Examining the Effects of Participation in Leisure and Social Activities on General Health and Life Satisfaction of Older Canadian Adults With Disability

Background: The Health and well-being of older Canadian adults have been extensively studied; however, less is known about the health and well-being of older Canadian adults with a disability. Objective: This study was done to determine if participation in leisure and social activities has a significant independent effect on the overall health and life satisfaction of older Canadian adults with a disability. Methods: A secondary analysis of cross-sectional data from the 2006 Participation and Activity Limitation Surveys (PALS) was performed. Respondents were those who reported disability and were at least 65 years of age at the time of the PALS 2006 (n=7,500, representing 1,755,870 Canadians). “Participation in social and leisure activities” was measured based on four types of activities outside the home in 12 months prior to the survey. The single-item measure of self-rated health was used to measure overall health. Life satisfaction was measures based on five items. Weighted data were used to describe the target population. Two sets of multivariate logistic regressions were conducted based on data for the total sample, and separately for men and women using bootstrapped weights. Results: A significant independent effect of participation in leisure and social activities on the general health and life satisfaction of older Canadians with a disability, for both men and women, was confirmed. Conclusion: Participation in leisure and social activities is a potential venue to enhance the health and well-being of older Canadian adults with a disability.</jats:p

Multimorbidity resilience and COVID-19 pandemic self-reported impact and worry among older adults: a study based on the Canadian Longitudinal Study on Aging (CLSA)

Abstract Background The Coronavirus Disease-2019 (COVID-19) pandemic has created a spectrum of adversities that have affected older adults disproportionately. This paper examines older adults with multimorbidity using longitudinal data to ascertain why some of these vulnerable individuals coped with pandemic-induced risk and stressors better than others – termed multimorbidity resilience. We investigate pre-pandemic levels of functional, social and psychological forms of resilience among this sub-population of at-risk individuals on two outcomes – self-reported comprehensive pandemic impact and personal worry. Methods This study was conducted using Follow-up 1 data from the Canadian Longitudinal Study on Aging (CLSA), and the Baseline and Exit COVID-19 study, conducted between April and December in 2020. A final sub-group of 9211 older adults with two or more chronic health conditions were selected for analyses. Logistic regression and Generalized Linear Mixed Models were employed to test hypotheses between a multimorbidity resilience index and its three sub-indices measured using pre-pandemic Follow-up 1 data and the outcomes, including covariates. Results The multimorbidity resilience index was inversely associated with pandemic comprehensive impact at both COVID-19 Baseline wave (OR = 0.83, p &lt; 0.001, 95% CI: [0.80,0.86]), and Exit wave (OR = 0.84, p &lt; 0.001, 95% CI: [0.81,0.87]); and for personal worry at Exit (OR = 0.89, p &lt; 0.001, 95% CI: [0.86,0.93]), in the final models with all covariates. The full index was also associated with comprehensive impact between the COVID waves (estimate = − 0.19, p &lt; 0.001, 95% CI: [− 0.22, − 0.16]). Only the psychological resilience sub-index was inversely associated with comprehensive impact at both Baseline (OR = 0.89, p &lt; 0.001, 95% CI: [0.87,0.91]) and Exit waves (OR = 0.89, p &lt; 0.001, 95% CI: [0.87,0.91]), in the final model; and between these COVID waves (estimate = − 0.11, p &lt; 0.001, 95% CI: [− 0.13, − 0.10]). The social resilience sub-index exhibited a weak positive association (OR = 1.04, p &lt; 0.05, 95% CI: [1.01,1.07]) with personal worry, and the functional resilience measure was not associated with either outcome. Conclusions The findings show that psychological resilience is most pronounced in protecting against pandemic comprehensive impact and personal worry. In addition, several covariates were also associated with the outcomes. The findings are discussed in terms of developing or retrofitting innovative approaches to proactive coping among multimorbid older adults during both pre-pandemic and peri-pandemic periods. </jats:sec

Levels of Depression and Anxiety Among Informal Caregivers During the COVID-19 Pandemic: A Study Based on the Canadian Longitudinal Study on Aging

