Effect of COVID-19 on quality of life of persons aged >70 years with adult spinal deformity: A cross-sectional case-control study

María Luz Suárez-Huerta, Alejandro Gomez-Rice, Miguel Carvajal Alvarez, Iria Carla Vazquez Vecilla, Enrique Izquierdo-Nuñez, Manuel Fernandez-Gonzalez, Lorenzo Zuñiga-Gómez, Jesus Betegon-Nicolas, Sonia Sanchez-Campos, María Luz Suárez-Huerta, Alejandro Gomez-Rice, Miguel Carvajal Alvarez, Iria Carla Vazquez Vecilla, Enrique Izquierdo-Nuñez, Manuel Fernandez-Gonzalez, Lorenzo Zuñiga-Gómez, Jesus Betegon-Nicolas, Sonia Sanchez-Campos

Abstract

This observational, cross-sectional case-control study evaluates the impact of coronavirus disease 2019 (COVID-19) on health-related quality of life (HRQoL) in elderly persons who have undergone surgery for adult spinal deformity (ASD). On December 31, 2019, the Chinese authorities first reported severe acute respiratory syndrome coronavirus 2, and on March 11, 2020, it was declared a pandemic. The pandemic seems to have had a negative effect on elderly patients who underwent ASD, in terms of functional and psychological quality of life. We selected patients with ASD aged > 70 years who had undergone surgery between 2010 and 2015 and compared them with age- and sex-matched patients who did not have ASD. We recorded sociodemographic variables, type of surgery, levels of spinal fusion, HRQoL (Scoliosis Research Society-22, Short Form 12 Health Survey, EuroQol-5D [EQ-5], Geriatric Depression Scale [Yesavage] [GDS], Modified Frailty Index-11, and Barthel index), fear of visiting a health center, fear of leaving one's house, and adherence to preventive measures. The study population comprised 174 patients (mean [standard deviation] age, 77.3 [5.9] years; 86% women), of whom 87 had undergone surgery for ASD. The incidence of COVID-19 was higher in patients aged > 85 years (P = .041), urban areas (P = .047), and in patients in long-term care (P = .03). Similarly, no differences were observed for the ability to cope with the pandemic (P > .05). Patients who underwent surgery also had a higher risk of depression (GDS, 6.7 [P = .02]), a lower EQ-5 score (P = .001), a higher body mass index (P = .004), greater consumption of drugs (P < .001), especially opiates (P < .001). Patients who underwent surgery constitute a vulnerable population during the COVID-19 pandemic, with poorer quality of life and had a much higher risk of depression. They are also polymedicated and prefrail, adhere well to COVID-19 preventive measures, and do not seem to fear visiting health centers.

Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

Figures

Figure 1.
Figure 1.
EuroQol-5D (EQ-5) in the study group (patients who underwent surgery) and control group (patients who did not undergo surgery).

