A holistic tunnel safety concept for a 20-year-old tunnel upgrade to an ADR "Category A” tunnel

Following the elaboration of a Tunnel Safety Documentation for the T4 tunnel, several deviations from the European and national Standards were identified. Moreover, due the tunnels' special characteristics and its ageing equipment, the rehabilitation plan had not only to upgrade the level of safety to "Category A” as per the ADR agreement, but also to perform heavy maintenance works and provide sustainable solutions for the tunnel operations and the local community. The construction methodology poses significant challenges in the operation and the construction. Therefore, special provisions, technical and operational, were required in order for the transport of heavy and dangerous goods vehicles to be allowed in the tunnel during construction. The Covid pandemic and the geopolitical conditions (Ukraine war), seem to negatively affect the projects' duration and financing. With a budget of more than €20M, it is the first tunnel upgrade project of this magnitude and complexity in Greece, that sets the basis as refence for future tunnel upgrades. © 2023 The Author(s).

Productive Aging During COVID-19 - Lessons from WH SeniorLink

Introduction: According to the National Academies of Science, Medicine, and Engineering, even before the pandemic, 24% of Americans 65+ were considered socially isolated, and 43% of adults 60+ were lonely. Both experiences are associated with serious physical and mental health problems, including increased risks of dementia, stroke, depression, and suicidal ideation. As older adults engage in stricter social distancing to protect themselves from COVID-19, their risk of social isolation and loneliness is heightened. According to research by the Kaiser Family Foundation, 46% of adults 65+ reported that the worry and stress caused by pandemic has had a negative impact on their mental health. In order to combat this unique challenge, we must employ innovative, flexible solutions that adapt to the shifting circumstances and an uncertain future. Method(s): WH SeniorLink has developed an innovative program for integrating friendly visiting, mutual aid, needs assessment and case management, all delivered remotely by trained volunteers. The program was conceived, developed and executed since the beginning of COVID-19 restrictions and has grown to become a fully fledged 501(c)(3) organization, and is a model of flexible service delivery during this unusual time. The program operates through a volunteerism-mutual aid model. Volunteers are trained using online modules and quizzes and supervised by a licensed social worker, including training on needs and risk assessment. Volunteers are then matched with an older adult with similar interests and language preferences to provide friendly weekly phone calls, care packages and letters. Older adults with higher needs are referred to WH SeniorLink's service navigation program which operates using the online platform, Apricot, and is staffed by masters level social work interns and supervised by licensed social workers. Service navigation involves conducting comprehensive assessments and identifying resources and referrals. Older adults who express interest are also paired with each other to provide social support. Barriers to program development have included identifying consistent funding sources and volunteer attrition. Result(s): Data shows 169% growth in contacts made with older adults between May and October, with 2.5 times more older adults served in November than in May. Initial responses to the Dejong Gierveld Loneliness Scale and qualitative data collection reflect that older adults continue to feel lonely and isolated in the midst of the pandemic, but that WH SeniorLink is helping. By placing emphasis on empowering older adults to form sustained relationships with volunteers and their peers, WH SeniorLink encourages reciprocal relationships through which older adult participants are valued for their experiences and contributions. Conclusion(s): The mission of WH SeniorLink is to strengthen community ties and improve health outcomes among older New Yorkers by providing social-emotional support and connection to essential services. WH SeniorLink was founded during the COVID-19 pandemic, in response to the myriad of new challenges faced by older adults including greater risk of social isolation and increased disconnection from essential services. However, we recognize that the pandemic has only exacerbated a problem that began long before, and older adults are at risk of being left behind in the coming months and beyond. Funding(s): WH SeniorLink is funded by a starter grant from Columbia School of Social Work and subsequent crowdfunded donations.Copyright © 2021

Experiences of accumulated stress among aging parent caregivers of adults with autism spectrum disorder

With the continuing increased incidence rate of autism spectrum disorder over the decades, there are increasing numbers of adults with autism who require varying levels of lifelong care, typically from parents. It is necessary to understand parents' lived experience of lifelong caregiving, and how their own aging process further impacts life quality. Furthermore, greater understanding of stressors, resources, appraisals, and coping among parent caregivers of children with "high functioning autism" who are transitioning into young adulthood is particularly necessary as services, needs, and experiences for both are nuanced due to functional status, deficits in the service system, and demographic disparities. Given lifespan aspects past research has not addressed, the study focused on development of a measure of parent accumulated stressors, and on interrelations of stressors, perceived social support, future time perspective, burden, satisfaction, and coping on health-related quality of life and meaning in life among 28 parents of young adults with autism. Although proposed quantitative analyses were not completed due to sample size, qualitative analyses on parent experiences and stressors revealed common themes of concern for child's future quality of life, complicated dynamics of providing help to their child overtime, and increased stress related to others' lack of understanding of their child. In total, 10 themes and multiple subthemes were identified in relation to aspects of accumulated stressors. Findings suggest parent stress with this specific population is complex, manifesting in nuanced ways at different life stages. Impacts of the COVID-19 pandemic are also explored, and implications for scientific advancement and clinical services are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

