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      Changes in Health Behaviors, Mental and Physical Health among Older Adults under Severe Lockdown Restrictions during the COVID-19 Pandemic in Spain

      research-article
      1 , 2 , 3 , * , 1 , 2 , 3 , 4 , 5 , 6 , 7 , 7 , 8 , 5 , 9 , 10 , 6 , 7 , 11 , 12 , 13 , 14 , 1 , 2 , 3 , 15 , 16 , 4 , 5 , 7 , 17 , 7 , 18 , 1 , 2 , 3 , 7 , 8 , 1 , 2 , 3 , 1 , 2 , 3 , 19 , 4 , 5 , 5 , 9 , 10 , 6 , 7 , 7 , 8 , 5 , 9 , 10 , 1 , 2 , 3 , 16
      International Journal of Environmental Research and Public Health
      MDPI
      COVID-19, lockdown, confinement, elderly, lifestyle behaviors, mental health, chronic pain

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          Abstract

          We used data from 3041 participants in four cohorts of community-dwelling individuals aged ≥65 years in Spain collected through a pre-pandemic face-to-face interview and a telephone interview conducted between weeks 7 to 15 after the beginning of the COVID-19 lockdown. On average, the confinement was not associated with a deterioration in lifestyle risk factors (smoking, alcohol intake, diet, or weight), except for a decreased physical activity and increased sedentary time, which reversed with the end of confinement. However, chronic pain worsened, and moderate declines in mental health, that did not seem to reverse after restrictions were lifted, were observed. Males, older adults with greater social isolation or greater feelings of loneliness, those with poorer housing conditions, as well as those with a higher prevalence of chronic morbidities were at increased risk of developing unhealthier lifestyles or mental health declines with confinement. On the other hand, previously having a greater adherence to the Mediterranean diet and doing more physical activity protected older adults from developing unhealthier lifestyles with confinement. If another lockdown were imposed during this or future pandemics, public health programs should specially address the needs of older individuals with male sex, greater social isolation, sub-optimal housing conditions, and chronic morbidities because of their greater vulnerability to the enacted movement restrictions.

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          Most cited references67

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          International physical activity questionnaire: 12-country reliability and validity.

          Physical inactivity is a global concern, but diverse physical activity measures in use prevent international comparisons. The International Physical Activity Questionnaire (IPAQ) was developed as an instrument for cross-national monitoring of physical activity and inactivity. Between 1997 and 1998, an International Consensus Group developed four long and four short forms of the IPAQ instruments (administered by telephone interview or self-administration, with two alternate reference periods, either the "last 7 d" or a "usual week" of recalled physical activity). During 2000, 14 centers from 12 countries collected reliability and/or validity data on at least two of the eight IPAQ instruments. Test-retest repeatability was assessed within the same week. Concurrent (inter-method) validity was assessed at the same administration, and criterion IPAQ validity was assessed against the CSA (now MTI) accelerometer. Spearman's correlation coefficients are reported, based on the total reported physical activity. Overall, the IPAQ questionnaires produced repeatable data (Spearman's rho clustered around 0.8), with comparable data from short and long forms. Criterion validity had a median rho of about 0.30, which was comparable to most other self-report validation studies. The "usual week" and "last 7 d" reference periods performed similarly, and the reliability of telephone administration was similar to the self-administered mode. The IPAQ instruments have acceptable measurement properties, at least as good as other established self-reports. Considering the diverse samples in this study, IPAQ has reasonable measurement properties for monitoring population levels of physical activity among 18- to 65-yr-old adults in diverse settings. The short IPAQ form "last 7 d recall" is recommended for national monitoring and the long form for research requiring more detailed assessment.
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            Frailty in Older Adults: Evidence for a Phenotype

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              A Short Scale for Measuring Loneliness in Large Surveys: Results From Two Population-Based Studies.

              Most studies of social relationships in later life focus on the amount of social contact, not on individuals' perceptions of social isolation. However, loneliness is likely to be an important aspect of aging. A major limiting factor in studying loneliness has been the lack of a measure suitable for large-scale social surveys. This article describes a short loneliness scale developed specifically for use on a telephone survey. The scale has three items and a simplified set of response categories but appears to measure overall loneliness quite well. The authors also document the relationship between loneliness and several commonly used measures of objective social isolation. As expected, they find that objective and subjective isolation are related. However, the relationship is relatively modest, indicating that the quantitative and qualitative aspects of social relationships are distinct. This result suggests the importance of studying both dimensions of social relationships in the aging process.
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                Author and article information