References

    1. Buell TJ, Chen CJ, Nguyen JH, et al. . Surgical correction of severe adult lumbar scoliosis (major curves ≥ 75°): retrospective analysis with minimum 2-year follow-up. J Neurosurg Spine. 2019:1–14.
    1. McMichael TM, Currie DW, Clark S, et al. . Epidemiology of Covid-19 in a long-term care facility in king county, Washington. N Engl J Med. 2020.
    1. Weekly Epidemiological update on COVID-19 - 18 January 2022. Available at: . [Access date January 20, 2022].
    1. Mazumder H, Hossain MM, Das A. Geriatric care during public health emergencies: lessons learned from novel corona virus disease (COVID-19) pandemic. J Gerontol Soc Work. 2020;1–2.
    1. Rios P, Radhakrishnan A, Williams C, et al. . Preventing the transmission of COVID-19 and other coronaviruses in older adults aged 60 years and above living in long-term care: a rapid review. Syst Rev. 2020;9.
    1. Vahia IV, Jeste DV, Reynolds CF. Older adults and the mental health effects of COVID-19. JAMA. 2020;324:2253–4.
    1. Sablerolles RSG, Lafeber M, van Kempen JAL, et al. . Association between clinical frailty scale score and hospital mortality in adult patients with COVID-19 (COMET): an international, multicentre, retrospective, observational cohort study. Lancet Healthy Longev. 2021;2:e163–70.
    1. Pinquart M, Sörensen S. Influences of socioeconomic status, social network, and competence on subjective well-being in later life: a meta-analysis. Psychol Aging. 2000;15:187–224.
    1. Bidzan-Bluma I, Bidzan M, Jurek P, et al. . A polish and German population study of quality of life, well-being, and life satisfaction in older adults during the COVID-19 pandemic. Front Psychiatry. 2020;11.
    1. Carreon LY, Jespersen AB, Støttrup CC, et al. . Is the hospital anxiety and depression scale associated with outcomes after lumbar spine surgery? Global Spine J. 2020;10:266–71.
    1. Herdman M, Badia X, Berra S. El EuroQol-5D: una alternativa sencilla para la medición de la calidad de vida relacionada con la salud en atención primaria. Aten Primaria. 2001;28:425–30.
    1. Versión española del cuestionario de Yesavage abreviado (GDS) para el despistaje de depresión en mayores de 65 años: adaptación y validación. Available at: . [Access date April 29, 2021].
    1. Shin C, Park MH, Lee SH, et al. . Usefulness of the 15-item geriatric depression scale (GDS-15) for classifying minor and major depressive disorders among community-dwelling elders. J Affect Disord. 2019;259:370–5.
    1. Martí D, Miralles R, Llorach I, et al. . Trastornos depresivos en una unidad de convalecencia: experiencia y validación de una versión española de 15 preguntas de la escala de depresión geriátrica de Yesavage. Rev Esp Geriatr Gerontol. 2000;35:7–14.
    1. Rockwood K, Song X, Mitnitski A. Changes in relative fitness and frailty across the adult lifespan: evidence from the Canadian National Population Health Survey. CMAJ. 2011;183:E487–94.
    1. Flexman AM, Charest-Morin R, Stobart L, et al. . Frailty and postoperative outcomes in patients undergoing surgery for degenerative spine disease. Spine J. 2016;16:1315–23.
    1. Bernaola-Sagardui I. Validación del índice de Barthel en la población española. Enferm clín (Ed impr). 2018;210–11.
    1. Schwab F, Blondel B, Chay E, et al. . The comprehensive anatomical spinal osteotomy classification. Neurosurgery. 2014;74:112–20; discussion 120.
    1. Zileli M, Dursun E. How to improve outcomes of spine surgery in geriatric patients. World Neurosurg. 2020;140:519–26.
    1. Miller EK, Vila-Casademunt A, Neuman BJ, et al. . External validation of the adult spinal deformity (ASD) frailty index (ASD-FI). Eur Spine J. 2018;27:2331–8.
    1. Passias PG, Segreto FA, Bortz CA, et al. . Probability of severe frailty development among operative and nonoperative adult spinal deformity patients: an actuarial survivorship analysis over a 3-year period. Spine J. 2020;20:1276–85.
    1. Miller EK, Neuman BJ, Jain A, et al. . An assessment of frailty as a tool for risk stratification in adult spinal deformity surgery. Neurosurg Focus. 2017;43:E3.
    1. López-Medina C, Ladehesa-Pineda L, Gómez-García I, et al. . Treatment adherence during the COVID-19 pandemic and the impact of confinement on disease activity and emotional status: a survey in 644 rheumatic patients. Joint Bone Spine. 2020;88:105085.
    1. Mills JP, Kaye KS, Mody L. COVID-19 in older adults: clinical, psychosocial, and public health considerations. JCI Insight. 2020.
    1. Climent JM, Bago J, Ey A, et al. . Validity of the Spanish version of the Scoliosis Research Society-22 (SRS-22) patient questionnaire. Spine. 2005;30:705–9.
    1. Karabulut C, Ayhan S, Yuksel S, et al. . Adult spinal deformity over 70 years of age: a 2-year follow-up study. Int J Spine Surg. 2019;13:336–44.
    1. Vilagut G, María Valderas J, Ferrer M, et al. . Interpretación de los cuestionarios de salud SF-36 y SF-12 en España: componentes físico y mental. Med Clin (Barc). 2008;130:726–35.
    1. Ministerio de Sanidad, Consumo y Bienestar Social - Portal Estadístico del SNS - Encuesta Nacional. Available at: . [Access date June 30, 2021].