A New Space in the Search for Meaning of Conservative-Pious Elders: Social Media

Population growth, urbanization, differentiations in family structure, Factors such as the diversification of economic activities have produced a new social reality. Elderly individuals face this reality. Individuals aged 65 and over had limited transportation and communication opportunities during their childhood and youth. They had lived a quiet life in their childhood because the change was slow. However, individuals aged 65 and over are trying to keep up with today's digital age, where speed is decisive. Today, internet cables and wireless networks surrounding the world are the driving force of change. Some of the internet users over the age of 65 were also using the internet in the middle age period. However, after age 65, there is a significant increase in the number of people acquainted with the internet. With the spread of smartphones, access to the internet has become more accessible. Therefore, the presence of the elderly in social networks has become visible. The elderly have eased the restrictions and prohibitions imposed due to the COVID-19 pandemic with social media. In this process, some elderly people became social media members with the influence of their children, grandchildren and friends. Over time, the time spent by the elderly on social networks has increased. Thanks to the internet, people could move without depending on time and space. Social media, which has entered people's lives since the beginning of the 2000s, has allowed people to produce their content. In this way, the elderly have engaged in activities that add meaning to their lives in the digital environment. Searching for life's meaning is as old as human history. People both question the problematic situations such as illness, accident, and helplessness they experience and turn to actions that will alleviate these troubles and give them happiness. In particular, religion guides the elderly in this regard. Religion affects the online and offline lives of the elderly. These people make religious shares on social media. In this regard, social networks are a new subject of analysis for social research. In this context, the research topic is the role of social media in the search for the meaning of individuals aged 65 and over who consider themselves religious and conservative. The problem of our research: how do social networks make up the meaningful world of religious, conservative individuals aged 65 and older? Also, how do the elderly produce solutions to the meaning crises they experience? For this purpose, two focus group interviews of 4 people were conducted. In addition, 23 people were interviewed in depth. Of the people interviewed, 13 are women, and 18 are men. These numbers are determined according to the proportion of men and women using social media in Turkiye. In this context, the research topic is the role of social media in the search for the meaning of individuals aged 65 and over who consider themselves religious and conservative. The problem of our research: how do social networks make up the meaningful world of religious, conservative individuals aged 65 and older? Also, how do the elderly produce solutions to the meaning crises they experience? For this purpose, two focus group interviews of 4 people were conducted. In addition, 23 people were interviewed in depth. Of the people solicited, 13 are women, and 18 are men. These numbers are determined according to the proportion of men and women using social media in Turkiye. Studies on the search for meaning in life are generally studies in psychology. The search for meaning is the product of an individual effort from this perspective. However, our study approaches the issue from a sociological point of view and discovers the connection of meaning with other individuals. In this respect, the social media experiences of the elderly are included in the analysis. Thanks to social networks, the elderly can find their schoolmates and express their thoughts on the agenda. Again, the elderly can express their anger here. For this reason, it has emerged that social media adds meaning to their lives. Using social media in a balanced way, not at the level of addiction, can contribute to the search for purpose of the elderly. For this reason, courses can be organized for the elderly to improve their ability to act in the digital space.

COVID-19 and immunity

Coronavirus disease-19 (COVID-19), caused by a β-coronavirus and its genomic variants, is associated with substantial morbidities and mortalities globally. The COVID-19 virus enters host cells upon binding to the angiotensin converting enzyme two receptors. Patients afflicted with COVID-19 may be asymptomatic or present with critical symptoms possibly due to diverse lifestyles, immune responses, aging, and underlying medical conditions. Geriatric populations, especially men in comparison to women, with immunocompromized conditions, are the most vulnerable to severe COVID-19-associated infections, complications, and mortalities. Notably, whereas immunomodulation, involving nutritional consumption, is essential to protecting an individual from COVID-19, immunosuppression is detrimental to the host with this hostile disease. As such, immune health is inversely correlated to COVID-19 severity and resulting consequences. Advances in genomic and proteomic technologies have helped us to understand the molecular events underlying symptomatology, transmission, and pathogenesis of COVID-19 and its genomic variants. Accordingly, there has been development of a variety of therapeutic interventions, ranging from mask wearing to vaccination to medication. Regardless of various measures, a strengthened immune system can be considered as a high priority of preventive medicine for combating this highly contagious disease. This chapter provides an overview of pathogenesis, effects of comorbidities on COVID-19 and their correlation to immunity, and prospective therapeutic strategies for the prevention and treatment of COVID-19. © 2023 Elsevier Inc. All rights reserved.

