adults' daily life, were also interrupted and potentially negatively impacted the QoL of older adults, volunteers themselves, and also employees in these institutions. In this context, this study aims to evaluate the impact of the return of volunteer-led activities in a long-term care institution on the QoL of older adult residents, employees, and volunteers.

METHODS

This study used a pre-test and post-test design within the same group. The first round of data collection was conducted before volunteer-led activities returned and the second round after 1 month of return. The instrument used to assess QoL was the EUROHIS-QoL-8 scale. This study was conducted within a nursing home in São Paulo, Brazil, created in 1937 by members of the Israeli community living in Brazil. Volunteer-led activities were part of residents' daily life before the COVID-19 pandemic, when these activities were interrupted for about 20 months. A total of 79 individuals participated in both rounds (pre and post), of which: 29 residents, 27 volunteers, and 23 employees of the long-term care institution.

RESULTS

Using a Wilcoxon signed-rank test, the analyses indicated improvements after the 1 month return in different QoL aspects for the three groups. Volunteers improved their personal relationships (Z - 2.332, p < .05), residents their overall health (Z - 2.409, p < .05) and employees in their overall QoL perception (Z - 2.714, p < .05). Influencing factors for residents were the number of activities (3 or more), gender (male), and education (undergraduate/graduate). For employees, those who assumed additional activities due to the volunteer-led activities interruption had a significant impact on their overall QoL.

CONCLUSIONS

Evidence from this study suggests that volunteers' return positively impacted different QoL aspects for volunteers, residents, and employees.

How Confinement and Back to Normal Affected the Well-Being and Thus Sleep, Headaches and Temporomandibular Disorders

The COVID-19 pandemic is having negative consequences not only for people's general health but also for the masticatory system. This article aimed to assess confinement and its new normal impact on well-being, sleep, headaches, and temporomandibular disorders (TMD). An anonymous survey was distributed to a Spanish university community. Participants completed a well-being index (WHO-5), a questionnaire related to sleep quality (the BEARS test), a headache diagnostic test (the tension type headache (TTH) and migraine diagnosis test), and the DC-TMD questionnaire. Questions were addressed in three scenarios: before confinement, during confinement, and the new normal. A total of 436 responses were collected (70% women, 30% men). A reduction in well-being and sleep quality was recorded. Respondents reported more TTH and migraines during and after confinement. Overall, confinement and return to normal did not increase TMD symptoms, and only minor effects were observed, such as more intense joint pain and a higher incidence of muscle pain in women during confinement. Reduced well-being is correlated with sleep quality loss, headaches, and TMD symptoms. This study provides evidence that pandemics and confinement might have had a negative impact on population health. Well-being was strongly affected, as were sleep quality, depression risk, TTH, and migraine frequency. In contrast, the temporomandibular joint and muscles showed more resilience and were only slightly affected.

Validating the Centre of Excellence on Longevity Self-AdMinistered (CESAM) Questionnaire: An Online Self-Reported Tool for Frailty Assessment of Older Adults

OBJECTIVES

Subjective health measures are often used to assess frailty, but the validity of self-reported online tools to identify frailty remains to be established. We aimed to assess concurrent, known-groups, convergent and predictive validity of the Centre of Excellence on Longevity Self-AdMinistered (CESAM) questionnaire for frailty assessment of older adults in an outpatient setting.

DESIGN

Cross-sectional analysis of 120 participants.

SETTING AND PARTICIPANTS

Participants of age ≥65 were recruited from an outpatient geriatric clinic. Individuals who had severe neurological, cognitive, or motor deficits were excluded.

METHODS

We assessed concurrent validity with area under receiver operating characteristic curve (AUC) against the Frailty Index (FI) and Clinical Frailty Scale (CFS). We analyzed known-groups validity between CESAM scores with frailty status (CFS and FI), Modified Barthel Index (MBI), and modified Chinese Mini-Mental State Examination (mCMMSE) using 1-way analysis of variance. We evaluated convergent validity using correlations with MBI, the Lawton index, mCMMSE, and Geriatric Depression Scale (GDS). Associations between CESAM-identified frailty for clinician-diagnosed geriatric syndromes, and health-related quality of life (HRQoL) was analyzed using regression analysis.

RESULTS

The CESAM questionnaire demonstrated excellent diagnostic performance for frailty using FI ≥0.25 (AUC = 0.88; 95% CI: 0.82-0.94; P < .001) and CFS ≥4 (AUC = 0.78; 95% CI: 0.68-0.88; P < .001). CESAM scores increased significantly with increasing frailty (both CFS and FI), lower MBI, and lower mCMMSE scores (all P < .001), indicating concurrent validity. The moderate-good correlation of CESAM scores with MBI (r = -0.61; P < 0.001), Lawton Index (r = -0.54; P < .001), mCMMSE (r = -0.53; P < .001) and GDS (r = 0.58; P < .001) supports convergent validity. Using a cutoff of ≥8 for frailty identification, CESAM-identified frailty was associated with cognitive impairment (OR = 3.7; 95% CI: 1.7-8.2; P = .001) depression (OR = 4.0; 95% CI: 1.7-9.6; P = .002), falls (OR = 3.1; 95% CI: 1.2-8.2; P = .021) and poorer HRQoL (β = -0.1; 95% CI: -0.2 to -0.02; P = .017).

