Functional Limitations Associated with Frailty Risk in Older Adults Increased after COVID-19 Infection in 2020 CDC NHIS Data

Abstract

Background: In 2020, the rise in COVID-19 infections swept the United States in an unprecedented wave that has widely affected communities, particularly for older adults. Individuals with frailty syndrome have increased adverse outcomes from COVID-19, and conversely, individuals following post-infection are at greater risk of developing frailty. Data from the 2020 CDC National Health Interview Survey for those 65 years and older assessed prevalence of functional, behavioral and affective limitations associated with frailty risk factors. Methods: Retrospective analysis of data collected by the CDC as part of their 2020 annual National Health Interview Survey using prospective sampling methods. Participants of study consisted of 1478 responses (5% of total responses collected). A nonparametric analysis was conducted using Kruskal Wallis (p < 0.05) and post hoc comparisons with Bonferroni’s adjustment was performed for three cohorts over the age of 65, those who: Tested negative for COVID-19; tested positive for COVID-19 with zero to mild symptoms; and tested positive for COVID-19 with moderate to severe symptoms. Results: Older adults with moderate to severe symptoms of COVID-19 demonstrated significant limitations associated with frailty risk, including feelings of tiredness, self-care limitations, and anxiety/depression compared to those negative for COVID-19. Having COVID-19 also resulted in a significantly greater need for walking assistance. Conclusions: Prevalence for limitations associated with frailty factors is greater in the community-dwelling older adult following COVID-19 infection, with symptom severity as a risk indicator. An effective follow-up screening performed at post-acute care discharge may help identify the occurrence and prevent the progression of frailty syndrome in the older adults compromised by COVID-19.