                Contributors
                Role: Academic Editor
                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
                01 July 2021
                July 2021
                : 18
                : 13
                : 7067
                Affiliations
                [1 ]Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain; ortolarosario@ 123456gmail.com (R.O.); mercedes.sotos@ 123456uam.es (M.S.-P.); Joseramon.banegas@ 123456uam.es (J.R.B.); ellen.struijk@ 123456uam.es (E.A.S.); d.martinez@ 123456uam.es (D.M.-G.); fernando.artalejo@ 123456uam.es (F.R.-A.)
                [2 ]IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), 28029 Madrid, Spain
                [3 ]CIBERESP (CIBER of Epidemiology and Public Health), 28029 Madrid, Spain
                [4 ]Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain; i.gine@ 123456pssjd.org (I.G.-V.); beatriz.olaya@ 123456pssjd.org (B.O.); jmharo@ 123456pssjd.org (J.M.H.)
                [5 ]CIBERSAM (CIBER of Mental Health), 28029 Madrid, Spain; elvira.lara@ 123456uam.es (E.L.); joseluis.ayuso@ 123456uam.es (J.L.A.-M.); marta.miret@ 123456uam.es (M.M.)
                [6 ]Foundation for Biomedical Research, Getafe University Hospital, 28905 Getafe, Spain; jcarnice@ 123456est-econ.uc3m.es (J.A.C.); a.alvarezbu@ 123456gmail.com (A.A.-B.); leocadio.rodriguez@ 123456salud.madrid.org (L.R.-M.)
                [7 ]CIBERFES (CIBER of Frailty and Healthy Aging), Instituto de Salud Carlos III, 28029 Madrid, Spain; asier.manas@ 123456uclm.es (A.M.); franjogarcia@ 123456me.com (F.J.G.-G.); narcis.gusi@ 123456gmail.com (N.G.); Irene.Rodriguez@ 123456uclm.es (I.R.-G.); ignacio.ara@ 123456uclm.es (I.A.)
                [8 ]GENUD Toledo Research Group, Universidad de Castilla-La Mancha, 45004 Toledo, Spain
                [9 ]Department of Psychiatry, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain
                [10 ]Department of Psychiatry, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Hospital Universitario de La Princesa, 28006 Madrid, Spain
                [11 ]GENUD (Growth, Exercise, Nutrition and Development) Research Group, Instituto Agroalimentario de Aragón IA2, Universidad de Zaragoza, 50013 Zaragoza, Spain; gervicen@ 123456unizar.es
                [12 ]CIBEROBN (CIBER of Obesity and Nutrition), 28029 Madrid, Spain
                [13 ]Faculty of Health and Sport Science, University of Zaragoza, 22001 Huesca, Spain
                [14 ]Department of Physiatry and Nursing, University of Zaragoza, 22002 Aragón, Spain
                [15 ]Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
                [16 ]IMDEA-Food Institute, CEI UAM+CSIC, 28049 Madrid, Spain
                [17 ]Hospital Virgen del Valle, Complejo Hospitalario de Toledo, 45071 Toledo, Spain
                [18 ]AFYCAV (Physical Activity, Quality of Life and Health) Research Group, Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
                [19 ]Department of Medicine, School of Medicine and Health Sciences, Universidad de Oviedo/ISPA, 33003 Oviedo, Spain; lanalberto@ 123456uniovi.es
                Author notes
                [* ]Correspondence: esthergge@ 123456gmail.com
                Author information
                https://orcid.org/0000-0002-8688-5174
                https://orcid.org/0000-0001-6952-9533
                https://orcid.org/0000-0002-6725-2638
                https://orcid.org/0000-0002-1683-1365
                https://orcid.org/0000-0002-7424-2198
                https://orcid.org/0000-0002-4303-4097
                https://orcid.org/0000-0001-9127-2586
                https://orcid.org/0000-0003-2046-3929
                https://orcid.org/0000-0001-6152-9862
                https://orcid.org/0000-0002-1622-7109
                https://orcid.org/0000-0002-2854-6684
                https://orcid.org/0000-0003-3252-854X
                https://orcid.org/0000-0001-9317-5755
                Article
                ijerph-18-07067
                10.3390/ijerph18137067
                8297096
                34281004
                afdb4227-e226-45f9-94b9-398eb5135c3c
                © 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 ( https://creativecommons.org/licenses/by/4.0/).

                History
                : 03 June 2021
                : 30 June 2021
                Categories
                Article

                Public health
                covid-19,lockdown,confinement,elderly,lifestyle behaviors,mental health,chronic pain
                Public health
                covid-19, lockdown, confinement, elderly, lifestyle behaviors, mental health, chronic pain

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