CONCLUSION AND IMPLICATIONS

Our results support the validity of an online self-reported tool to identify frailty and geriatric syndromes in an outpatient setting, an approach that is potentially applicable for remote screening of frailty.

Poverty in old age in times of COVID-19-Empirical results from Austria

Early in the pandemic, researchers were cautioning that COVID-19 and the associated health policy countermeasures would have an increased negative impact on groups that were already vulnerable before the pandemic. One of these groups are older people affected by poverty, who according to official figures make up 13.9% of older population in Austria. Even before the pandemic, their living situation was considered precarious. Not without reason, this group has been identified as a high-risk group of the pandemic, due to their increased likelihood of severe COVID-19 related illness and their limited monetary resources and thus lower chances of coping with the pandemic. Nevertheless, research on this group has remained sparse to date. Therefore, the aim of the study is to focus on older people (60+ years) below the poverty line and to compare them with non-poor individuals. Data from the SHARE (Survey of Health Aging and Retirement in Europe) project is used, combining data from the two SHARE Corona Surveys (summer 2020 and summer 2021) and the SHARE Corona Special Austria Survey (December 2020) to gain the most complete picture of life situation during the pandemic. Results demonstrate that older people in poverty were more likely to report poor subjective health before as well as during the pandemic yet were significantly more likely to refuse vaccination against COVID-19, despite adhering to other measures against the pandemic to the same extent as non-poor people. Restrictions in the health care system affected both groups equally and no significant differences in the frequency of social contacts could be found. However, older people below the poverty line were significantly more likely to rely on social support to obtain necessities during the pandemic and were less likely to use the internet. Together, these results point out that disadvantage exist for the older poor in some but not all areas of life during the pandemic. This paper is aimed at providing first insights into the lives of poor older persons during a taxing time and may perhaps inspire more in-depth study of this particularly understudied population.

New Dimension on Quality of Life Differences among Older Adults: A Comparative Analysis of Digital Consumption in Urban and Rural Areas of China

The purpose of this study was to compare the variability in quality of life in the area of digital consumption among older adults in urban and rural China during the COVID-19 pandemic. This study proposed a low-cost mixed research method, and the methodology used a quantitative study of a large regional sample combined with a qualitative study of a small regional sample. Data for the large-scale area sample were obtained from the China family panel study (CFPS) dataset, and data for the small-scale regional sample were obtained from Nanjing, China. The quantitative analysis of the large-scale regional sample used the least squares regression analysis (OSL) and propensity score matching (PSM). The qualitative analysis of the small-scale regional sample used the selection optimization and compensation (SOC) model. The findings show that economic income is a direct driver of digital consumption. Digital consumption had a significant positive relationship with the quality of life for urban and rural older adults. In addition, the study established the semantic network relationships of the coping strategies of digital consumption of older adults and their drivers. Finally, the theoretical and practical implications of these findings are discussed in the context of other related studies.

Health Security, Quality of Life and Democracy during the COVID-19 Pandemic: Comparative Approach in the EU-27 Countries

The aim of this paper is to emphasize the role played by the social, economic and political variables in shaping models of sustainable healthcare systems and strategies able to support and improve the quality of life during and after the COVID-19 pandemic. The context of our research is represented by the medical and socioeconomic crises generated by the COVID-19 pandemic. The current pandemic negatively affects healthcare systems, quality of life and the global economy. In this respect, this paper aims to thoroughly scrutinize the effects of the COVID-19 pandemic on the social and healthcare systems of EU countries, to analyze the impact of human development in the field of the Global Health Security Index and to estimate the relation between resilience and quality of life during the COVID-19 pandemic. The research design is quantitative, resorting to the use of both descriptive and inferential statistics, against the background of a long-term comparative approach to the respective situations in the EU-27 countries. Empirical findings are relevant for emphasizing the fact that human development and social progress are predictors for the dynamics of health security measures. Moreover, the quality of the political regime, particularly in the case of full and flawed democracies, is strongly related to a high level of resilience and could influence the perception of quality of life. All of these empirical results could prove valuable for scholars interested in understanding the relationships between democracy, healthcare systems and quality of life, and for political decision makers involved in the effort of reducing the negative effects of COVID-19 in EU-27 countries.

