Physical Activity Changes and Its Risk Factors among Community-Dwelling Japanese Older Adults during the COVID-19 Epidemic: Associations with Subjective Well-Being and Health-Related Quality of Life

Abstract

Psychological distress caused by decreased physical activity (PA) is a growing concern among the elderly due to public health measures since the coronavirus disease (COVID-19). We aimed to (1) assess how public health restrictions impact PA, subjective well-being (SWB), and health-related quality of life (HRQoL) of community-dwelling elderly, and (2) investigate risk factors that lead to a decline in PA. Self-administered questionnaires assessed the changes in PA, SWB, HRQoL. Multivariate logistic regression analysis was performed to identify significant associated risk factors for decreased PA. Of 165 participants (valid response rate, 41.3%; mean age, 78.5 ± 8.0 years), 47.3% became less active, 23.0% became more active, and 29.7% maintained PA levels. There was a significant decrease in SWB at baseline and follow-up after COVID-19 restrictions in the less active group (p < 0.01). Higher levels of moderate or strenuous exercise/sports activity at baseline (odds ratio [OR], 1.12; 95% confidence interval [CI], 1.01–1.24), and lower mental component HRQoL scores at baseline (OR, 0.96; 95% CI, 0.93–0.99) were associated with an increased risk of decreased PA. Public health restrictions impact the PA of the elderly, especially those who had higher levels of exercise/sports activity and lower HRQoL before COVID-19. Decreased PA was strongly associated with lower SWB.

Depressive Symptoms, Fatigue and Social Relationships Influenced Physical Activity in Frail Older Community-Dwellers during the Spanish Lockdown due to the COVID-19 Pandemic

“…Previous studies from Italy and Japan also reported a decrease in PA [ 6 , 14 , 15 , 16 , 17 , 18 , 19 , 38 ]; or a rising prevalence of inactive older persons [ 18 , 19 ]. Despite the similarities in the mobility restriction measures among the three countries, the study populations are different: the Italian study used a cohort that underwent the implantation of a cardio meter-defibrillator before the pandemic [ 14 , 18 ] whereas the one enrolled by Suzuki et al [ 18 ] was discharged from a rehabilitation setting; both samples were significantly younger than ours. Compared with the study by Yamada et al, which showed a relevant prevalence of frailty (25%) [ 18 , 19 ], our population was older and frailer.…”

“…Despite the similarities in the mobility restriction measures among the three countries, the study populations are different: the Italian study used a cohort that underwent the implantation of a cardio meter-defibrillator before the pandemic [ 14 , 18 ] whereas the one enrolled by Suzuki et al [ 18 ] was discharged from a rehabilitation setting; both samples were significantly younger than ours. Compared with the study by Yamada et al, which showed a relevant prevalence of frailty (25%) [ 18 , 19 ], our population was older and frailer. The impact on the mental and physical health status of preventive social distancing measures in frail community-dwelling older adults has been poorly described.…”

“…PA has been previously described as a risk factor for frailty [ 8 , 9 , 10 ] and a key component of interventions to prevent or reduce the development and progression of frailty [ 3 , 11 , 12 , 13 ]. It has been estimated that the preventive measures applied during the COVID-19 pandemic led to a 25% reduction of PA in the general population [ 6 , 14 , 15 , 16 , 17 ], and more than 45% in older adults [ 6 , 14 , 15 , 16 , 18 , 19 ]. Despite these data, the possible determinants of this reduction in PA levels have not been explored yet.…”

Coping Mechanisms: Exploring Strategies Utilized by Japanese Healthcare Workers to Reduce Stress and Improve Mental Health during the COVID-19 Pandemic

“…Deterioration of people’s mental health has been a problem in past pandemics of widespread infectious diseases [ 7 , 8 , 9 , 10 ], but COVID-19 is a worldwide epidemic, and lockdowns and other movement restrictions have been taken in many countries. Even in Japan, such restrictions and tight medical care are unprecedented, and there is concern that mental health may deteriorate [ 11 , 12 ]. These conditions produced anxiety among healthcare workers because of fears of becoming infected themselves [ 13 ].…”

The Effect of the COVID-19 Pandemic Movement Restrictions on Self-Reported Physical Activity and Health in New Zealand: A Cross-Sectional Survey

“…These studies have indicated significant declines in self-reported physical activity levels during COVID-19 restrictions compared to before. Other studies have reported on the effects of the overall pandemic on PA levels in the context of mental health, specifically anxiety and depressive symptoms [ 27 , 28 , 29 , 30 ]. Studies that have investigated the effect of the overall pandemic on PA and well-being, found that reductions in PA and increases in sedentary behaviour (SB) were associated with poorer mental health and increased anxiety [ 14 , 16 , 18 , 21 , 24 , 31 ].…”