scholarly journals Impact of the COVID-19 Stay-at-Home Order on Diet and Health in Community-Dwelling Older Adults With Obesity

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 461-461
Author(s):  
Kathryn Porter Starr ◽  
Michael Borack ◽  
Marshall Miller ◽  
Heather Hutchins-Wiese ◽  
Alyssa King ◽  
...  
Keyword(s):  
Older Adults ◽  
Food Security ◽  
Weight Gain ◽  
Dietary Habits ◽  
Community Dwelling ◽  
Health Lifestyle ◽  
Positive Behaviors ◽  
Increased Risk ◽  
The Impact ◽  
At Home

Abstract Profound restrictions were placed on previously free-living older adults due to mandatory stay-at-home orders for Covid-19. Recognizing the potential for worsening health and heightened risk of Covid-19 complications with older age and obesity, we conducted a survey to assess the impact of stay-at-home requirements on diet, health/social behaviors, and food security in 58 older adults (age=70.8±6.2, 55% Black, 93% female) who had participated in past obesity-reduction trials. A 71-item questionnaire was administered by phone and included demographics, health, lifestyle and dietary habits, food attitudes, and food security questions. Results showed indicators of heightened health risk, including health care appointments either delayed/cancelled (69%) and self-reported weight gain (62%). Of those with weight gain, 22% reported a gain of >10 pounds (33% gained 5-10 pounds and 7% < 5 pounds). Increased food intake was reported by 67% and 45% felt their eating patterns were less healthy due to increased snacking (71%) and consumption of sweets (41%). Food access and isolation were also an issue, as 51% were concerned about leaving the house for food and 81% reported eating alone. While some positive behaviors were reported (new ways to access food and health information, more reported cooking at home), the majority of findings indicated increased risk of obesity and its complications. The findings emphasize the need for effective lifestyle interventions that can be delivered remotely to high-risk older adults; this would benefit those presently self-restricted for Covid-19 concerns as well as other isolated older adults who need better access to individualized interventions.

scholarly journals Predictors of Food Insecurity Before and During COVID-19 Among Middle-Aged and Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 956-956
Author(s):  
Emily Nicklett ◽  
Jianjia Cheng
Keyword(s):  
Older Adults ◽  
Food Security ◽  
Food Insecurity ◽  
Repeated Measures ◽  
Community Dwelling ◽  
Future Research ◽  
Median Income ◽  
Middle Aged ◽  
Increased Risk ◽  
The Impact

Abstract The indirect impact of COVID-19 on food security of middle aged and older adults is not well understood. This study examines changes in risk factors for food security from 2018-2020 in a population-based sample. Using data from the Health and Retirement Study (2018 and 2020 waves), we utilized generalized estimating equations (GEE) with repeated measures to examine factors associated with food insecurity among US adults aged 50 and older (n=3170) before COVID-19 and since COVID-19. The prevalence of food insecurity doubled from 2018 (4.83%) to 2020 (9.54%). In multivariate analyses, the population-averaged odds of experiencing food insecurity was 81% higher in 2020 compared to 2018. Other factors significantly associated with higher odds of food insecurity included being female (OR: 1.29), Black (OR: 1.46), lowest quintile for wealth (OR: 1.82), not working due to a disability (OR: 3.29), renting (OR: 2.04), greater IADL limitations (OR: 1.32), and greater number of chronic illness comorbidities (OR: 1.14). Factors significantly associated with lower odds of food insecurity included older age (65-74: OR: 0.73; 75+: OR: 0.56) and being above the median income level (OR: 0.47). Partnership status, education level, and ADL limitations were not significantly associated with the population-averaged odds of experiencing food insecurity. This study identified factors related to food insecurity among a community-dwelling sample of middle aged and older adults in the U.S. Future research should examine the impact of policies and intervention strategies to address the disproportionate impact of COVID-19 on populations at increased risk of experiencing food insecurity.

scholarly journals Stress and Adjustment During the COVID-19 Pandemic: A Qualitative Study on the Lived Experience of Older Adults

2021 ◽  
Author(s):  
Alexandra J. Jasmine Fiocco ◽  
Charlie Gryspeerdt ◽  
Giselle Franco
Keyword(s):  
Older Adults ◽  
Lived Experience ◽  
Social Isolation ◽  
Independent Living ◽  
Living Arrangement ◽  
Community Dwelling ◽  
Behavioral Strategies ◽  
Increased Risk ◽  
The Impact ◽  
Community Dwelling Older Adults