Health-Related Quality of Life and Mental Well-Being during the COVID-19 Pandemic in Five Countries: A One-Year Longitudinal Study

This study aimed to investigate socioeconomic and health-related determinants and recent life events and their relation to changes in health-related quality of life (HRQoL) and mental well-being during the first year of the COVID-19 pandemic. A web-based survey was administered repeatedly to participants from Greece, Italy, the Netherlands, the United Kingdom, and the United States. Primary outcome measures were HRQoL (measured by EQ-5D-5L) and mental well-being (measured by WHO-5). Linear regression analyses were performed to estimate the impact of determinants on HRQoL and well-being. In total, 6765 respondents completed the questionnaire at T1 (April-May 2020) and T2 (May-June 2021). Regarding results, 33% showed improved HRQoL at T2, whereas 31% deteriorated. In terms of mental well-being, 44% improved and 41% deteriorated. The greatest deterioration in HRQoL and mental well-being from T1 to T2 was observed with an increasing number of chronic conditions. The effect of negative life events on HRQoL and mental well-being was larger than the effect of positive life events. We conclude that slightly more respondents showed improved rather than deteriorated HRQoL and mental well-being, with some variation by outcome measure and country.

Analysing the Quality of Life of Older Adults: Heterogeneity, COVID-19 Lockdown, and Residential Stability

This study aims to, first, investigate the quality of life (QOL) of older adults in Taiwan, from the perspective of heterogeneity and, second, clarify the social isolation affecting their QOL during the pandemic. Additionally, it explores the residential stability of older adults. Our empirical model, a Generalized Ordered Probit Model, uses secondary data from the 2019 Taiwan Social Change Survey for people aged 65 and above, with a total sampling size of 417. The results show that the self-assessed physical health of older adults is a significantly heterogeneous variable affecting their QOL, and has a varying impact on the probability of them being satisfied with their QOL. Results suggest that better financial plans and staying healthy are the main determinants of their QOL. Social isolation during the COVID-19 pandemic significantly hampered their QOL, which was not compensated by the use of the internet. Furthermore, older adults' residential stability significantly influences their QOL. Family members and relevant social work units should contribute to in-person home care for older adults to reduce their social isolation, with a focus on improving their living environments and to ensure that they age in a safe and healthy place.

Experiences of Active Everyday Life Among Persons with Prodromal Alzheimer's Disease: A Qualitative Study

Introduction

Identifying strategies to prevent or delay cognitive decline among the rising numbers of elderly is acknowledged as a global public health priority. Research suggests that an active lifestyle in terms of participation in activities has the potential to reduce the risk of later-life cognitive decline. The concept of "active everyday life", however, needs to be further explored.

Aim

The study aimed to explore and describe the active everyday lives of persons with prodromal Alzheimer's disease (AD) in terms of quality of participation in activities and perceived restrictions.

Methods

This qualitative study was part of a larger project, the MIND-ADMINI trial. Nine in-depth interviews were conducted with seven participants (2 males, 5 females; mean age of 72.3) at baseline before the intervention. The data were collected from January to October 2018 and analyzed using the grounded theory approach.

Results

Four categories emerged from the analysis: (i) active body and mind; (ii) doing desired meaningful activities to feel engaged, contented, and satisfied; (iii) doing in the context of being connected to others; (iv) ability in making decisions and taking actions. From these categories, which presented the key elements of an active everyday life, a core category was identified: Living a complete life in flow.

Conclusion

The findings suggest key elements of participation quality that contribute to an active life. The identified elements are important to be considered in rehabilitation to provide opportunities and possibilities for participation to enable and improve the quality of participation among persons with cognitive impairments.

The long-tail effect of the COVID-19 lockdown on Italians' quality of life, sleep and physical activity

From March 2020 to May 2021, several lockdown periods caused by the COVID-19 pandemic have limited people’s usual activities and mobility in Italy, as well as around the world. These unprecedented confinement measures dramatically modified citizens’ daily lifestyles and behaviours. However, with the advent of summer 2021 and thanks to the vaccination campaign that significantly prevents serious illness and death, and reduces the risk of contagion, all the Italian regions finally returned to regular behaviours and routines. Anyhow, it is unclear if there is a long-tail effect on people’s quality of life, sleep- and physical activity-related behaviours. Thanks to the dataset described in this paper, it will be possible to obtain accurate insights of the changes induced by the lockdown period in the Italians’ health that will permit to provide practical suggestions at local, regional, and state institutions and companies to improve infrastructures and services that could be beneficial to Italians’ well being.

