No abstract

Background COVID-19 has taken its toll on citizens in all 50 states of the United States. The United States (U.S.) leads the world with 30,291,863 confirmed reported cases and 549,664 deaths as of March 29, 2021 compared to globally confirmed cases at 127,442,926 and 2,787,915 deaths as of March 29, 2021. The U.S. federal government primarily left the response to the virus to individual states, and each implemented varying measures designed to protect health of citizens and the state’s economic well-being. Unintended consequences of the virus and measures to stop its spread may include decreased physical activity and exercise, shifting access and consumption of food, and lower quality-of-life. Therefore, our primary goal was to quantify the impact of COVID-19 on health and well-being by measuring changes in physical activity, mental health-quality of life, food security and nutrition in adults ages 40 and older. We believed shifts in health behaviors would be more prevalent in minorities, less educated, lower socio-economic status, older adults, and those with underlying health conditions, so a secondary goal was to determine the impact of COVID-19 on these sub-populations. Methods We conducted an online survey with 9969 adults 40 years and older between 9 August and 15 September 2020 in urban areas across the four U.S. census regions. The survey included questions about demographic variables, pre-existing health conditions, physical activity, access to food, quality-of-life, and nutritional food status and asked participants to respond with information from pre-pandemic and pandemic conditions. We used paired-sample t-tests to detect changes in variables after the start of the pandemic and Cohen’s d to determine effect sizes. Results Our main findings showed a decrease in physical activity since the onset of COVID-19 for minorities and non-minorities. Food security also slightly increased for minorities during the pandemic, but we found no other changes in food security, quality-of-life indicators, or nutritional status of those who responded to this survey. Conclusions It is concerning that physical activity declined. Such activity helps maintain physical and mental health, and it is also an important time to socialize for many older adults. In many ways, our data indicate that the older adult population in U.S. cities may be more resilient than expected during the pandemic. However, the pandemic could have negative impacts that we did not detect, either due to the survey instrument or the timing of our survey, so the health and well-being of older adults should continue to be monitored in order to mitigate potential negative impacts.

An ankle-brachial index (ABI) is determined by comparing blood pressures of the extremities. No study that compared the blood pressure measurements obtained by standard or vascular cuffs was found. This study investigated the reliability of ABI measures using standard and vascular pressure cuffs. Two raters measured 480 systolic blood pressures of 10 healthy participants using standard and vascular cuffs. Intrarater reliability for standard cuffs was weak (intraclass correlation coeffi cient [ICC] ϭ 0.42-0.63) and moderate to strong for vascular cuffs (ICC ϭ 0.70-0.87). Interrater reliability was moderate to strong for both standard and vascular cuffs (ICC ϭ 0.83-0.96). Reliability of ABI measures with vascular cuffs was moderate to strong. The results of this study suggest and recommend the vascular cuff for accurate measures to determine reliable ABI values. If a standard cuff is used, the blood pressure should be measured twice and averaged for the ABI calculation.