Adults over age 50 who experience mild or moderate COVID-19 are at greater risk of worsening mobility and physical function even if hospitalization is not required to treat the virus, according to new research out of Dalhousie and other Canadian universities.
The findings, which used data from the Canadian Longitudinal Study on Aging (CLSA), highlight the burden of COVID-19 among middle-aged and older adults who are not hospitalized, and suggest that many patients who experience even mild COVID-19 have persistent and troublesome symptoms.
Researchers surveyed more than 24,000 people over the age of 50 from across Canada during the initial phase of the lockdown in 2020 to determine the effect of a COVID diagnosis on their mobility. Their findings were published Wednesday in the journal JAMA Network Open.
The team looked at mobility issues including difficulty getting up from sitting in a chair, ability to walk up and down stairs without assistance and walking two to three neighbourhood blocks, as well as changes in participants’ ability to move around the home, engage in housework and physical activity.
Susan Kirkland (shown left), a Dalhousie research professor and head of the school’s Department of Community Health and Epidemiology, co-authored the paper that is believed to be one of the first to evaluate the association between mobility and COVID-19 in older adults.
“We found that even those with mild and moderate illness due to COVID-19 experienced adverse changes in mobility and physical function compared to individuals without COVID-19,” says Dr. Kirkland.
“These findings are worth noting because they indicate that the negative effects of COVID-19 are much broader and impact a wider range of older adults than those who are hospitalized for COVID-19.”
Double the odds
Participants with COVID-19 had nearly double the odds of worsening mobility and physical function compared to those without COVID-19, although most had mild or moderate symptoms. Of the 2,748 individuals with confirmed, probable or suspected COVID-19, 94 per cent were not hospitalized.
Individuals with confirmed or probable COVID-19 had double the odds of worsening ability to engage in household activities and participate in physical activity than those without COVID-19. Similar results were found for those with suspected COVID-19.
“Our results showed there was a higher risk for mobility problems in people who were older, had lower income, those with three or more chronic conditions, low physical activity and poorer nutrition,” says Marla Beauchamp, an assistant professor in the School of Rehabilitation Science at McMaster.
“However, those factors alone did not account for the mobility problems we observed among people with COVID-19. Rehabilitation strategies need to be developed for adults who avoid hospitalization due to COVID-19 but still need support to restore their mobility and physical function.”
The researchers concluded that there is a need to further understand the long-term impacts of COVID-19 and consider “the development and implementation of effective intervention and management approaches to address any persistent deficits in mobility and functioning among those living in the community.”
Funding for the CLSA COVID-19 Questionnaire Study was provided by the Nova Scotia COVID-19 Health Research Coalition, the Public Health Agency of Canada, the Juravinski Research Institute and McMaster University.
The overall CLSA research platform is funded by the Government of Canada through the Canadian Institutes of Health Research and the Canada Foundation for Innovation.