Table 3 Characteristics of included studies on the lockdown impact of older adult’s residents in nursing homes health
From: How did COVID-19 lockdown impact the health of older adults in nursing homes? A scoping review
Authors, publication year, country | Aims of the study | Isolation measures | Data collection period | Study design | Residents (women) | Outcomes | |
|---|---|---|---|---|---|---|---|
Cortés-Zamora et al. 2020 [20]. Spain | To analyse psychological and functional consequences after the first wave of COVID-19 To analyze differences in psychological and functional variables, four phenotypes: COVID-19 no or low comorbidity” “COVID-19 no or high comorbidity” “COVID-19 yes/ low comorbidity” and “COVID-19 yes/high comorbidity | Not described | March-June 2020 June-November 2020 | Longitudinal cohort study | 215 (135 women) | At 3 months after the beginning of the COVID-19 pandemic: - Anxiety (HADS): prevalence increased 29.3% - Depression (HADS): prevalence increased 57.7% - Post-traumatic syndrome (TOP-8) present on 19.1%. of residents - Insomnia (IES) present on 93% of residents - Loss of functionality (FAC and MNA-SF) present in 47% | |
Crespo-Martín et al. 2022 [21] Spain | To understand underlying beliefs, values, and motivations behind individual health behaviors | Visitors ban Suspension of activities No interaction between residents (social distancing) | Two phases between May 2020 and December 2021 | Interpretative exploratory (Sandelowski model) | 24 (18 women) | Emotional impact (main topics): - Opposite feelings - Illness and death - Importance of routine - Feeling busy - Role of religious beliefs Support as a therapeutic instrument: - Family, roommates and staff | |
Curran et al. 2022 [22] Australia | To analyse changes in mental health (symptom burden) before the pandemic, following the first wave and following the second wave | Bespoke classification: mild RS: no non- essential visitors but alternative contact with family/carers/social network available (e.g. window visits or regular video calls) and at least 50% of usually scheduled internal activities continued; moderate RS: no or minimal alternative family/carers/social network visits and/or less than 50% of usually scheduled activities ongoing, but no restriction to individual rooms; severe RS: restriction to individual rooms for at least 3 weeks during wave two in addition to limited activities and social contact | October 1st, 2019, and February 1st, 2020 April 30th, 2020, and May 15th, 2020 September 27th, 2020, to October 18th, 2020 | Longitudinal retrospective | 91 (51 women) | - NPI-NH increased scores after the first wave (Mean: 19.0). Drop below initial scores after second wave (Mean: 15.5) - No significant changes comparing first and second wave scores with pre-pandemic | |
Egbujie et al. 2024 [23] Canada | Examine whether functional decline accelerated during the first wave of the COVID-19 pandemic (March to June 2020) | Restrictions on visits from family members or other visitors, | January 31, 2019, and June 30, 2020 | Population-based longitudinal | 199.598 (133.835 women) | - Higher rates of functional decline during the first wave of the COVD-19 pandemic: 23.3% vs 22.3%; (p < .0001) - Individuals 17% more likely to experiment functional decline during pandemic period - Environmental factors related to functional impairment: living in a large urban nursing home | |
El Haj et al. 2020 [24] France | To assess the increased symptoms of depression and anxiety in patients with Alzheimer’s disease during the pandemic | Significantly restricted visits since 15 March 2020 Activities considered as non-essential have been suspended, including restricting access to non-essential personnel | N/A | Quantitative, longitudinal | 58 (37 women) | - Depression (HADS) Greater depression during confinement (Mean: 14.21; SD: 3.17) than PRE-COVID (Mean: 12.34; SD: 4.10) - Anxiety (HADS): Increased anxiety during confinement. (Mean: 13.24, SD: 3.39) than PRE-COVID (Mean = 11.38, SD: 4.36) | |
El Haj & Gallouj 2022 [25] France | To assess the loneliness level in patients with Alzheimer’s disease | Visitors ban Limited communication between residents Social distancing | N/A | Cross-section descriptive | 63 (39 women) | - Depression (HADS) Greater depression during confinement (Mean: 14.21; SD: 3.17) than PRE-COVID (Mean: 12.34; SD: 4.10) - Anxiety (HADS): Increased anxiety during confinement. (Mean: 13.24, SD: 3.39) than PRE-COVID (Mean = 11.38, SD: 4.36) | |
Górski et al. 2021 [26] Poland | To assess the risk of suffering from depression and to explore the relationship between depression and cognitive impairment | Limitation of or ban on family visits, restricting contacts between the residents, and sometimes between the residents and staff. Ceased running group activities for the residents and holding communal meals | March- December, 2020 | Longitudinal descriptive | 273 (141 women) | - March: 16.1% MMSE scores within normal limits. No elevated risk of depression was detected - December: 10.3% MMSE scores within normal limits. Depression (DSI): 14.3% moderate risk: 14.3%, and high risk: 2.6% | |
Holston et al. 2024 [27] United States | Describe and understand the psychiatric symptoms experienced by older adults with mental health or neurocognitive conditions residing in skilled nursing facilities during the COVID-19 pandemic | Not described | March 2019 to March 2021 | Descriptive | 84 (49 women) | Cognitive impairment: - Pre COVID-19: Mean BIMS: 11.7 (moderate) - First year of COVID-19: Mean BIMS 11.6. (moderate) Depression levels: - Pre COVID-19: Mean PHQ-9 5.3 (mild) - First year of COVID-19: Mean PHQ-9 3.7 (none) First year of COVID: 67% symptoms related to altered behaviours, including delusions, disruptive physical and verbal behaviours, hallucinations, and inattentiveness | |