Did the Pandemic Impact the Brains of Our Science Students?

Ian Gotlib, lead author of the study stated, "We know that early adversity and stress can accelerate biological aging and brain maturation. [...]these students face a higher risk of memory and learning problems and may be why we are seeing skyrocketing cases of anxiety and depression among our students since the pandemic. The articles in this special issue provide ideas for teachers to upgrade their knowledge on immunology, gain ideas for infusing immunology into their teaching, and rethink applicability and language of the standards to include scientific phenomena that emerge daily but are not necessarily reflected within NGSS and state standards.

Evaluation of the Association between Self-Perceptions of Aging and Care Deferrals Among US Adults Aged >=50 Years during the COVID-19 Pandemic

Objectives: Self-perceptions of aging (SPA) have been shown to influence healthcare-seeking behaviors among middle-aged and older adults. Negative SPA may intensify the COVID-19 pandemic-related healthcare disruptions in this population. Therefore, this study seeks to evaluate the association between SPA and care deferrals among community-dwelling adults aged >=50 years in the US during the COVID-19 pandemic. Method(s): A cross-sectional study of the eligible sample was conducted using data from the 2020 wave of the Health and Retirement Study. SPA score was measured using a validated eight-item instrument with higher scores indicating negative SPA. The association between SPA and care deferrals during the COVID-19 pandemic was assessed using multivariable logistic regression adjusted for respondents' sociodemographic and clinical characteristics, past COVID-19-related experiences, and COVID-19 worry. Result(s): The final sample consisted of 4,153 community-dwelling adults aged >=50 years. 30% reported care deferrals during the COVID-19 pandemic. Among respondents who deferred care, the majority were aged 50-64 years (46.6%), females (65.4%), and White (64.5%). Most commonly reported care deferrals were dental appointments (74.5%) and physician visits (56.5%). Care deferrals were mainly due to clinic/office rescheduling or cancelling appointments (57.5%), respondent deciding the care could wait (33.8%), and COVID-19 fear (21.8%). Respondents reporting care deferrals reported higher mean SPA scores, indicating negative aging attitudes, compared those who did not defer care (Mean (SD): 3.24 (1.02) vs. 3.05 (1.04), p<0.001). After accounting for covariates, higher SPA scores were associated with significantly higher odds of care deferrals (aOR: 1.20, 95% CI: 1.11 - 1.30, p<0.001). Conclusion(s): This study found that negative SPA were associated with care deferrals during the COVID-19 pandemic among community-dwelling adults aged >=50 years. As healthcare delivery rebounds to pre-pandemic levels, the role of SPA in healthcare-seeking behaviors should be recognized. Health promotion efforts may target positive aging attitudes to encourage timely and proactive use of healthcare.Copyright © 2023

Autonomy, identity, and design in the COVID-19 era

This chapter examines the state of response and likely long-term implications across the continuum of place types for older adults, from independent housing to skilled nursing, with a focus on how physical settings and technological systems can empower autonomy and identity. It does so by adopting a person-environment (P-E) exchange framework as articulated by Chaudhury and Oswald (J Aging Stud 51:100821, 2019) This framework is structured in three sections: components of P-E interaction, P-E processes, and environment-related outcomes. Components of P-E interaction include individual characteristics, social factors, physical/built environments, and technological systems with this chapter focusing on the last two. These components form a milieu within which the dialectic interaction between agency and belonging occurs and ultimately informs assessments regarding autonomy and identity. Emergent themes discussed in this chapter include a heightened emphasis on inclusive housing models, age-friendly integration of technology, environmental flexibility in design and programming, and enhanced support for the needs of caregivers. Examining place change through an integrative P-E framework offers a lens to understanding what implications to agency and belonging might be tied to modifications in the physical and technological environment in response to COVID-19 and how that might inform outcomes related to autonomy and identity among older adults. The environmental responses to COVID-19 will accelerate the ability of independent housing to serve individuals longer in their homes and should promote a radical embrace of small house approaches to skilled care, thereby challenging assisted living as a place type altogether. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

(Re)designing the continuum of care for older adults: The future of long-term care settings

