Background Feelings of loneliness and social isolation are common among the elderly, affecting both health and wellbeing. The COVID-19 pandemic has altered social connections through health precautions, restrictions and other factors. However, limited research has been conducted on how older people’s health and wellbeing in different countries has been impacted by the COVID-19 pandemic. The aim of this study was to develop methodology that would allow us to compare elderly populations, aged 67 + in Latvia and Iceland, and to discuss the potential impact of diverging factors on the association between loneliness, social isolation and health.Methods Quantitative data on 420 respondents from Wave 8 of the Survey of Health, Ageing and Retirement in Europe (SHARE) was utilized in Latvia. Data on health and wellbeing of elderly in Iceland from a HL20 study with 1033 respondents was used to provide comparative analytic material for studying the differences between Latvia and Iceland, and within each country.Results The study revealed considerable differences between the countries regarding the frequency of loneliness and social isolation. About 80% of Latvian respondents felt socially isolated and 45% were lonely, compared to 42.7% socially isolated and 30% lonely Icelanders. In general, more elderly people in Latvia experienced difficulties than their peers in Iceland. Social isolation tends to differ across genders and age groups in both countries. This is related to marital and employment status, financial situation, and education. COVID-19 had a stronger deteriorating effect on mental and physical health among both lonely Latvian and Icelandic respondents. However, health deterioration was stronger amongst more socially isolated Icelanders compared to Latvians.Conclusions The study suggests that social isolation is a contributing factor and increases the risk of loneliness, which might have been enhanced by restrictions during the COVID-19 pandemic.

Background and Objectives: preoperative differentiation of enlarged parathyroid glands may be challenging in conventional B-mode ultrasound. The aim of our study was to analyse qualitative and quantitative characteristics of parathyroid gland lesions, using multiparametric ultrasound protocol—B-mode, Colour Doppler (CD), and contrast-enhanced ultrasound (CEUS)—and to evaluate correlation with morphology in patients with hyperparathyroidism (HPT). Materials and Methods: consecutive 75 patients with 88 parathyroid lesions and biochemically confirmed HPT prior to parathyroidectomy were enrolled in the prospective study. B-mode ultrasound, CD, and CEUS were performed with the subsequent qualitative and quantitative evaluation of acquired data. We used 1 mL or 2 mL of intravenous ultrasound contrast agent during the CEUS examination. Correlation with post-surgical morphology was evaluated. Results: seventy parathyroid adenomas were hypoechoic and well contoured with increased central echogenicity (44.3%), peripheral-central vascularization (47%), and polar feeding vessel (100%). Twelve hyperplasias presented with similar ultrasound appearance and were smaller in volume (p = 0.036). Hyperplasias had a tendency for homogenous, marked intense enhancement vs. peripherally enhanced adenomas with central wash-out in CEUS after quantitative analysis. No significant difference was observed in contrasting dynamics, regardless of contrast media volume use (1 mL vs. 2 mL). We achieved 90.9% sensitivity and 72.7% specificity, 93% positive predictive value (PPV), 87.3% negative predictive value (NPV), and 87.3% accuracy in the differentiation of parathyroid lesions prior to post-processing. In a quantitative lesion analysis, our sensitivity increased up to 98%, specificity 80%, PPV 98%, and NPV 80% with an accuracy of 96.4%. Conclusions: CEUS of parathyroid lesions shows potential in the differentiation of adenoma from hyperplasia, regardless of the amount of contrast media injected. The quantitative analysis improved the sensitivity and specificity of differentiation between parathyroid lesions. Hyperplasia was characterized by homogeneous enhancement, fast uptake, and homogeneous wash-out appearance; adenoma—by peripheral uptake, central wash-out, and reduced hemodynamics. The use of CEUS quantification methods are advised to improve the ultrasound diagnostic role in suspected parathyroid lesions.

Lielāka varbūtība piedzīvot psihoemocionālos traucējumus ir sievietēm, kā arī cilvēkiem, kuri savu veselības stāvokli vērtē kā sliktu vai drīzāk sliktu un kuri ir vai jūtas vientuļi

The COVID-19 in the context of healthy ageing is associated with decline in body functional abilities and serious illness in older individuals. Regular assessment of ageing processes, including intrinsic capacity factors, provides an opportunity for better understanding of the individual’s functional abilities and vulnerabilities. Based on the data (2017–2020) from two waves (7 and 8) of the Survey of Health, Ageing and Retirement in Europe (SHARE), an evaluation and comparison of the intrinsic capacity factors of older individuals (50+ years) before and during COVID-19 was conducted, including data from 4422 individuals in Baltic countries (from Latvia – 648, Lithuania – 1079 and Estonia – 2695). Excellent or very good health status before the outbreak reported 35.3% respondents in Latvia, 54.9% in Lithuania and 45.3% in Estonia (p < 0.001). On worsened health status since the outbreak reported 7% respondents in Latvia, 13.8% in Lithuania and 5.9% in Estonia (p < 0.001). Feeling of nervousness, depression and loneliness during COVID-19 outbreak increased among all respondents, regardless of nationality and severity of symptoms before outbreak (p < 0.001). The results indicate that during COVID-19 outbreak respondents were experiencing deterioration in cognitive and psychological health. To maintain the level of individual’s functional abilities during situations like COVID-19 outbreak preventive actions are needed by promoting physical activities and social networks, especially for older individuals.