In response to the COVID-19 pandemic, social distancing measures were put into place to flatten the pandemic curve. It was projected older adults were at increased risk for poor psychological and health outcomes resulting from increased social isolation and loneliness. However, little re-search has supported this projection among community-dwelling older adults. While growing body of research has examined the impact of the COVID-19 pandemic on older adults, there is a paucity of qualitative research that captures the lived experience of community-dwelling older adults. The current study aimed to better understand the lived experience of community-dwelling older adults during the first six months of the pandemic. Semi-structured one on one interviews were conducting with independent living older adults aged 65 years and older. After achieving saturation, 22 interview were analyzed using inductive thematic analysis. Following a recursive process, two overarching themes emerged from the data: perceived threat and challenges of the pandemic and coping with the pandemic. Specifically, participants reflected on the threat of contracting the virus and challenges associated with living arrangement, social isolation, and financial insecurity. Participants shared their coping strategies to maintain health and wellbeing, including behavioral strategies, emotion-focused strategies, and social support. Overall, this re-search highlights resilience among older adults during the first six months of the pandemic.

scholarly journals Long-Term Blood Pressure Variability and Risk of Cardiovascular Disease Events Among Community-Dwelling Elderly

Hypertension ◽  
2020 ◽  
Vol 76 (6) ◽  
pp. 1945-1952
Author(s):  
Michael E. Ernst ◽  
Enayet K. Chowdhury ◽  
Lawrence J. Beilin ◽  
Karen L. Margolis ◽  
Mark R. Nelson ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Older Adults ◽  
Blood Pressure Variability ◽  
Community Dwelling ◽  
Sensitivity Analyses ◽  
Link Type ◽  
Increased Risk ◽  
The Impact

High office blood pressure variability (OBPV) in midlife increases the risk of cardiovascular disease (CVD), but the impact of OBPV in older adults without previous CVD is unknown. We conducted a post hoc analysis of ASPREE trial (Aspirin in Reducing Events in the Elderly) participants aged 70-years and older (65 for US minorities) without history of CVD events at baseline, to examine risk of incident CVD associated with long-term, visit-to-visit OBPV. CVD was a prespecified, adjudicated secondary end point in ASPREE. We estimated OBPV using within-individual SD of mean systolic BP from baseline and first 2 annual visits. Cox proportional hazards regression was used to calculate hazard ratios (HR) and 95% CI for associations with CVD events. In 16 475 participants who survived to year 2 without events, those in the highest tertile of OBPV had increased risk of CVD events after adjustment for multiple covariates, when compared with participants in the lowest tertile (HR, 1.36 [95% CI, 1.08–1.70]; P =0.01). Similar increased risk was observed for ischemic stroke (HR, 1.56 [95% CI, 1.04–2.33]; P =0.03), heart failure hospitalization, or death (HR, 1.73 [95% CI, 1.07–2.79]; P =0.02), and all-cause mortality (HR, 1.27 [95% CI, 1.04–1.54]; P =0.02). Findings were consistent when stratifying participants by use of antihypertensive drugs, while sensitivity analyses suggested the increased risk was especially for individuals whose BP was uncontrolled during the OBPV estimation period. Our findings support increased OBPV as a risk factor for CVD events in healthy older adults with, or without hypertension, who have not had such events previously. Registration— URL: https://www.clinicaltrials.gov ; Unique identifiers: NCT01038583; URL: https://www.isrctn.com ; Unique identifiers: ISRCTN83772183.

scholarly journals Stress and Adjustment during the COVID-19 Pandemic: A Qualitative Study on the Lived Experience of Canadian Older Adults

2021 ◽  
Vol 18 (24) ◽  
pp. 12922
Author(s):  
Alexandra J. Fiocco ◽  
Charlie Gryspeerdt ◽  
Giselle Franco
Keyword(s):  
Older Adults ◽  
Lived Experience ◽  
Social Isolation ◽  
Living Arrangements ◽  
Independent Living ◽  
Community Dwelling ◽  
Behavioral Strategies ◽  
Increased Risk ◽  
The Impact ◽  
Community Dwelling Older Adults