Huber & Seifert 2022 [28] Switzerland | To establish the correlation between loneliness and other independent variables | Not described | May 2021 | Retrospective descriptive Multivariate regression analysis | 828 (621 women) | Loneliness (LS): present in 23.5% Independent variables, subjective increase for: - Female sex - Less subjective enjoyment of life - Lower satisfaction with life - Less satisfaction with care received in residences | |
Johansson-Pajala et al. 2022 [29] Sweden | To understand the first wave impact of the pandemic (March–May 2020) on experiences of anxiety and loneliness | On April 1, 2020, visitor restrictions were implemented nationwide in nursing homes. In some nursing homes physical visits were replaced by social contact via telephone, video calls or through windows. However, home dwelling elders in Sweden were not subjected to visitor restrictions | March–May 2020 | National retrospective cross-sectional | 27,872 (18,871 women) | Ad hoc questionnaires: Anxiety: - Severe: 12% - Slight: 51% - No present: 37% Loneliness: - Often: 19% - Sometimes: 50% - No present: 30% | |
Kaelen et al. 2021 [30] Belgium | To explore what mental health and psychosocial needs identified and experienced by residents | Visitors ban Suspension of group activities No interaction between residents (social distancing) Outings ban | June 2020 | Thematic content analysis | 56 (35 women) | Main topics: - Loss of freedom - Loss of social life - Loss of distraction and stimulation - Loss of autonomy - Perception of wellbeing - Identified needs: social contact, freedom, activities, communication, and autonomy | |
Leontowitsch et al. 2023 [31] Germany | How older adults experienced lockdown from sociology, developmental psychology, and environmental gerontology perspectives | No visits from family members or friends No contact with other residents Little to no movement within the care home building Staff wearing full protective clothing Residents could only have one visit per week (starting from May 2020) for up to one hour by a close relative or friend, under strict conditions (mask-wearing, social distancing of 1.5 m, and no physical contact) | June 2020 | Thematic content analysis | 22 (14 women) | Three main themes emerged: [1] Care home settings and staff’s approach: - Ceasing or maintaining daily activities - Care home staff’s time and ability to turn a blind eye [2] Biographical sense of resilience: - Learning experiences from the past [3] A hierarchy of life issues: - Personal challenges - Challenges and hopes for society at large | |
Lood et al. 2021 [32] Sweden | To explore and describe the experiences of older adults | Visitors ban Outings ban Daily routines and essential activities could still be carried out Outside activities ban | June 2020 | Triangulation through constant comparative analysis | 10 (7 women) | Main topic: - It’s like living in a bubble Subtopics: - Live day to day without fear of the virus - Feel cared for - Having limited freedom - Missing out on the little extras | |
Nair et al. 2021 [33] Malaysia | To investigate the prevalence of depression, anxiety, and perceived social support | Not described | June -August 2020 | Cross-sectional descriptive | 224 (164 women) | - Depression (GDS-30): Prevalence 94.2% Severe depression: 50.9% - Anxiety (BAI): mild (36.6%) and moderate (38.4%) Perceived social support (MSPSS): low: 3.21 (SD: 0.89) | |
Pérez- Rodríguez et al. 2021 [34] Spain | To compare the functional, cognitive, and nutritional status before and after the first wave of the pandemic To assess differences between COVID and NON-COVID groups | Not described | May 21—June 21 2020 | Observational multicentre | 435 (341 women) | - Functional deterioration decreases of 20% in at least one BI category and 18.5% in at least one FAC category - Worsening of cognitive impairment of 22% in GDS and 25.9% in MEC Onset of depressive symptoms in 48% - Malnutrition prevalence (MNA-SF): increased by 36.8%. Weight loss: 38.4% | |
Rose et al. 2023 [35] | Examine the impact of the COVID-19 lockdown on anxiety symptoms | Restricted entry for visitors and nonessential personnel and ceased communal activities inside the facilities, | March 2019 and March 2021 | Latent growth curve modelling with psychiatric diagnosis, psychiatric medication, and demographic factors included as covariates | 1149 (806 women) | - Before the outbreak: Average anxiety level: 3.35 - After the outbreak: Average anxiety level: 3.41 - Mean difference (MD) in the intercepts (baseline anxiety levels): -0.058 (p < 0.005) - Effect size, measured by Cohen’s: d(-0.059), confidence interval ranging from -0.140 to 0.023 (suggests small effect) | |
Van der Roest et al. 2020 [36] Netherlands | To know the consequences of anti-COVID-19 measures on loneliness, mood, and behaviour problems | On March 20, Dutch government implemented a visitors ban in all nursing homes. Physical visits were replaced by social contact via telephone and video calls, or through windows. Many nursing homes closed social facilities and stopped daytime programs | May 2020 | Cross-sectional descriptive | 193 (N/A women) | Loneliness (MHI-5): 77% showed feelings of loneliness: - 50% moderately alone - 16% intensely - 11% very intensely alone | |