Abstract Objectives Studies on informal caregiving during the coronavirus disease 2019 (COVID-19) pandemic have mainly focused on subgroups of caregivers using cross-sectional or convenience samples, limiting the generalizability of findings. Conversely, this longitudinal study examines the effects of the pandemic and caregiving factors on depressive symptoms and anxiety over 9 months among informal caregivers in Canada. Methods This study uses data from the Baseline (2011–2015), Follow-up 1 (2015–2018), and COVID-19 Study Baseline survey (April to May 2020) and Exit surveys (September to December 2020) of the Canadian Longitudinal Study on Aging (CLSA). A total of 14,118 CLSA participants who were caregivers at Follow-up 1 and participated in the COVID-19 studies were selected. Linear mixed models were used to examine the effect of sex of caregiver, changes in caregiving (increase in caregiving hours and inability to care), and location of care (same household, another household, and health care institution) on depressive symptoms and anxiety from COVID-19 studies Baseline to Exit surveys (about 6–7 months apart). Results Informal caregivers reported more frequent depressive symptoms from the COVID-19 Baseline to Exit surveys, but not anxiety. Female caregivers reported greater depressive symptoms and anxiety, and male caregivers exhibited a greater increase in depressive symptoms and anxiety over time. More caregiving hours and inability to provide care were significantly positively associated with depressive symptoms and anxiety. Also, in-home caregivers reported more depressive symptoms and anxiety than those who cared for someone in health care institution, and more anxiety than those who cared for some in another household. Discussion The findings shed light on the change in mental health among informal caregivers during the outset of the pandemic. The demonstrated associations between studied variables and mental health among informal caregivers provide empirical evidence for intervention programs aiming to support caregivers, particularly those who are female, and providing intensive care at home. </jats:sec

Persistent COVID-19 symptoms in community-living older adults from the Canadian Longitudinal Study on Aging (CLSA)

Abstract Background Symptom persistence in non-hospitalized COVID-19 patients, also known as Long COVID or Post-acute Sequelae of COVID-19, is not well characterized or understood, and few studies have included non-COVID-19 control groups. Methods We used data from a cross-sectional COVID-19 questionnaire (September-December 2020) linked to baseline (2011–2015) and follow-up (2015–2018) data from a population-based cohort including 23,757 adults 50+ years to examine how age, sex, and pre-pandemic physical, psychological, social, and functional health were related to the severity and persistence of 23 COVID-19-related symptoms experienced between March 2020 and questionnaire completion. Results The most common symptoms are fatigue, dry cough, muscle/joint pain, sore throat, headache, and runny nose; reported by over 25% of participant who had (n = 121) or did not have (n = 23,636) COVID-19 during the study period. The cumulative incidence of moderate/severe symptoms in people with COVID-19 is more than double that reported by people without COVID-19, with the absolute difference ranging from 16.8% (runny nose) to 37.8% (fatigue). Approximately 60% of male and 73% of female participants with COVID-19 report at least one symptom persisting &gt;1 month. Persistence &gt;1 month is higher in females (aIRR = 1.68; 95% CI: 1.03, 2.73) and those with multimorbidity (aIRR = 1.90; 95% CI: 1.02, 3.49); persistence &gt;3 months decreases by 15% with each unit increase in subjective social status after adjusting for age, sex and multimorbidity. Conclusions Many people living in the community who were not hospitalized for COVID-19 still experience symptoms 1- and 3-months post infection. These data suggest that additional supports, for example access to rehabilitative care, are needed to help some individuals fully recover. </jats:sec

Obesity and adverse childhood experiences in relation to stress during the COVID-19 pandemic: an analysis of the Canadian Longitudinal Study on Aging

Abstract Background People with obesity are at increased risk of chronic stress, and this may have been exacerbated during the COVID-19 pandemic. Adverse childhood experiences (ACE) are also associated with both obesity and stress, and may modify risk of stress among people with obesity. The objectives of this study were to evaluate the associations between obesity, ACEs, and stress during the pandemic, and to determine if the association between obesity and stress was modified by ACEs. Methods A longitudinal study was conducted among adults aged 50–96 years (n = 23,972) from the Canadian Longitudinal Study on Aging (CLSA) COVID-19 Study. Obesity and ACEs were collected pre-pandemic (2015–2018), and stress was measured at COVID-19 Exit Survey (Sept-Dec 2020). We used logistic, Poisson, and negative binomial regression to estimate relative risks (RRs) and 95% confidence intervals (CIs) for the associations between obesity, ACEs, and stress outcomes during the pandemic. Interaction by ACEs was evaluated on the additive and multiplicative scales. Results People with obesity were more likely to experience an increase in overall stressors (class III obesity vs. healthy weight RR = 1.19; 95% CI: 1.12–1.27) as well as increased health related stressors (class III obesity vs. healthy weight RR: 1.25; 95% CI: 1.12–1.39) but did not perceive the consequences of the pandemic as negative. ACEs were also associated an increase in overall stressors (4–8 ACEs vs. none RR = 1.38; 95% CI: 1.33–1.44) and being more likely to perceive the pandemic as negative (4–8 ACEs vs. none RR = 1.32; 95% CI: 1.19–1.47). The association between obesity and stress was not modified by ACEs. Conclusions Increased stress during the first year of the COVID-19 pandemic was observed among people with obesity or ACEs. The long-term outcomes of stress during the pandemic need to be determined. </jats:sec