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J Am Med Dir Assoc
. 2021 Feb 22;S1525-8610(21)00233-4.
doi: 10.1016/j.jamda.2021.02.019. Online ahead of print.
Increase in Frailty in Nursing Home Survivors of Coronavirus Disease 2019: Comparison With Noninfected Residents
Giada Ida Greco 1 , Marianna Noale 2 , Caterina Trevisan 3 , Giancarlo Zatti 1 , Martino Dalla Pozza 1 , Martina Lazzarin 1 , Labjona Haxhiaj 1 , Roberto Ramon 4 , Alessandra Imoscopi 4 , Stefano Bellon 4 , Stefania Maggi 2 , Giuseppe Sergi 1
Affiliations
- PMID: 33757725
- DOI: 10.1016/j.jamda.2021.02.019
Abstract
Objectives: Institutionalized older adults have a high prevalence of frailty and disability, which may make them more vulnerable to the negative consequences of coronavirus disease 2019 (COVID-19). We investigated the impact of COVID-19 on the level of frailty, physical, and cognitive performance in nursing home residents.
Design: Nested case-control study.
Setting and participants: The study included nursing home residents who were infected with COVID-19 (case group, n = 76), matched by age to a control group (n = 76).
Methods: Participants' sociodemographic and medical data were collected, and they were also assessed for physical function (handgrip and walking speed), cognitive performance (Mini-Mental State Examination) and frailty (Frail-NH scale) before the first wave of the COVID-19 pandemic (October to December 2019, pre-COVID-19) and after (June to July 2020, post-COVID-19). COVID-19 symptoms and clinical course were recorded for the cases.
Results: Between the pre- and post-COVID-19 assessments, we found a 19% greater deterioration in handgrip, a 22% greater increase in walking speed, and a 21% greater increase in Frail-NH scores in cases compared with controls. In both cases and controls, on the other hand, there was a significant 10% decrease in Mini-Mental State Examination scores over the study period. Multivariable logistic regression showed that COVID-19 survivors had a 4-fold increased chance of developing frailty compared with controls (odds ratio 4.95, 95% confidence interval 1.13-21.6, P = .03), but not cognitive decline.
Conclusions and implications: COVID-19 can accelerate the aging process of institutionalized older adults in terms of physical performance and frailty by around 20%. However, we found similar levels of decline in cognitive performance in both cases and controls, likely because of the burden of social isolation and containment measures on neuropsychological health.
Keywords: COVID-19; aged; frailty; nursing homes; physical functional performance.