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Background: The COVID-19 pandemic has led to abrupt restrictions of lile-space mobility The impact of shelter-in-place orders on older adults’ health and well-being is still unclear Objective: To investigate the relationship between life-space mobility and quality of life (QoL) in older adults with and without frailty during the COVID-19 pandemic Design: Multicenter prospective cohort study based on structured telephone interviews Setting: Four geriatric outpatient clinics in the metropolitan area of Sao Paulo, Brazil Participants: 557 community-dwelling adults aged 60 years and older Measurements: The Life-Space Assessment was used to measure community mobility before and during the COVID-19 pandemic, and a previously validated decrease of ≥ 5 points defined restricted life-space mobility Frailty was assessed through the FRAIL (fatigue, resistance, ambulation, illnesses, and loss of weight) scale The impact of shelter-in-place orders on QoL was evaluated with the question «How is the COVID-19 pandemic affecting your QoL?», to which participants could respond «not at all», «to some extent», or «to a great extent» We used ordinal logistic regressions to investigate the relationship between restricted life-space mobility and impact on QoL, adjusting our analyses for demographics, frailty, comorbidities, cognition, functionality, loneliness, depression, and anxiety We explored whether frailty modified the association between life-space mobility and impact on QoL Results: Participants were on average 80±8 years old, 65% were women, and 33% were frail The COVID-19 quarantine led to a restriction of community mobility in 79% of participants and affected the QoL for 77% of participants We found that restricted life-space mobility was associated with impact on QoL in older adults during the pandemic, although frailty modified the magnitude of the association (P-value for interaction=0 03) Frail participants who experienced restricted life-space mobility had twice the odds of reporting an impact on QoL when compared with non-frail individuals, with respective adjusted odds ratios of 4 20 (95% CI=2 36–7 50) and 2 18 (95% CI=1 33–3 58) Conclusion: Older adults experienced substantial decreases in life-space mobility during the COVID-19 pandemic, and this unexpected change impacted their QoL Providers should be particularly watchful for the consequences of abrupt life-space restrictions on frail individuals © 2020, Serdi and Springer-Verlag International SAS, part of Springer Nature
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