In response to the COVID-19 pandemic, social distancing measures were put into place to flatten the pandemic curve. It was projected that older adults were at increased risk for poor psychological and health outcomes resulting from increased social isolation and loneliness. However, little research has supported this projection among community-dwelling older adults. While a growing body of research has examined the impact of the COVID-19 pandemic on older adults, there is a paucity of qualitative research that captures the lived experience of community-dwelling older adults in Canada. The current study aimed to better understand the lived experience of community-dwelling older adults during the first six months of the pandemic in Ontario, Canada. Semi-structured one-on-one interviews were conducted with independent-living older adults aged 65 years and older. A total of 22 interviews were analyzed using inductive thematic analysis. Following a recursive process, two overarching themes were identified: perceived threat and challenges of the pandemic, and coping with the pandemic. Specifically, participants reflected on the threat of contracting the virus and challenges associated with living arrangements, social isolation, and financial insecurity. Participants shared their coping strategies to maintain health and wellbeing, including behavioral strategies, emotion-focused strategies, and social support. Overall, this research highlights resilience among older adults during the first six months of the pandemic.

Daily Assessment of Executive Functioning and Expressive Suppression Predict Daily Functioning among Community-Dwelling Older Adults

2021 ◽  
pp. 1-10
Author(s):  
Stacey L. Brothers ◽  
Yana Suchy
Keyword(s):  
Older Adults ◽  
Executive Functioning ◽  
Past Research ◽  
Community Dwelling ◽  
Self Report ◽  
Expressive Suppression ◽  
Emotion Regulation Strategy ◽  
Ecological Momentary ◽  
The Impact ◽  
At Home

Abstract Objective: Executive functioning (EF) is known to be associated with performance of instrumental activities of daily living (IADLs). However, prior research has found that the degree to which EF fluctuates was more predictive of self-reported cognitive and IADL lapses than was average EF performance. One source of such EF fluctuations is engagement in an emotion regulation strategy known as expressive suppression (ES). Importantly, ES has also been shown to relate to IADL performance, presumably due to its impact on EF. However, past research is limited due to assessing IADLs only in the laboratory or via self-report. The present study examined (a) the association of daily EF and ES fluctuations with performance of actual IADL tasks in participants’ homes, and (b) whether any significant association between ES fluctuations and daily IADLs would be mediated by daily EF variability. Method: Participants were 52 older adults aged 60 to 95. Over the course of 18 days while at home, participants completed daily IADL tasks as well as daily measures of EF and ES via ecological momentary assessment. Results: Contrary to our hypothesis, average EF across days predicted at-home IADLs above and beyond daily EF variability, which itself was also predictive. ES variability also predicted daily IADLs, and this association was fully mediated by average daily EF. Conclusions: Daily fluctuations in ES appear to have a deleterious impact on performance of IADLs at home, likely due to the impact of such fluctuations on EF, although the average level of EF capacity is also important.

scholarly journals COVID-19 Pandemic Restrictions Affecting Older Adults' Social Interactions and Communication

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 247-247
Author(s):  
Mackinsey Shahan ◽  
Seung Eun Jung ◽  
Frankie Palmer ◽  
Amy Ellis
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Online Survey ◽  
Community Dwelling ◽  
Individual Interviews ◽  
Funding Sources ◽  
Phone Calls ◽  
Use Of Technology ◽  
Increased Risk ◽  
The Impact

Abstract Objectives Due to increased risk of social isolation caused by COVID-19, this study was conducted to understand changes in health behaviors among older adults, particularly concerning means of social interaction. Methods Community dwelling adults ages 60 and older completed qualitative individual interviews via Zoom and a 24 item online survey, the Questionnaire for Assessing the Impact of the COVID-19 Pandemic in Older Adults. Data were analyzed using directed content analysis and descriptive statistics. Results A total of 23 participants completed interviews and 25 completed online surveys. Participants were mainly female (72%), white (96%), with a mean age of 71.96 years. Nineteen (76%) participants were very concerned by the pandemic, and only one participant was not at all concerned. Participants frequently reported more interactions with their immediate family. Only five (20%) reported communicating with close friends and family less often than before the pandemic began. Seven (28%) reported communicating with friends and family more often than before and about half (52%) reported that their frequency of communication was “about the same” as pre-pandemic. Twenty-one (84%) participants communicated with others daily or at least several times per week. However, participants reported less face-to-face interaction and increased use of technology, such as virtual happy hours. All participants stayed in touch with others by phone calls (100%). Other often used means of communication were texting (92%), video calls (68%), email (68%), social media (52%), and postal mail (48%). Participants also reported some social gatherings with individuals bringing their own food and social distancing maintained. Despite this, 16 participants (64%) reported feeling isolated from others sometimes or often. Conclusions Although many older adults have adjusted their usual behaviors to stay in contact with others during the pandemic, this study found that most still felt isolated. Long-term feelings of isolation and lack of social support may compromise nutrition for this population. Therefore, it is crucial that nutrition professionals incorporate aspects of social support when working with these individuals. Funding Sources Julie O'Sullivan Maillet Research Grant Award funded by the Academy of Nutrition and Dietetics Foundation (ANDF).