Ensuring access to healthcare is critical to prevent illnesses and maintain health and functional abilities for older individuals. The Covid-19 pandemic is a major global public health threat that challenges healthcare availability and accessibility. The objective of the study was to compare healthcare accessibility for older individuals since and during Covid-19 pandemic. The study was based on a sample of individuals from wave 8 Covid-19 add-on and wave 9 Covid-19-add-on of the Survey of Health, Ageing and Retirement in Europe (SHARE) in the period from 2020 till 2021. The sample size was 44043 respondents from 26 European countries. Descriptive statistics, Chi-square and McNemar test was performed. Overall, in 2021 there is a statistically significant decrease in proportion of respondents who forwent medical treatment (from 12% to 8%, in Latvia from 14,6% to 7%), postponed medical appointment due to Covid-19 (from 27% to 13%, in Latvia from 14,6% to 3,2%) and to whom appointment was denied by healthcare facility due to Covid-19 (from 5,3% to 4,5%, in Latvia from 6.9% to 3,3%) (p &lt; 0.001). More often forwent medical appointment in 2021 was reported from females as well as respondents younger than 75 years, with good or very good self-rated health status and with less or no limitations due to health. Forwent medical treatment was reported more often from respondents with diabetes and hypertension. Results indicate that remote consultations are used more often than in 2020 (number of remote consultations varied between 1 and more than 100) and more often were reported by younger respondents (50-74 years). No significant association was found in self-rated health changes since and during Covid-19 pandemic for respondents who reported healthcare accessibility issues. As those issues were reported also by individuals with poor or fair self-rated health status and serious health conditions it can lead to a more rapid decline in health and functional abilities in the future. Key messages

According to the WHO, healthy ageing is characterized by such interrelated determinants as intrinsic capacity, functional ability and environment. An individual's intrinsic capacity is a powerful predictor of the future ageing process and includes 5 areas - cognitive, psychological, sensory, locomotion and vitality. Exploration of these areas can provide necessary information for therapeutic and preventive actions that can be tailored to an individual's needs, priorities and values to support participation and quality of life. The objective of this study was to evaluate and compare healthy ageing determinants of older individuals in the Baltic States. The research was based on the sample of older individuals (50 years and older) from wave 8 of the Survey of Health, Ageing and Retirement in Europe (SHARE) during the period from November 2019 to March 2020. The obtained results indicate a low level/poor results in such determinants as locomotion, sensory, vitality and functional ability (more than 50% of the respondents among the Baltic countries has poor health, various long-term illnesses, limitations in daily activities, suffer from moderate or severe pain, requires help to meet daily needs, etc.), has various behavioral risks, however has higher assessment of cognitive and psychological determinants.

Background In order to implement the necessary measures to prevent the consequences of the Covid-19 pandemics, long-term assessment of health status is needed. The objective of the study - to determine the prognostic factors of self-rated health deterioration during the first wave of Covid-19 pandemics. Methods The study was based on a sample of individuals from wave 7, wave 8 and Covid-19 add-on of the Survey of Health, Ageing and Retirement in Europe (SHARE) in the period from 2017 till 2020. The sample size was 4429 respondents - Latvia: 649, Lithuania: 1083, Estonia: 2697. Descriptive statistics as well as univariate and multivariate binary logistic regression was performed, including health determinants, demographics and factors associated with Covid-19. Results Based on univariate binary logistic regression analysis, the main predictors for deterioration of self-rated health (unadjusted OR; 95%CI) were: age 80+ years (reference group 50-59 years) for Estonia (3.03; 2.93-3.14), diagnosed with major condition since Covid-19 for Latvia (15.45; 15.14-15.77) and Estonia (6.75; 6.57-6.94), fair or poor health since Covid-19 for Lithuania (4.92; 4.86-4.99), loneliness since Covid-19 for Lithuania (5.03; 4.94-5.12), limited in activities due to health condition for Latvia (4.53; 4.42-4.64), depression since Covid-19 for Lithuania (3.78-3.71-3.85), limited in activities due to age for Latvia (3.01; 2.95-3.08), nervousness since Covid-19 for Lithuania (2.08; 2.04-2.12). All predictors were statistically significant for all three Baltic countries. Conclusions The results in all three Baltic States indicated a similar trend that, taking into account the influence of other factors, the most important predictive factors were related to health and demographic indicators. Only one factor related to the first wave of Covid-19 (in Latvia - nervousness since Covid-19, in Lithuania and Estonia - less or no direct contact with children since Covid-19) predicts deterioration in health. Key messages The results indicate that deterioration in health cannot currently be considered to be caused by the first wave of Covid-19. Further research to assess long-term impact of Covid-19 to health is needed.

This research is aimed to analyse the role of current and retrospective factors in participation in educational and training courses among 50-64year-old adults from the Baltic states. A sample of 3448 working age adults was drawn from SHARE wave 7 database Analysis shows significant cross-country differences with the highest proportion of attendance in Estonia. Participation is related to personality traits, being active in the labour market, education level and some retrospective factors.