Pandemic has left the elderly more sedentary

Cindy Myers, an executive at a nonprofit organization, said that even in normal times she is not very active. “I work sitting at a desk. I don’t do much physical exercise.”

Even so, before the pandemic, she, who is 64 years old and has a doctorate in organization development, commuted daily from her home in Petaluma, Calif., to her office in San Francisco. She would meet friends for lunch or coffee and attend restaurants, theaters and lectures with her wife. “There was a lot more variety in my life, more places, more people,” she said. “You’re not even aware of how much you’re moving.”

Like many company employees, Myers has now been working remotely for two years, reducing the social and cultural events he attends and avoiding commuting. All of this, she said, possibly also exacerbated by a phase of depression she suffered in 2020, had physical consequences. Your arms and legs are weakened and your balance has deteriorated; Myers has suffered several falls.

“Some very basic types of movement that you always found natural, like walking from one end of the house to the other, are now exhausting,” she commented. “I’m worried.”

Many health experts are concerned about the loss of fitness and mobility seen among older adults since Covid profoundly altered people’s routines. Recent research indicates that many people who have had mild to moderate cases of Covid and even some who have managed to avoid the coronavirus altogether may be experiencing functional decline.

Much of the attention so far focused on the effects of the pandemic on the elderly population has focused on the high mortality rate. Nearly three-quarters of Americans who died from Covid were 65 or older.

Researchers also report that older adults whose Covid symptoms have worsened to the point of requiring hospital admission in many cases already had previous physical and mental health problems.

“When you’re hospitalized and you’re elderly, it takes a long time to recover,” said Marla Beauchamp, who studies mobility, aging and chronic disease at McMaster University in Hamilton, Ontario. “Covid continues to impact seniors significantly even many months later.”

But the milder Covid can also affect people’s physical ability. Beauchamp led a recent study of Canadians over 50 who had confirmed, probable or suspected Covid in 2020, when testing was not yet widely available. The study revealed a deterioration in mobility among those who had mild to moderate symptoms — 93% of whom were not even hospitalized — when compared to people without Covid.

Nearly half of people age 65 and older who contracted Covid reported being less able to engage in physical activity like walking and exercise than they had before the pandemic — but a quarter of people in the same age group who didn’t contract the virus reported the same thing. A smaller share of the uninfected said their ability to move around the house and perform household tasks like dusting furniture and washing dishes had also declined.

While some of this decline may reflect normal aging, the study tracked the changes over a period of just nine months. Among people who haven’t had Covid, “the most plausible reason for the decline is the health restrictions put in place during the pandemic,” Beauchamp said.

Decline in physical function has also been noted in older Americans. In early 2021 a team from the University of Michigan studied nearly 2,000 American adults ages 50 to 80, asking about their activity levels (but not about Covid).

Nearly 40% of people over 65 surveyed reported that their physical activity has decreased since the start of the pandemic in March 2020, as has the amount of time they spend standing. In this nationally representative sample, these factors were associated with a deterioration in fitness and mobility.

“It’s a cascade of effects,” said Geoffrey Hoffman, a health services researcher at the university’s School of Nursing and lead author of the study. “It all starts with changes in activity levels. This leads to a deterioration in function, which in turn is associated with falls and a fear of falling.”

Beauchamp added: “It’s really concerning to see this reduction in mobility. It tells us that the pandemic itself has had a significant impact on older adults.”

These observational studies done in Canada and the United States did not investigate the reasons for the self-reported increase in physical decline. But the study authors suggested that restrictions linked to the pandemic may have triggered physical deconditioning, even in people who didn’t contract Covid.

Not only have gyms, yoga studios, swimming pools, community centers and senior centers closed for long periods, many seniors have reduced their normal chores and may have avoided their usual hobbies.

“If a person starts going out to the supermarket less often or has the groceries delivered to their house, if they stop visiting their grandchildren or helping to take care of them, if they stop meeting their friends at a cafe – all these things involve a certain level of physical activity,” said Beauchamp.

Many elderly people went out less and avoided shopping in person. Religious services, family gatherings and medical appointments have also moved online. “Think about how much physical activity we do without even thinking about it,” Hoffman said. When that changes too much “and these changes persist for six or nine months, the result is a loss of balance and muscle strength, which leads to more trips and falls.”

Health and income disparities also appear to play a role. Decreased mobility and fitness were more frequently reported in both the US and Canada by lower-income respondents, whether they were in good or poor health or suffered from a variety of chronic health conditions.

“Older, relatively healthy adults have sufficient health reserves, even if they reduce their activity,” explained geriatrician Neil Alexander of the University of Michigan, who was not involved in the study. “These numbers may reflect people at high risk.”

He also highlighted that at the beginning of the pandemic, older patients had less access to rehabilitation and other services. “It was difficult to get physical therapists or occupational therapists into patients’ homes,” he explained. “Support services that help keep people mobile and functioning well have been discontinued.” He highlighted that at the moment, the shortage of professionals may be having a similar effect.

Physical function is crucial to living independently, the future to which the vast majority of older people aspire. A loss of mobility and function in a considerable portion of the elderly population can result in increased disability, a greater need for eventual long-term care, and higher medical costs.

But that’s not inevitable, Hoffman said. “Physical deconditioning can be reversed. It is possible to regain mobility.”

Translation by Clara Allain