scholarly journals DENTITION AND MALNUTRITION RISK IN COMMUNITYDWELLING OLDER ADULTS

2018 ◽  
pp. 1-8
Author(s):  
R. Zelig ◽  
L. Byham-Gray ◽  
S.R. Singer ◽  
E.R. Hoskin ◽  
A. Fleisch Marcus ◽  
...  
Keyword(s):  
Older Adults ◽  
At Risk ◽  
Nutritional Status ◽  
Nutritional Assessment ◽  
Mini Nutritional Assessment ◽  
Community Dwelling ◽  
Nutrition Status ◽  
Cross Sectional ◽  
Increased Risk ◽  
The Impact

Background and Objective: Older adults are at risk for both impaired oral health and suboptimal nutritional status. The objective of this study was to explore the relationships between malnutrition risk and missing teeth in community-dwelling older adults. Design: This was a retrospective cross-sectional analysis of data obtained from the electronic health records of 107 patients aged 65 and older who attended an urban northeast US dental school clinic between June 1, 2015 and July 15, 2016. Odontograms and radiographs were used to identify teeth numbers and locations; malnutrition risk was calculated using the Self-Mini Nutritional Assessment (Self-MNA). Relationships between numbers of teeth and malnutrition risk were assessed using bivariate logistic regression. Results: Participants (N=107) were 72.6 years (SD=5.6) of age; 50.5% were female. Mean Self-MNA score was 12.3 (SD=2.0) reflective of normal nutrition status; 20.6% were at risk for malnutrition, 4.7% were malnourished. Greater than 87% were partially or completely edentulous. Those with 10-19 teeth had lower Self-MNA scores (mean=11.6, SD=2.5) than those with 0-9 teeth (mean=12.7, SD=1.3) or 20 or more teeth (mean=12.6, SD=1.8) and had an increased risk for malnutrition (OR=2.5, p=0.076). Conclusion: The majority of this sample of older adults were partially edentulous and of normal nutritional status. Those with 10-19 teeth were more likely to be at risk for malnutrition. Further studies are needed to examine relationships between tooth loss and malnutrition risk and the impact of impaired dentition on the eating experience in a larger sample and to inform clinical practice.

scholarly journals No clear relationship between antihypertensive class and cognitive function over 12 months in a cohort study of community-dwelling adults aged 80 and over

2019 ◽  
Vol 10 ◽  
pp. 204062231882084 ◽  
Author(s):  
Ruth Peters
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
Adult Population ◽  
Community Dwelling ◽  
Channel Blockers ◽  
80 And Over ◽  
Aged 80 And Over ◽  
Increased Risk ◽  
Older Adult Population ◽  
The Impact

Background: Hypertension is prevalent in older adults. Hypertension has also been associated with an increased risk of cognitive decline. However, evidence relating to the impact of antihypertensive use is mixed. Calcium-channel blockers (CCB) have been suggested as the most beneficial class of antihypertensive for protection of cognition in older adults, however, to date, there have been no cohort studies designed to examine this. Methods: Community-dwelling treated hypertensive adults aged 80 and over were recruited from general practice sites and followed for 1 year. Cognitive function was assessed at baseline and 12 months using the modified Mini-Mental State Exam (3MS). Regression was used to examine the association between 12-month exposure to antihypertensive class and change in cognitive function. Results: A total of 292 participants completed the study. Mean change in 3MS score was a rise of 0.53 [standard deviation (SD) 4.7] 3MS points in those taking CCBs ( n = 135) compared with a drop of 0.09 (SD 5.1) in those without ( n = 157) p = 0.28. There was no relationship between CCBs or between any antihypertensive class and change in cognitive function over 1 year. Additional analyses using a clinically meaningful fall of 5 or more 3MS points showed similar results. Conclusion: In a hypertensive community-dwelling older adult population treated with antihypertensives, there was no evidence that CCBs were protective of cognitive function over a 12-month exposure. If a protective effect is present, it may be small or require a longer treatment period. Larger longer studies are required for confirmation.

