Changes in physical and social activities among community‐dwelling Japanese older adults during three years of the <scp>COVID</scp>‐19 pandemic

Abstract

In May 2023, the legal status of the coronavirus disease 2019 (COVID-19) was changed from a category 2 to a category 5 infectious disease in Japan. Since 2020, there was a strong need for behavioral restrictions and infection control measures in Japan, resulting in significantly reduced physical and social activity among older adults.1-3 However, vaccinations began in the second year of the COVID-19 pandemic, and some behavioral restrictions eased as a consequence, leading to changes in the social environment. This follow-up survey aimed to determine changes in physical and social activities among community-dwelling older adults in Japan from January 2020 to January 2023, corresponding to the COVID-19 pandemic period. We conducted an online survey with community-dwelling older adults at four time points between 2020 and 2023 to examine physical and social activities in January of each year (January 2020,1 January 2021,2 January 2022,3 and January 2023). The analysis included participants who were not frail according to the Kihon Checklist4 at baseline and who responded to all four surveys. Among the 1600 participants in the baseline survey, 388 older adults were already frail, and 275, 140, and 83 participants did not respond to the first, second, and third follow-up surveys, respectively. Thus, there were 714 participants for analysis (follow-up rate: 58.9%). Physical activity was assessed using a short version of the International Physical Activity Questionnaire,5 and the total physical activity time per week was calculated for each period. In addition, we investigated social activity through a social participation score defined by eight types of activities (volunteer groups, sports groups, hobby groups, cultural clubs, senior citizen clubs, neighborhood associations, town events, and jobs) and by the frequency of each.3 The mean age, body mass index, and proportion of females in January 2020 were 72.9 ± 5.3 years, 22.3 ± 2.7 kg/m2, and 45.1% (n = 322), respectively. The trajectories of physical activity and social activity were similar over the 3 years of the COVID-19 pandemic (Fig. 1). The median (interquartile range) total physical activity durations in January 2020, 2021, 2022, and 2023 were 300 (120–563) min, 210 (40–420) min, 270 (60–540) min, and 300 (120–543) min, respectively. The median (IQR) total social participation scores in January 2020, 2021, 2022, and 2023 were 4 (0–7), 0 (0–4), 2 (0–5), and 3 (0–6) points, respectively. These findings indicate that both physical and social activities among older adults declined during the first year of the pandemic; however, a recovery trend was observed from the second year onwards, and both types of activity had almost returned to pre-pandemic levels 3 years later. In other words, restrictions on physical and social activities due to the COVID-19 pandemic persisted for 3 years. These results are crucial for managing frailty and disability in older populations, and it is therefore necessary to anticipate the possibility of future adverse health events caused by such restrictions. The authors declare no conflict of interest. We cannot publicly provide individual data due to participants' privacy, as specified by the ethics committee. The informed consent obtained does not include a provision for publicly sharing data.

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