    1. Kieser DC, Bourghli A, Larrieu D, et al. . Impact of COVID-19 on the pain and disability of patients with adult spinal deformity. Spine Deform. 2021;9:1073–6.
    1. [30]Tanne JH Hayasaki E Zastrow M Pulla P Smith P Rada AG. Covid-19: how doctors and healthcare systems are tackling coronavirus worldwide. BMJ. 2020;368:m1090.
    1. [31]Parrish E. The next pandemic: COVID-19 mental health pandemic. Perspect Psychiatr Care. 2020;56:485.
    1. Mental health services for older adults in China during the COVID-19 outbreak - PubMed. Available at: . [Access date May 24, 2021].
    1. Armitage R, Nellums LB. COVID-19 and the consequences of isolating the elderly. Lancet Public Health. 2020;5:e256.
    1. Afonso P. The impact of the COVID-19 pandemic on mental health. Acta Med Port. 2020;33:356–7.
    1. van Tilburg TG, Steinmetz S, Stolte E, et al. . Loneliness and mental health during the COVID-19 pandemic: a study among Dutch older adults. J Gerontol B Psychol Sci Soc Sci. 2020.
    1. Brooks SK, Webster RK, Smith LE, et al. . The psychological impact of quarantine and how to reduce it: rapid review of the evidence. The Lancet. 2020;395:912–20.
    1. Chronic Pain and Obesity in Elderly People: Results from the Einstein Aging Study - McCarthy - 2009 - Journal of the American Geriatrics Society - Wiley Online Library. Available at: . [Access date June 16, 2021].
    1. Bauer H, Emeny RT, Baumert J, et al. . Resilience moderates the association between chronic pain and depressive symptoms in the elderly. Eur J Pain. 2016;20:1253–65.
    1. Is Pain Perception Altered in People With Depression? A Systematic Review and Meta-Analysis of Experimental Pain Research - The Journal of Pain . Available at: . [Access date June 16, 2021].
    1. Theologis AA, Ailon T, Scheer JK, et al. . Impact of preoperative depression on 2-year clinical outcomes following adult spinal deformity surgery: the importance of risk stratification based on type of psychological distress. J Neurosurg Spine. 2016;25:477–85.
    1. Diebo BG, Lavian JD, Murray DP, et al. . The impact of comorbid mental health disorders on complications following adult spinal deformity surgery with minimum 2-year surveillance. Spine (Phila Pa 1976). 2018;43:1176–83.
    1. Soares S, Barbosa P, Santos J, et al. . Association between depression and quality of life in older adults: primary health care. Revista Enfermagem. 2017:25.
    1. Musche V, Bäuerle A, Steinbach J, et al. . COVID-19-related fear and health-related safety behavior in oncological patients. Front Psychol. 2020;11.
    1. Gavilán-Moral E, Villafaina-Barroso A, Jiménez-de Gracia L, et al. . Ancianos frágiles polimedicados: ¿es la deprescripción de medicamentos la salida? Revista Española de Geriatría y Gerontología. 2012;47:162–7.
    1. Sjøgren P, Grønbæk M, Peuckmann V, et al. . A population-based cohort study on chronic pain: the role of opioids. Clin J Pain. 2010;26:763–9.
    1. The role of opioid prescription in incident opioid abuse and dependence among individuals which chronic non-cancer pain. Available at: . [Access date June 13, 2021].
    1. Liu K, Chen Y, Lin R, et al. . Clinical features of COVID-19 in elderly patients: a comparison with young and middle-aged patients. J Infect. 2020;80:e14–8.
    1. Song X, Mitnitski A, Rockwood K. Prevalence and 10-year outcomes of frailty in older adults in relation to deficit accumulation. J Am Geriatr Soc. 2010;58:681–7.
    1. Guerra-Martín MD, Ramírez Fernández-Pro MI, Guerra-Martín MD, et al. . Calidad asistencial en la atención prestada a los ancianos en los centros residenciales. Gerokomos. 2020;31:232–8.
    1. Quintero A, Henao ME, Villamil MM, et al. . Changes in depression and loneliness after laughter therapy in institutionalized elders. Biomédica. 2015;35:90–100.
    1. Rodríguez-Blázquez C, Martín-García S, Frades-Payo B, et al. . Calidad de vida y estado de salud en personas mayores de 60 años con demencia institucionalizadas. Revista Española de Salud Pública. 2015;89:51–60.
    1. Wu CY, Hu HY, Huang N, et al. . Determinants of long-term care services among the elderly: a population-based study in Taiwan. PLoS One. 2014;9:e89213.
    1. Nations U. El impacto de la pandemia en las ciudades | Naciones Unidas. United Nations. Available at: . [Access June 21, 2021].
    1. La COVID-19 en un mundo urbano – Observatorio del Derecho Humano a la Vivienda Adecuada. Available at: . [Access date June 16, 2021].
    1. 57 Congreso SECOT 2020. Available at: . [Access date June 10, 2021].
    1. Amerio A, Aguglia A, Odone A, et al. . Covid-19 pandemic impact on mental health of vulnerable populations. Acta Biomed. 2020;91:95–6.
    1. Schwab FJ, Blondel B, Bess S, et al. . Radiographical spinopelvic parameters and disability in the setting of adult spinal deformity: a prospective multicenter analysis. Spine. 2013;38:E803–12.
    1. Lafage R, Schwab F, Challier V, et al. . Defining spino-pelvic alignment thresholds: should operative goals in adult spinal deformity surgery account for age? Spine. 2016;41:62–8.

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