scholarly journals Health impacts of the “Stay at Home” order on community dwelling older adults and how technologies may help: A focus group study (Preprint)

2020 ◽  
Author(s):  
Jessica Daly ◽  
Colin Depp ◽  
Sarah Graham ◽  
Dilip V. Jeste ◽  
Ho-Cheol Kim ◽  
...  
Keyword(s):  
Older Adults ◽  
Focus Group ◽  
Physical Health ◽  
Social Isolation ◽  
Community Dwelling ◽  
Potential Game ◽  
Viral Spread ◽  
The Impact ◽  
Mental And Physical Health ◽  
At Home

BACKGROUND The COVID-19 pandemic has resulted in nearly 250,000 deaths as of mid-November 2020 with 80% of those being people over 65 years of age. Since March 2020, preventive measures including lockdowns, social isolation, quarantine and social distancing have been implemented to reduce viral spread. These measures, while effective for risk prevention, may contribute to increased social isolation and loneliness among older adults and negatively impact mental and physical health. OBJECTIVE A qualitative study was conducted to identify the impact of the “Stay-at-Home” order on older adults living in a Continued Care Senior Housing Community (CCSHC) in southern California. METHODS Four 90-minute focus groups were convened using the Zoom communications platform during May 2020 with 21 CCSHC residents participating. Participants were asked to describe how they were managing during the “stay-at-home” mandate that was implemented in March 2020, including impact on their physical and mental health. Transcripts of each focus group were analyzed using qualitative methods. RESULTS Four themes emerged from the qualitative data including: Impact of Quarantine on Health and Well-Being; 2 - Communication Innovation; 3 - Effective Ways of Coping with Quarantine; and 4 – Improving Access to Technology and Training. Participants reported a threat to their mental and physical health directly tied to quarantine and exacerbated by social isolation and decreased physical activity. Technology was identified as a lifeline for many who are socially isolated from friends and family. CONCLUSIONS Technology access, connectivity, and literacy are potential game-changers to supporting the mental and physical health of older adults and must be prioritized. CLINICALTRIAL N/A

scholarly journals The association of weight change and all-cause mortality in older adults: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Tagrid A Alharbi ◽  
Susan Paudel ◽  
Danijela Gasevic ◽  
Joanne Ryan ◽  
Rosanne Freak-Poli ◽  
...  
Keyword(s):  
Older Adults ◽  
Weight Loss ◽  
Weight Gain ◽  
Mortality Risk ◽  
Weight Change ◽  
Meta Analysis ◽  
Community Dwelling ◽  
Weight Fluctuation ◽  
All Cause Mortality ◽  
The Impact

Abstract Objective there may be age-related differences in the impact of weight change on health. This study systematically reviewed the evidence on the relationship between weight change and all-cause mortality in adults aged 65 years and older. Methods MEDLINE, EMBASE and CINAHL were searched from inception to 11 June 2020, PROSPERO CRD 42019142268. We included observational studies reporting on the association between weight change and all-cause mortality in older community-dwelling adults. A random-effects meta-analysis was performed to calculate pooled hazard ratios and scored based on the Agency for Healthcare Research and Quality guidelines. Results a total of 30 studies, including 1,219,279 participants with 69,255 deaths, demonstrated that weight loss was associated with a 59% increase in mortality risk (hazard ratio (HR): 1.59; 95% confidence interval (CI): 1.45–1.74; P < 0.001). Twenty-seven studies that reported outcomes for weight gain (1,210,116 participants with 65,481 deaths) indicated that weight gain was associated with a 10% increase in all-cause mortality (HR: 1.10; 95%CI: 1.02, 1.17; P = 0.01). Four studies investigated weight fluctuation (2,283 events among 6,901 participants), which was associated with a 63% increased mortality risk (HR: 1.66; 95%CI: 1.28, 2.15). No evidence of publication bias was observed (all P > 0.05). Conclusion for community-dwelling older adults, weight changes (weight loss, gain or weight fluctuation) are associated with an increased risk of all-cause mortality risk relative to stable weight. Further research is needed to determine whether these associations vary depending upon initial weight, and whether or not the weight loss/gain was intentional.

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