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      The Effects of Cognitive Ability, Mental Health, and Self-Quarantining on Functional Ability of Older Adults During the COVID-19 Pandemic: Results From the Canadian Longitudinal Study on Aging

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          Abstract

          Objectives

          Determine whether levels of anxiety and depression, cognitive ability, and self-quarantining during and prior to the pandemic predict decreases in perceived functional ability.

          Design and Setting

          Longitudinal data collected from the Canadian Longitudinal Study on Aging (CLSA) COVID-19 Questionnaire Study (2020) and core CLSA study (Follow-Up 1; 2014-2018).

          Participants

          17 541 CLSA participants.

          Measurements

          Self-quarantining behaviours from questionnaires administered at Baseline (April 2020), Monthly, and Exit (December 2020) time points of the CLSA COVID-19 Questionnaire Study, levels of anxiety and depression at Baseline, perceived change in functional ability at Exit, and performance on neuropsychological tests (Rey Auditory Verbal Learning Task, Mental Alternation Task, Animal Fluency Test) and functional ability (Older Americans Resources and Services [OARS] Multidimensional Assessment Questionnaire) from the core CLSA study.

          Results

          Greater cognitive ability pre-pandemic ( B = −.003, P < .01), higher levels of anxiety ( B = −.024, P < .01) and depressive symptoms ( B = −.110, P < .01) at Baseline, and higher frequency of engaging in self-quarantining throughout the COVID-19 survey period ( B = −.098, P < .01) were associated with perceived loss in functional ability at Exit. Self-quarantining behaviour was associated with perceived loss in functional ability only at average and high levels of depressive symptoms ( B = −.013, P < .01).

          Conclusions

          Older adults with higher cognitive and lower functional ability prior to the pandemic were at greater risk of decreased perceived functional ability during the first year of the pandemic, as were those who experienced greater levels of anxiety and depressive symptoms during the pandemic. Strategies/interventions to preserve functional ability in older adults with cognitive independence prior to future pandemics are warranted.

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          Most cited references28

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          A brief measure for assessing generalized anxiety disorder: the GAD-7.

          Generalized anxiety disorder (GAD) is one of the most common mental disorders; however, there is no brief clinical measure for assessing GAD. The objective of this study was to develop a brief self-report scale to identify probable cases of GAD and evaluate its reliability and validity. A criterion-standard study was performed in 15 primary care clinics in the United States from November 2004 through June 2005. Of a total of 2740 adult patients completing a study questionnaire, 965 patients had a telephone interview with a mental health professional within 1 week. For criterion and construct validity, GAD self-report scale diagnoses were compared with independent diagnoses made by mental health professionals; functional status measures; disability days; and health care use. A 7-item anxiety scale (GAD-7) had good reliability, as well as criterion, construct, factorial, and procedural validity. A cut point was identified that optimized sensitivity (89%) and specificity (82%). Increasing scores on the scale were strongly associated with multiple domains of functional impairment (all 6 Medical Outcomes Study Short-Form General Health Survey scales and disability days). Although GAD and depression symptoms frequently co-occurred, factor analysis confirmed them as distinct dimensions. Moreover, GAD and depression symptoms had differing but independent effects on functional impairment and disability. There was good agreement between self-report and interviewer-administered versions of the scale. The GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research.
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            The CES-D Scale: A Self-Report Depression Scale for Research in the General Population

            L Radloff (1977)
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              The development, validity, and reliability of the OARS multidimensional functional assessment questionnaire.

              This report outlines the development, validity, and reliability of Part A of the OARS Multidimensional Functional Assessment Questionnaire. Part A permits assessment of individuals' functioning on each of five dimensions (social, economic, mental health, physical health and self-care capacity), the detailed information in each area being summarized on a 6-point rating scale by a rater. Content and consensual validity were ensured by the manner of construction. Information on criterion validity was obtained for all dimensions except social. The criterion used and their associated Kendall's Tau values were: an objective economic scale (.62); ratings based on personal interviews by geropsychiatrists (.60); physician's associates (.82); and physical therapists (.89). For 11 geographically dispersed raters from research and clinic settings, intraclass correlational coefficients, based on 30 subjects, ranged from .66 on physical health to .87 in self-care capacity; 74% of the ratings were in complete agreement, 24% differed by one point.
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                Author and article information

                Journal
                J Geriatr Psychiatry Neurol
                J Geriatr Psychiatry Neurol
                spjgp
                JGP
                Journal of Geriatric Psychiatry and Neurology
                SAGE Publications (Sage CA: Los Angeles, CA )
                0891-9887
                1552-5708
                20 December 2023
                July 2024
                : 37
                : 4
                : 307-317
                Affiliations
                [1 ]Department of Psychology, Ringgold 8205, universityUniversity of Victoria; , Victoria, BC, Canada
                [2 ]Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, Ringgold 3710, universityMcMaster University; , Hamilton, ON, Canada
                [3 ]McMaster Institute for Research on Aging, Ringgold 3710, universityMcMaster University; , Hamilton, ON, Canada
                [4 ]Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, Ringgold 5620, universityMcGill University; , Montreal, QC, Canada
                [5 ]Department of Medicine, Ringgold 70401, universityUniversity of Calgary Cumming School of Medicine; , Calgary, AB, Canada
                [6 ]Department of Community Health & Epidemiology and Division of Geriatric Medicine, Ringgold 3688, universityDalhousie University; , Halifax, NS, Canada
                [7 ]Neuropsychology and Cognitive Health, universityBaycrest Health Sciences Centre; , Toronto, ON, Canada
                Author notes
                [*]Theone S. E. Paterson, Department of Psychology, University of Victoria, P. O. Box 1700 STN CSC, Victoria, BC V8W 2Y2, Canada. Email: tpaterson@ 123456uvic.ca
                [*]

                These authors contributed equally to this work.

                Data Availability Statement included at the end of the article

                Author information
                https://orcid.org/0000-0002-4461-3621
                https://orcid.org/0000-0002-5876-1991
                Article
                10.1177_08919887231218755
                10.1177/08919887231218755
                11089823
                38116645
                6cfd54bd-ddcd-40cd-9ca6-4edf30526744
                © The Author(s) 2023

                This article is distributed under the terms of the Creative Commons Attribution 4.0 License ( https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the Sage and Open Access page ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 26 March 2023
                : 12 October 2023
                : 30 October 2023
                Funding
                Funded by: Nova Scotia COVID-19 Health Research Coalition;
                Funded by: Canadian Institutes of Health Research, FundRef https://doi.org/10.13039/501100000024;
                Award ID: LSA 94473
                Funded by: Michael Smith Health Research BC/Lotte & John Hecht Memorial Foundation Scholar Award;
                Award ID: SCH-2022-2664
                Funded by: Juravinski Research Institute;
                Funded by: Faculty of Health Sciences, McMaster University;
                Funded by: McMaster University, FundRef https://doi.org/10.13039/100009776;
                Funded by: McMaster Institute for Research on Aging;
                Funded by: Public Health Agency of Canada, FundRef https://doi.org/10.13039/100011094;
                Funded by: Canada Foundation for Innovation, FundRef https://doi.org/10.13039/501100001805;
                Funded by: McLaughlin Foundation Professorship in Population and Public Health;
                Categories
                Original Articles
                Custom metadata
                ts10

                canadian longitudinal study on aging,anxiety,depression,covid-19,functional ability,mental health,cognition

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