Impacts of COVID-19 lockdowns on frailty and wellbeing in older people and those living with long-term conditions

Abstract

Lockdowns and social distancing have been important and successful strategies to limit the spread of the coronavirus disease 2019 (COVID-19) virus. However, excess deaths related to non-COVID-19 causes have been reported, suggesting issues around availability and use of health services, particularly for people with conditions needing ongoing medical support. In addition, evidence indicates that a range of age-related diseases and frailty are impacted by physical activity and social engagement, both limited in lockdown situations. It is therefore important to learn from the effects of lockdowns in order to limit any impacts, while still protecting people from the infection. This editorial summarizes two research themes at the Centre for Ageing Research at Lancaster University in the UK, one assessing impacts of lockdown for people living with a long-term neurodegenerative condition, Parkinson's disease, and one assessing longitudinal impacts on frailty and wellbeing, with older adults aged over 70, including those living with at least one long-term condition. Uncertainty related to Parkinson's disease and to COVID-19 amplified each other, and cancelled clinical appointments and limitations on physical activity had very significant impacts on wellbeing for this group. In the longitudinal study, frailty was more severe during lockdown periods. While lockdowns reduce spread of the virus, becoming frailer could make older adults more vulnerable to the effects of the virus during these periods. Regular exercise during lockdown had beneficial effects aiding recovery once restrictions relaxed. These studies suggest factors that could lessen negative impacts of future lockdowns. Maintaining physical activity and providing access to health services during periods of lockdown are suggested as priorities.

Frailty trajectories in community‐dwelling older adults during COVID‐19 pandemic: The PRESTIGE study

“… 43 Moreover, in a prospective study conducted between May and October 2020 among older adults in England and Spain, it has been observed a reduction of frailty as the restriction measures become less stringent, 44 suggesting that such effect of pandemic on frailty status might be potentially reversible. 16 …”

“…depression, anxiety and loneliness), malnutrition (over‐ or under‐nutrition) and cognitive impairment, which may contribute to incidence and progression of frailty condition. 15 , 16 , 17 However, there is still a paucity of direct evidence on the impact of COVID‐19 outbreak on frailty status in a population‐based setting. Recently a novel conceptual model for frailty evaluation has been proposed, based on tenets of Comprehensive Geriatric Assessment (CGA) and called “multidimensional model”.…”

“…Also indirect effects of COVID‐19 pandemic, mainly related on restriction measures, have been extensively studied including the obvious difficulties in the access to care for subjects with chronic diseases, as well as with the impressive increased incidence of psychosocial disorders (e.g. depression, anxiety and loneliness), malnutrition (over‐ or under‐nutrition) and cognitive impairment, which may contribute to incidence and progression of frailty condition 15–17 . However, there is still a paucity of direct evidence on the impact of COVID‐19 outbreak on frailty status in a population‐based setting.…”

The Degree of Meeting the Needs of Older People with Frailty Syndrome in the Residential Environment in Relation to Interventions—Experimental Study

“…Frailty is a dynamic condition and contains physical, psychological, and social factors that interact with each other, disturb the body’s homeostasis of the organism and lead to negative consequences. This multifaceted approach seems appropriate for evaluating this problem in care planning [ 5 , 6 , 7 ]. From a clinical and physical point of view, the factors related to the aging of the body, such as a decrease in muscle strength, a decrease in lean body mass, a deterioration in balance, a decrease in endurance, a decrease in the ability to move as well as a reduction in physical activity, are considered factors in the development of the frailty.…”

Editorial: Psychological frailty in aging: Lifespan trajectories and emerging risks

“…Instead, what takes place is an interaction between socio-economic, familial, cognitive, and physiological factors present in aging (Navarro-Pardo et al, 2020). Similarly, the health crisis of COVID-19, as well as the psychosocial risks associated with the measures that governments around the world have adopted to stop the spread of the virus, could have a significant impact directly on physical health, mental health and frailty, as well as indirectly, as a consequence of restrictions in mobility, activity, and social and family relationships, isolation, increased difficulties in performing physical exercise, delay in access to services health and loss of autonomy, to benefit from other services that have moved to the online space (Lozupone et al, 2020;Maltese et al, 2020;Pelicioni et al, 2020;Holland et al, 2021;Garner et al, 2022).…”