Poor Health Behaviors among Housebound Japanese Community-Dwelling Older Adults Due to Prolonged Self-Restraint during the First COVID-19 Pandemic: A Cross-Sectional Survey

Abstract

Background Prolonged self-restraining behaviors induced by the coronavirus disease 2019 (COVID-19) pandemic’s containment measures can limit various positive health behaviors. Objective We examined the decline in going-out and certain other positive health behaviors and investigated the relationship between excessive decreases in going-out frequency and declining engagement in positive health behaviors among community-dwelling older adults during the self-restraint period. Design This study employed a cross-sectional survey design. Setting This study was conducted in Nishi Tokyo City, Tokyo, Japan. Participants The participants were 294 respondents (150 women) aged 50 years and older who lived in public housing that were permitted to be surveyed during the self-restraint period. Measurements Their pre-pandemic going-out frequency around February 2020 and going-out frequency during the self-restraint period starting in April 2020 were reported. We mainly assessed the existence of home health behaviors (i.e., exercise, in-person and phone conversations, and healthy diet). A self-report questionnaire was used to obtain data. Results Going-out frequency decreased in 41.2% of the 294 respondents owing to the government’s request for self-restraint. In total, 13 individuals had been going out less than one time per week (housebound) before the request. Of the 281 people who were not housebound before the government’s self-restraint request, 13.9% were newly housebound. Newly housebound individuals were 5.3 times less likely to exercise, had 2.1 times fewer social contacts, and 2.6 times less balanced or healthy diets than those who maintained their frequency of going out. Conclusions Prolonged self-restraint due to the COVID-19 pandemic may lead to housebound status and poor health behaviors. Public health intervention is needed to prevent excessive self-restraint, along with new measures integrating information and communication technologies to enable older adults to live active lives.

Impact of social engagement on the development of sarcopenia among community‐dwelling older adults: A Kashiwa cohort study

“…These circumstances not only make it more challenging to engage socially, but also lead to decreased physical activity or muscle loss. 29,30 The present study has several strengths. First, because we assessed varied items, we could develop a multidimensional factor hypothesis model.…”

“…However, the COVID‐19 pandemic drastically disrupted routines and social connections, and increased social isolation, particularly in older adults. These circumstances not only make it more challenging to engage socially, but also lead to decreased physical activity or muscle loss 29,30 …”

Association of decreased frequency of conversation with depression, oral function and eating alone: A cross‐sectional study of older adults during the COVID‐19 pandemic

“…9 Tanaka et al studied the changes in the frequency of going out during the COVID-19 pandemic in relation to health behaviors including the opportunity to talk to people. 1 They focused on older adults with decreased opportunities for conversation, and examined the association with opportunities to go out. However, although these studies used "frailty" and "frequency of going out" as the main outcome, we chose to focus on the subjective sense of a decrease in opportunities for conversation as the main outcome, and considered frailty as an associated factor of opportunities for conversation.…”

“…Due to the government's self-restraint policy in 2020, a decrease in the frequency of outings among communitydwelling older adults was reported. 1 More specifically, the time older adults living in a continuing care retirement community spent in common areas and their walking distance decreased after the declaration of the state of emergency. 2 From January to April 2020, when COVID-19 began to spread, the total physical activity time per week for community-dwelling older adults decreased by 26.5% (65 min).…”

“…Because older adults are more susceptible to severe symptoms of infection, exercise classes, club activities and volunteer activities that cater to them were cancelled. Due to the government's self‐restraint policy in 2020, a decrease in the frequency of outings among community‐dwelling older adults was reported 1 . More specifically, the time older adults living in a continuing care retirement community spent in common areas and their walking distance decreased after the declaration of the state of emergency 2 .…”