Title | Functional Decline in Long-Term Care Homes in the First Wave of the COVID-19 Pandemic: A Population-based Longitudinal Study in Five Canadian Provinces |
Publication Type | Journal Article |
Year of Publication | 2024 |
Authors | Egbujie BA, Turcotte LA, Heckman GA, Morris JN, Hirdes JP |
Journal | Journal of the American Medical Directors Association |
Volume | 25 |
Issue | 2 |
Pagination | 282-289 |
ISBN Number | 1538-9375 |
Accession Number | 37839468 |
Keywords | *COVID-19/epidemiology, *Long-Term Care, Activities of Daily Living, Aged, aging, cohort study, COVID-19, functional decline, Humans, InterRAI, Long-Term Care, Longitudinal Studies, Ontario/epidemiology, Pandemics |
Abstract | We aimed to examine whether functional decline accelerated during the first wave of the COVID-19 pandemic (March to June 2020) for persons in long-term care facilities (LTCs) in Canada compared with the pre-pandemic period. We conducted a population-based longitudinal study of persons receiving care in LTC homes in 5 Canadian provinces before and during the COVID-19 pandemic. Residents in 1326 LTC homes within the Canadian provinces of Alberta, British Columbia, Manitoba, Newfoundland & Labrador, and Ontario between January 31, 2019, and June 30, 2020, with activities of daily living Hierarchy scale less than 6 and so, who still have potential for decline (6 being the worst of the 0-6 scale). We fit a generalized estimating equation model with adjustment for repeated measures to obtain the adjusted odds of functional decline between COVID period exposed and unexposed pre-pandemic residents. LTC residents experienced slightly higher rates of functional decline during the first wave of the COVD-19 pandemic compared with the pre-pandemic period (23.3% vs 22.3%; P < .0001). The adjusted odds of functional decline were slightly greater during the pandemic (odds ratio [OR], 1.17; 95% CI, 1.15-1.20). Likewise, residents receiving care in large homes (OR, 1.20; 95% CI, 1.17-1.24) and urban-located LTC homes (OR, 1.20; 95% CI, 1.17-1.23), were more likely to experience functional decline during the COVID-19 pandemic. The odds of functional decline were also only significantly higher during the pandemic for LTC home residents in British Columbia (OR, 1.17; 95% CI, 1.11-1.23) and Ontario (OR, 1.25; 95% CI, 1.21-1.29). This study provides evidence that the odds of experiencing functional decline were somewhat greater during the first wave of the COVID-19 pandemic. It highlights the need to maintain physical activity and improve nutrition among older adults during periods of stress. The information would be helpful to health administrators and decision-makers seeking to understand how the COVID-19 pandemic and associated public health measures affected LTC residents' health outcomes. |
DOI | 10.1016/j.jamda.2023.09.007 |
Custom 1 | Disclosure The authors declare no conflicts of interest. |