在COVID-19期间初级和专科医疗服务使用减少的情况下，老年人的认知功能、身体功能和心理健康：HUNT研究

IF 5.4 2区医学 Q1 GERIATRICS & GERONTOLOGY

GeroScience Pub Date : 2025-09-27 DOI:10.1007/s11357-025-01909-x

Tanja Louise Ibsen,Ekaterina Zotcheva,Sverre Bergh,Debby Gerritsen,Gill Livingston,Hilde Lurås,Svenn-Erik Mamelund,Anne Marie Mork Rokstad,Bjørn Heine Strand,Richard C Oude Voshaar,Geir Selbæk

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引用次数: 0

摘要

COVID-19遏制措施减少了老年人获得医疗保健的机会，对认知、身体和精神健康的长期影响不确定。调查大流行期间初级和专科卫生保健服务使用的减少是否与社区居住老年人认知、身体和心理健康的变化有关，并注意性别差异。挪威Trøndelag健康研究在大流行之前（HUNT4 70 +, 2017-2019）和之后（HUNT AiT, 2021-2023）收集的数据包括5387名70岁以上的参与者（53%为女性）。考虑基线混杂因素的倾向评分匹配用于检查大流行前后卫生保健服务使用减少与认知、身体和心理健康变化之间的关系。与全科医生接触减少与女性认知能力下降更严重相关（moca变化- 0.32 [95% CI - 0.62, - 0.32]）。在身体或心理健康方面没有观察到差异。其他初级保健服务（例如，家庭护理、实际帮助）的减少与认知功能的更大下降有关（moca变化- 0.94[- 1.53,- 0.36]），特别是在男性中（moca变化- 2.12[- 3.13,- 1.11]）。男性的身体功能也有所下降（sppb变化- 1.06[- 1.79,- 0.33]）。在心理健康方面没有观察到差异。专科医疗服务的减少与整体样本的健康变化无关，但与女性身体功能的改善有关（sppb变化0.32[0.11,0.53]）。尽管大流行期间减少卫生保健服务使用与认知、身体和精神健康之间的关联有限，但研究结果强调了在公共卫生危机期间保持老年人获得初级保健的重要性。该研究已在ClinicalTrials.gov 02.02.2021进行预注册，识别号为NCT04792086。

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Cognitive function, physical function, and mental health in older adults amid reduced primary and specialist healthcare service use during COVID-19: the HUNT study.

COVID-19 containment measures reduced older adults' healthcare access, with uncertain long-term effects on cognitive, physical, and mental health. To investigate whether reductions in primary and specialist healthcare service use during the pandemic were associated with changes in cognitive, physical, and mental health in community-dwelling older adults, with attention to sex differences. Data from the Norwegian Trøndelag Health Study collected before (HUNT4 70 + , 2017-2019) and after the pandemic (HUNT AiT, 2021-2023) included 5387 participants (53% women) aged 70 + . Propensity score matching, accounting for baseline confounders, was used to examine associations between reduced healthcare service use and cognitive, physical, and mental health changes from pre- to post-pandemic. Reduced contact with general practitioners was associated with greater cognitive decline among women (MoCa-change - 0.32 [95% CI - 0.62, - 0.32]). No differences were observed in physical or mental health. Reductions in other primary care services (e.g., in-home nursing, practical assistance) were associated with greater decline in cognitive function (MoCa-change - 0.94 [- 1.53, - 0.36]), particularly among men (MoCa-change - 2.12 [- 3.13, - 1.11]). Men also had a decline in physical function (SPPB-change - 1.06 [- 1.79, - 0.33]). No differences in mental health were observed. Reductions in specialist healthcare services were unrelated to health changes in the overall sample but linked to improved physical function in women (SPPB-change 0.32 [0.11, 0.53]). Although associations between reduced healthcare service use during the pandemic and cognitive, physical, and mental health were limited, findings highlight the importance of sustaining access to primary care for older adults during public health crises.Trial registration The study is pre-registered at ClinicalTrials.gov 02.02.2021, with the identification number NCT04792086.

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来源期刊

GeroScience Medicine-Complementary and Alternative Medicine

CiteScore

10.50

自引率

5.40%

发文量

182

期刊介绍： GeroScience is a bi-monthly, international, peer-reviewed journal that publishes articles related to research in the biology of aging and research on biomedical applications that impact aging. The scope of articles to be considered include evolutionary biology, biophysics, genetics, genomics, proteomics, molecular biology, cell biology, biochemistry, endocrinology, immunology, physiology, pharmacology, neuroscience, and psychology.