Measurement(s)	Quality of Life • Overall Sleep Quality Rating • Physical Activity Measurement
Technology Type(s)	SF-36 • Overall Sleep Quality Rating • International Physical Activity Questionnaire (August 2002) Short Last 7 Days Self-Administered Format
Sample Characteristic - Organism	Homo sapiens
Sample Characteristic - Environment	questionnaire

Assessment of Subjective Well-Being in a Cohort of University Students and Staff Members: Association with Physical Activity and Outdoor Leisure Time during the COVID-19 Pandemic

Time spent outdoors and physical activity (PA) promote mental health. To confirm this relationship in the aftermath of COVID-19 lockdowns, we explored individual levels of anxiety, depression, stress and subjective well-being (SWB) in a cohort of academic students and staff members and tested their association with sport practice, PA at leisure time and time spent outdoors. Our cross-sectional study collected data during the COVID-19 outbreak (April−May 2021) on 939 students and on 238 employees, who completed an online survey on sociodemographic and lifestyle features, depression, anxiety, stress, and SWB. Results showed that the students exhibited higher levels of anxiety, depression, and stress, and lower levels of SWB (p < 0.001 for all domains) compared to the staff members. Correlation analysis confirmed that PA and time spent in nature were associated to high mental health scores among staff and, more consistently, among students. Finally, mediation analyses indicated that the time spent in nature, social relationships, and levels of energy play a mediator role in the relationship between sport practice and SWB. Our evidence reinforces the protective role of time spent in nature in improving mental health, and provides support for policymakers to make appropriate choices for a better management of COVID-19 pandemic consequences.

Longitudinal Impact of the COVID-19 Pandemic on Older Adults' Wellbeing

Background

The COVID-19 pandemic is a major stressful life event. This pandemic is causing significant changes in older adults' daily life affecting their physical and mental health. Psychological wellbeing is a protective variable when facing adverse circumstances, like the COVID-19 pandemic. This study analyzes the impact of COVID-19 on older adults' psychological wellbeing (personal growth and purpose in life) over time.

Materials and Methods

One hundred ninety-two people over 60 years old participated in a longitudinal study. Data were collected in three time points: during the lockdown on March 2020, when the lockdown finished (4 months after baseline), and during the third wave (10 months after baseline). We used latent growth curve models to assess the linear longitudinal trajectories of psychological wellbeing.

Results

Older adults did not show worse psychological wellbeing over time. Age has a positive impact on purpose in life. Furthermore, being a male, worrying about adverse effects of COVID-19, family functioning, resilience, personal growth, and acceptance associated with purpose in life.

Discussion

These results suggest that despite the difficult circumstances experienced during the COVID-19 pandemic, older adults have used protective variables for their psychological wellbeing.

Self-Esteem, Happiness, and Flourishing in Times of COVID-19: A Study During the Lockdown Period in Ecuador

Objective: Several studies have investigated the negative toll the pandemic has had on people’s mental health. However, there is limited research on the pandemic’s effect on positive mental health variables. This article reports on the levels of self-esteem and well-being (flourishing and happiness) in a sample of adults living in Ecuador and their relationships with the characteristics of their personal situation and the effects of the COVID-19 pandemic had on their personal lives.

Methods: A total of 766 adults completed an anonymous online survey between March and August 2020.

Results: Participants reported average scores in the flourishing scale, the majority considered themselves to be happy or very happy people, and more than half presented high levels of self-esteem. Age, education, socioeconomic status, time spent using mobile phones and on hobbies, among others, explained self-esteem, happiness, and flourishing.

Conclusion: The relationships between sociodemographic and situational variables of confinement during the pandemic are discussed, as well as the possible predictors of happiness, flourishing, and self-esteem.

Association between Frequency of Going Out and Psychological Condition among Community-Dwelling Older Adults after the COVID-19 Pandemic in Japan

Background: The psychological condition and frequency of going out (FGO) of community-dwelling older adults after the spread of COVID-19 will provide insights for supporting the daily lives of community-dwelling older adults. Going out is defined as moving from one’s own home to a place or region beyond one’s own home and is considered to reflect the daily and social life of community-dwelling older adults. This study investigates the relationship between the FGO and current psychological condition after the second wave of COVID-19 in community-dwelling older adults in Japan. Methods: This study adopted a self-administered questionnaire by mail. A total of 493 members of CO-OP Kagoshima were included in the analysis and divided into two groups according to the change in FGO. Multiple logistic regression analysis was conducted after a bivariate analysis to investigate the relationship between the FGO and psychological condition. Results: Significant differences were noted between the groups with decreased FGO and those with increased/unchanged FGO in general and pandemic-related psychological condition. Multiple logistic regression analysis showed a significant relationship between FGO and psychological condition, such as mental fatigue, not smiling as much as before, and anxiousness to go outside. Conclusion: Community-dwelling older adults may have experienced a decrease in the frequency of going out and a detrimental effect on their psychological condition after the COVID-19 pandemic. This finding may inform strategies to identify priorities for psychological approaches altered by COVID-19 to prevent confinement and stress in older adults.