Patterns of physical activity among nursing home residents before and during the Covid 19 pandemic—a systematic observation

Abstract

Background The Covid-19 outbreak in spring of 2020 posed an array of challenges for nursing homes, including promoting resident physical activity (PA). Given the diversity of factors affecting resident PA, we explored how activity patterns outside weekly-scheduled structured activities changed during the pandemic and what factors promoted or inhibited PA during the pandemic. Methods We conducted systematic direct observations over 823.5 h in eight nursing homes in Southern Germany in 2020 and 2021. Results: In 2020, 84.7% of person observation units were classified as sedentary (average activity level: 1.14 MET). In 2021, the percentage increased to 91.6% of observed person units (average activity level: 1.08 MET) (t = 6.947; p = .000). According to tree classification, influencing factors of PA included mealtime and daytime in 2020 and 2021, as well as presence of men residents only in 2020 and guided low threshold activities in 2021. Conclusions Nursing homes constitute highly sedentary places—an issue exacerbated by access restrictions for external activity experts and significant others as well as behavioural restrictions for residents during the Covid-19 pandemic. Staff could not compensate due to existing time restraints and lack of training in PA promotion. Based on our findings, we recommend future studies to develop feasible and resource-low activities to be integrated into the daily routines of nursing homes.

Effect of COVID‐19 on physical function decline predictors in nursing home residents

“…2 It might have been inevitable for elderly individuals at that time to have had increased sedentariness in care facilities, leading to further physical function decline. 3 Thus, the findings during the pandemic could be attributed to the overestimation of the physical function decline predictors. For example, among long-term nursing home residents during the pandemic, the prevalence of worsening cognitive function was observed, 4 assuming that the outbreak was in some way related to "Waking at midnight," as sleep disturbances are strongly associated with the abnormal daytime behavior of patients with dementia.…”

“…2 Heart failure (HF) has also been shown to be associated with an increased risk of dementia and AD in the elderly. 3 Although the mechanism underlying that relationship remains unclear, the reduced systemic perfusion may affect cerebral perfusion homeostasis. In the Framingham Offspring Cohort, a lower cardiac index was associated with decreased cerebral blood flow (CBF), decreased total brain matter volume, and was a significant predictor of AD.…”