Perceived impacts of COVID-19 on wellbeing among US working-age adults with ADL difficulty.
Claire B Pendergrast, Shannon M Monnat
PMID 35643600WHAT IT FOUND
Working-age adults with severe difficulty in daily activities reported much higher rates of COVID-19 infection, hospitalization, and worsened physical health than those without.
They also reported more strain on family relationships, but no significant difference in financial impacts or ability to see a doctor.
Key findings
01Adults with ADL difficulty had 2.1 times the odds of reporting a COVID-19 infection and 6.7 times the odds of being hospitalized for it compared to those without ADL difficulty.
02Adults with ADL difficulty had twice the odds of reporting negative physical health impacts due to the pandemic, but the increase in negative mental health impacts did not reach statistical significance.
03There were no significant differences between groups in reported financial impacts or in the ability to see a doctor because of COVID-19.
STILL TO COME
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What it does not show
The study relied on self-reported data and cross-sectional design, so it cannot prove that ADL difficulty caused these outcomes; the difficulty may have resulted from the pandemic or other factors. The survey excluded people who died of COVID-19 before the survey or who could not access an online survey, likely underestimating the true disparity. The definition of ADL difficulty was strict ('a lot of difficulty'), and sensitivity analyses using a broader definition ('some' or 'a lot') showed different results for some outcomes, such as financial impacts. The sample was not necessarily representative of all people with ADL difficulties, particularly those in institutional settings or those who were most severely impacted.
Declared interests
The authors declare no conflicts of interest. The study was supported by grants from the National Institute on Aging and the Eunice Kennedy Shriver National Institute of Child Health and Human Development.
The easy way to misread this
Do not interpret the lack of significant difference in financial impacts or mental health as evidence that these domains were unaffected. The study found no significant difference compared to the non-ADL group, but both groups reported high rates of negative impacts, and the cross-sectional nature limits causal inference.