Associations Between Eating, Mobility, and Toileting Functional Dependence and COVID-19 Symptoms

Benjamin E Canter; Russell Goebel; Varsha Kulkarni; Wingyun Mak; Jason Falvey; Kenneth Boockvar

doi:10.1016/j.jamda.2023.11.012

Associations Between Eating, Mobility, and Toileting Functional Dependence and COVID-19 Symptoms

J Am Med Dir Assoc. 2024 Feb;25(2):342-347.e4. doi: 10.1016/j.jamda.2023.11.012. Epub 2023 Dec 20.

Authors

Benjamin E Canter¹, Russell Goebel², Varsha Kulkarni², Wingyun Mak³, Jason Falvey⁴, Kenneth Boockvar⁵

Affiliations

¹ Department of Occupational Therapy, Boston University College of Rehabilitation: Sargent College, Boston, MA, USA. Electronic address: bcanter@bu.edu.
² Department of Mathematics and Statistics, Boston University College of Arts and Sciences, Boston, MA, USA.
³ The Research Institute on Aging, The New Jewish Home, New York, NY, USA; Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
⁴ Department of Physical Therapy and Rehabilitation Science, University of Maryland, Baltimore, MD, USA; Department of Epidemiology & Public Health, University of Maryland, Baltimore, MD, USA.
⁵ The Research Institute on Aging, The New Jewish Home, New York, NY, USA; Division of Gerontology Geriatrics and Palliative Care, University of Alabama, Birmingham, Birmingham, AL, USA.

PMID: 38141663
DOI: 10.1016/j.jamda.2023.11.012

Abstract

Objectives: The first goal of this study was to explore associations between functional dependence levels during activities of daily living (eg, functional mobility, eating, and toileting) before COVID-19 and presence of COVID-19 symptoms (eg, fever, dehydration, lethargy, and shortness of breath) during illness. The second goal of this study was to explore associations between presence of specific COVID-19 symptoms and level of functional decline from before to after illness.

Design: Retrospective cohort study.

Setting and participants: A total of 375 residents at a single skilled nursing facility in New York City.

Methods: Data were extracted from the Minimum Data Set 3.0 and chart reviews. Multiple linear regressions analyzed relationships between baseline functional dependence in eating, functional mobility, and toileting and presence of dehydration, lethargy, shortness of breath, and fever. Ordinal linear regressions analyzed associations between COVID-19 symptom presence and changes in functional dependence from before to after illness.

Results: Pre-COVID-19 eating dependence was significantly associated with dehydration during COVID-19. Dehydration during COVID-19 was significantly associated with greater functional declines in functional mobility from before to after illness. Shortness of breath was significantly associated with increased functional declines in eating and functional mobility.

Conclusions and implications: Patients with COVID-19 should be monitored for shortness of breath and dehydration, as these symptoms are associated with functional decline. Individuals experiencing functional decline before COVID-19 onset are especially vulnerable to these symptoms. Future research should further explore the relationship between functional status and COVID-19 symptoms.

Keywords: COVID-19; Dehydration; activities of daily living; functional status; mobility; symptoms.

MeSH terms

Activities of Daily Living
COVID-19*
Dehydration
Dyspnea
Functional Status
Humans
Lethargy
Retrospective Studies