COVID-19, Life, and Physical Activity in Community-Dwelling Older Adults: A Mediation Analysis

PURPOSE: In 2020, the coronavirus disease 2019 (COVID-19) pandemic adversely changed people’s lives. However, there is insufficient research on the changed lives and current life with the COVID-19. So, this study examined the association between the COVID-19, life, and change of physical activity in older adults.

DESIGN: Cross-sectional study.

METHOD: We extracted older adults’ data from the 2020 Korea Community Health Survey. The dependent variable was life score, which was measured using the question follows as: If your daily life status before the COVID-19 outbreak is 100 points and your daily life completely stopped with 0 points, what is your current status? The answer was scored to 100 (same) from 0 (completely stopped). The independent variable was whether participants have experienced isolation or hospitalization due to COVID-19 (0: No, 1: Yes). The mediation variable was the change of physical activity due to COVID-19, measured using the question follows as: Are there any changes in the amount of physical activity such as walking and exercise compared to before the COVID-19 pandemic? (0 = Increase and same, 1 = Decrease). We performed mediation analysis to examine the association between COVID-19, life score and the change in physical activity. The SAS program (SAS Institute, Cary, North Carolina) was used for data cleaning and descriptive statistic, and the Mplus (version 8.4, Los Angeles, CA, USA) was used for mediation analysis.

RESULT: The participants who experienced isolation and hospitalization were 154 (0.22%), and there are 67 (43.51%) males and 87 (56.49%) females. The average age of they are 73.50 years old (standard deviation = 6.78). The mediation analysis model indicates a significant association of isolation and hospitalization due to COVID-19 on the change in physical activity (β = 0.151, p<0.001) and life score (β = -5.770, p = 0.001). Furthermore, the change in physical activity has a significant association on life score (β = -10.773, p<0.001 ). The mediating effect compared to the total effect was 21.98%. The association of the COVID-19 on life can be explained by the direct effect (78.02%), but about 21.98% of the association is the indirect effect that occurs through the mediation variable.

CONCLUSION: First, there was a negative association between the changes in physical activity and life score. Second, isolation and hospitalization due to COVID-19 had a negative association with life. Third, changes in physical activity that mediate isolation and hospitalization and life of older adults had an indirect effect.

IMPACT STATEMENT: These results suggest that life changes have more negative associations with life than isolation caused by COVID-19 in older adults. The occupational therapist needs to understand the association between COVID-19 and occupation. In addition, it is necessary to mediate this to reduce the long-term relationship of COVID-19. This study comprehensively examined the association between lifestyle and life changes due to COVID-19. This suggests that it is necessary to evaluate and intervene in the lifestyle of participants after quarantine release and discharge. In addition, as an occupational therapist, the importance of lifestyle change due to COVID-19 should be recognized and applied to intervention.

References

Olaya, B., Moneta, M. V., Doménech-Abella, J., Miret, M., Bayes, I., Ayuso-Mateos, J. L., & Haro, J. M. (2017). Mobility difficulties, physical activity, and all-cause mortality risk in a nationally representative sample of older adults. Journals of Gerontology, 73(9), 1272-1279. https://doi.org/10.1093/gerona/glx121

Reiner, M., Niermann, C., Jekauc, D., & Woll, A. (2013). Long-term health benefits of physical activity – A systematic review of longitudinal studies. BMC Public Health, 13(1), 813. https://doi.org/10.1186/1471-2458-13-813