Background

The COVID-19 pandemic has affected mental health, psychological wellbeing, and social interactions. People with physical disabilities might be particularly likely to be negatively affected, but evidence is scarce. Our aim was to evaluate the emotional and social experience of older people with physical disabilities during the early months of the COVID-19 pandemic in England.

Methods

In this longitudinal cohort study, we analysed data from the English Longitudinal Study of Ageing collected in 2018–19 and June–July, 2020, from participants aged 52 years and older and living in England. Physical disability was defined as impairment in basic and instrumental activities of daily living (ADL) and impaired mobility. Depression, anxiety, loneliness, quality of life, sleep quality, and amount of real-time and written social contact were assessed online or by computer-assisted telephone interviews. Comparisons of experiences during the COVID-19 pandemic of people with and without a physical disability were adjusted statistically for pre-pandemic outcome measures, age, sex, wealth, ethnicity, presence of a spouse or partner, number of people in the household, and chronic pain. All participants with full data available for both surveys were included in the analyses.

Findings

Between June 3 and July 26, 2020, 5820 participants responded, 4887 of whom had full data available for both the pre-pandemic measures and the COVID-19 survey and were included in the analysis. During the COVID-19 pandemic, significantly more people with ADL impairment had clinically significant symptoms of depression (odds ratio 1·78 [95% CI 1·44–2·19]; p<0·0001), anxiety (2·23 [1·72–2·89]; p<0·0001), and loneliness (1·52 [1·26–1·84]; p<0·0001) than people without ADL impairment. Significantly more people with ADL impairment also had impaired sleep quality (1·44 [1·20–1·72]; p<0·0001) and poor quality of life than people without ADL impairment. The results were similar when disability was defined by impaired mobility. People with ADL impairment had less frequent real-time contact (0·70 [0·55–0·89]; p=0·0037) and written social contact (0·54 [0·45–0·64]; p<0·0001) with family than people without ADL impairment. Results for social contact were similar when disability was defined by impaired mobility.

Interpretation

People with physical disability might be at particular risk for emotional distress, poor quality of life, and low wellbeing during the COVID-19 pandemic, highlighting the need for additional support and targeted mental health services.

Funding

Economic and Social Research Council/UK Research and Innovation, National Institute on Aging, National Institute for Health Research.

中文翻译：

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COVID-19 大流行期间英格兰身体残疾老年人的心理健康和社会互动：一项纵向队列研究

背景

COVID-19 大流行影响了心理健康、心理健康和社交互动。身体残疾的人可能特别容易受到负面影响，但证据很少。我们的目的是评估在英格兰 COVID-19 大流行的最初几个月中身体残疾的老年人的情感和社会体验。

方法

在这项纵向队列研究中，我们分析了 2018-19 年和 2020 年 6-7 月收集的英国老龄化纵向研究的数据，这些数据来自 52 岁及以上且居住在英格兰的参与者。身体残疾被定义为日常生活中基本和工具性活动（ADL）的损害以及行动不便。在线或通过计算机辅助电话访谈评估抑郁、焦虑、孤独、生活质量、睡眠质量以及实时和书面社交联系的数量。对 COVID-19 大流行期间有和没有身体残疾的人的经历比较进行了统计调整，以针对大流行前的结果指标、年龄、性别、财富、种族、配偶或伴侣的存在、家庭中的人数以及慢性疼痛。

发现

在 2020 年 6 月 3 日至 7 月 26 日期间，5820 名参与者做出了回应，其中 4887 人拥有可用于大流行前措施和 COVID-19 调查的完整数据，并被纳入分析。在 COVID-19 大流行期间，明显更多的 ADL 障碍患者出现临床上显着的抑郁症状（优势比 1·78 [95% CI 1·44–2·19]；p<0·0001）、焦虑（2·23 [1·72–2·89]；p<0·0001) 和孤独感 (1·52 [1·26–1·84]；p<0·0001) 比没有 ADL 障碍的人。与没有 ADL 障碍的人相比，有明显更多的 ADL 障碍者睡眠质量受损 (1·44 [1·20–1·72]；p<0·0001) 和生活质量差。当残疾被定义为行动不便时，结果是相似的。有 ADL 障碍的人实时接触的频率较低（0·70 [0·55–0·89]；p=0·0037) 和书面社会接触 (0·54 [0·45–0·64]; p<0·0001) 与没有 ADL 障碍的人相比。当残疾被定义为行动不便时，社会接触的结果是相似的。

解释

在 COVID-19 大流行期间，身体残疾的人可能面临情绪困扰、生活质量差和幸福感低下的特别风险，这突出表明需要额外的支持和有针对性的心理健康服务。

资金

经济和社会研究委员会/英国研究与创新、国家老龄化研究所、国家健康研究所。