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      Depressive Symptoms, Fatigue and Social Relationships Influenced Physical Activity in Frail Older Community-Dwellers during the Spanish Lockdown due to the COVID-19 Pandemic

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          Abstract

          Due to the dramatic impact of the COVID-19 pandemic, Spain underwent a strict lockdown (March–May 2020). How the lockdown modified older adults’ physical activity (PA) has been poorly described. This research assesses the effect of the lockdown on PA levels and identifies predictors of sufficient/insufficient PA in frail older community-dwellers. Community-dwelling participants from the +ÀGIL Barcelona frailty intervention program, suspended during the pandemic, underwent a phone-assessment during the lockdown. PA was measured before and after the lockdown using the Brief Physical Activity Assessment Tool (BPAAT). We included 98 frail older adults free of COVID-19 (mean age = 82.7 years, 66.3% women, mean Short Physical Performance Battery = 8.1 points). About one third of participants (32.2%) were not meeting sufficient PA levels at the end of the lockdown. Depressive symptoms (OR = 0.12, CI95% = 0.02–0.55) and fatigue (OR = 0.11, CI95% = 0.03–0.44) decreased the odds of maintaining sufficient PA, whereas maintaining social networks (OR = 5.07, CI95% = 1.60–16.08) and reading (OR = 6.29, CI95% = 1.66–23.90) increased it. Living alone was associated with the reduction of PA levels (b = −1.30, CI95% = −2.14–−0.46). In our sample, pre-lockdown mental health, frailty-related symptoms and social relationships were consistently associated with both PA levels during-lockdown and pre-post change. These data suggest considering specific plans to maintain PA levels in frail older community-dwellers.

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          A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation

          The objective of this study was to develop a prospectively applicable method for classifying comorbid conditions which might alter the risk of mortality for use in longitudinal studies. A weighted index that takes into account the number and the seriousness of comorbid disease was developed in a cohort of 559 medical patients. The 1-yr mortality rates for the different scores were: "0", 12% (181); "1-2", 26% (225); "3-4", 52% (71); and "greater than or equal to 5", 85% (82). The index was tested for its ability to predict risk of death from comorbid disease in the second cohort of 685 patients during a 10-yr follow-up. The percent of patients who died of comorbid disease for the different scores were: "0", 8% (588); "1", 25% (54); "2", 48% (25); "greater than or equal to 3", 59% (18). With each increased level of the comorbidity index, there were stepwise increases in the cumulative mortality attributable to comorbid disease (log rank chi 2 = 165; p less than 0.0001). In this longer follow-up, age was also a predictor of mortality (p less than 0.001). The new index performed similarly to a previous system devised by Kaplan and Feinstein. The method of classifying comorbidity provides a simple, readily applicable and valid method of estimating risk of death from comorbid disease for use in longitudinal studies. Further work in larger populations is still required to refine the approach because the number of patients with any given condition in this study was relatively small.
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            Frailty in Older Adults: Evidence for a Phenotype

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              Assessment of Older People: Self-Maintaining and Instrumental Activities of Daily Living

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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                19 January 2021
                January 2021
                : 18
                : 2
                : 808
                Affiliations
                [1 ]Parc Sanitari Pere Virgili, Area of Intermediate Care, 08023 Barcelona, Spain; ccastellano@ 123456perevirgili.cat (C.C.-T.); lsoto@ 123456perevirgili.cat (L.S.-B.); jars@ 123456perevirgili.cat (J.A.); minzitari@ 123456perevirgili.cat (M.I.)
                [2 ]RE-FiT Barcelona Research Group, Vall d’Hebron Institute of Research & Parc Sanitari Pere Virgili, 08023 Barcelona, Spain; sbaro@ 123456perevirgili.cat (S.B.); pespi@ 123456perevirgili.cat (P.E.-V.)
                [3 ]GIES Research Group, Basic Psychology Department, Autonomous University of Barcelona, 08193 Bellaterra, Spain
                [4 ]Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, 20138 Milano, Italy; matteo.cesari@ 123456unimi.it
                [5 ]Department of Clinical Sciences and Community Health, Università di Milano, 20138 Milano, Italy
                [6 ]Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, 31008 Pamplona, Navarra, Spain; fabricio.zambom.ferraresi@ 123456navarra.es
                [7 ]Primary Healthcare Center Larrard, Atenció Primària Parc Sanitari Pere Virgili, 08023 Barcelona, Spain
                [8 ]Primary Healthcare Center Bordeta-Magòria, Institut Català de la Salut, 08014 Barcelona, Spain; fdiazg.bcn.ics@ 123456gencat.cat
                [9 ]Department of Health Sciences, Blanquerna—Ramon Llull University, 08022 Barcelona, Spain; jordivc@ 123456blanquerna.url.edu
                [10 ]Institut Català de la Salut, Gerència de Barcelona, 08007 Barcelona, Spain; menfedaque.bcn.ics@ 123456gencat.cat
                [11 ]Department of Medicine, Autonomous University of Barcelona, 08035 Barcelona, Spain
                Author notes
                [* ]Correspondence: lperez@ 123456perevirgili.cat ; Tel.: +34-932-594000
                Author information
                https://orcid.org/0000-0003-3152-9882
                https://orcid.org/0000-0002-8377-9827
                https://orcid.org/0000-0002-2150-8992
                https://orcid.org/0000-0002-3796-0625
                Article
                ijerph-18-00808
                10.3390/ijerph18020808
                7832838
                33477879
                3e4e9c5d-1e57-4c83-9f0c-61f96144fe73
                © 2021 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 21 December 2020
                : 13 January 2021
                Categories
                Article

                Public health
                covid-19,frailty,aging,physical activity,mental health,social relationships
                Public health
                covid-19, frailty, aging, physical activity, mental health, social relationships

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