COVID-19 Pandemic Impact on Trajectories in Cardiometabolic Health, Physical Activity, and Functioning Among Adults from the 2006–2020 Health and Retirement Study

Abstract

Abstract Background The aim of this study was to evaluate the impact of the COVID-19 pandemic on trajectories in cardiometabolic health, physical activity, and functioning among U.S. older adults, overall and according to selected baseline sociodemographic characteristics. Methods We performed secondary analyses using longitudinal data on 1,372 participants from the 2006–2020 Health and Retirement Study. Pre-post COVID-19 pandemic onset was examined in relation to body mass index (BMI), number of cardiometabolic risk factors and/or chronic conditions, physical activity, Activities of Daily Living (ADL), and Instrumental Activities of Daily Living (IADL) using mixed-effects regression models and group-based trajectory models. Results The COVID-19 pandemic was associated with significantly increased BMI (β = 1.39, 95% confidence interval [CI]: 0.74, 2.03). Furthermore, the odds of having at least one cardiometabolic risk factor and/or chronic disease increased pre-post COVID-19 onset (odds ratio 1.16, 95% CI: 1.00, 1.36), whereas physical functioning worsened pre-post COVID-19 onset (ADL: β = 1.11, 95% CI: 0.94, 1.28; IADL: β = 0.59, 95% CI: 0.46, 0.73). The pre-post COVID-19 period (2018–2020) showed a stable group of trajectories, with low, medium and high levels of the selected health indicators. Health disparities according to sex, race/ethnicity, educational level, work status, and total wealth are highlighted. Conclusions The COVID-19 pandemic onset appears to worsen cardiometabolic health and physical functioning among U.S. older adults, with clusters of individuals defined by selected sociodemographic characteristics experiencing distinct trajectories pre-post COVID-19 pandemic onset.