This book broadens the visioning on new care environments that are designed to be inclusive, progressive, and convergent with the needs of an aging population. The contents cover a range of long-term care (LTC) settings in a single collection to address the needs of a wide audience. Due to the recent COVID-19 pandemic, rethinking the spatial design of care facilities in order to prepare for future respiratory and contagious pathogens is one of the prime concerns across the globe, along with social connectedness and autonomy in care settings. This book contributes to the next generation of knowledge and understanding of the growing field of the design of technology, programs, and environments for LTC that are more effective in infection prevention and control as well as social connectedness. To address these issues, the chapters are organized in four sections: Part I: Home- and community-based care;Part II: Facility-based care;Part III: Memory care and end-of-life care;and Part IV: Evidence-based applied projects and next steps. (Re)designing the Continuum of Care for Older Adults is an essential resource for researchers, practitioners, educators, policymakers, and students associated with LTC home and healthcare settings. With diverse topics in theory, substantive issues, and methods, the contributions from notable researchers and scholars cover a range of innovative programming, environments, and technologies which can impact the changing needs and support for older adults and their families across the continuum of care. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

A qualitative cross-case analysis of older adults' acceptance and resiliency behaviors amidst the COVID-19 pandemic crisis

Resilience has been identified as a dynamic process of sustaining healthy acceptance, adaptation, and effective coping strategies – multiplicity within the aging population is broadly acknowledged. Recognize the concept of resiliency with acceptance in aging interposes during successful aging. Seven 65-75-year-old adult purposive samples were interviewed, and data were collected, extracted, analyzed, and validated with four neutral major themes and 12 supporting subthemes using Colaizzi's method. The study was designed to validate a proposition in the aging-related resiliency theory, which states that when risks and adversities of aging are accepted, older adults tend to use adaptive strategies and supportive resources to improve their coping and resilience. Seven older adults (65-75 years old) purposive samples were interviewed, and data were collected, extracted, analyzed, and validated with four neutral major themes and 12 supporting subthemes using Colaizzi's method. During the COVID-19 pandemic, it is essential to include healthcare interventions that may augment acceptance and resilience in a manner of promoting older adults' healthy aging. It is also important to provide guidelines on how to reduce the negative effects on older adults during the pandemic. © 2023 The Authors. Published by IASE.

The relationship between corona anxiety and daily memory in the elderly: The mediating role of anxiety sensitivity

The decrease of memory abilities is one of the main problems in the elderly exacerbated by psychological factors such as anxiety. Therefore, the present study was to investigate the relationship between Corona anxiety and daily memory in the elderly through the mediating role of anxiety sensitivity. This was a descriptive-correlational research of path analysis kind. The statistical population of the study included all the education retirees over 60 years old living in Shiraz, Iran, 250 of whom were selected using convenience sampling. In this study, Alipour's Corona anxiety, Sunderland's daily memory and Floyd's anxiety sensitivity questionnaires were filled out online by the participants. Data were analyzed using SPSS-26 software and Lisrel-8.32. The results of path analysis demonstrated that there is a negative direct relationship between Corona anxiety and daily memory, a positive direct relationship between Corona anxiety and anxiety sensitivity, and a negative direct relationship between anxiety sensitivity and daily memory. Corona anxiety also had an indirect and significant relationship with daily memory through the mediating role of anxiety sensitivity. According to the results, anxiety caused by the outbreak of Corona disease can affect memory function in the elderly. Hence, in addition to physical health, providing mental health of the elderly seems to be crucial as well in pandemic conditions. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Importance of meaningful engagement: how and why older adults volunteer in uncertain times

PurposeMany older adults engage in volunteer activities, drawing meaning and purpose through such efforts. Social distancing restrictions, put in place during Covid-19 surges to reduce the risk of transmission, disrupted older adult volunteers' lives and volunteer experiences. Social distancing measures provide a unique opportunity to explore what happened when the choices around pausing or stopping volunteering were not entirely within the control of older adults. This paper aims to explore the experiences of older adult volunteers as they navigated uncertainties and made difficult decisions around balancing their safety and their desire to continue volunteering.Design/methodology/approachThe authors conducted interviews with 26 community-dwelling older adults, age 50+, who had engaged in volunteer activities for at least 1 h a week prior to the start of the pandemic. The interviews were conducted on the phone or via Zoom. The authors used thematic analysis to help us analyze the data and identify patterns from participants' experiences.FindingsDespite the risk presented by Covid-19, most participants volunteered during the pandemic. They continued some or all of their previous activities with safety-related adjustments, with some seeking new or different opportunities. Participants' discussions highlight the challenges of volunteering during the pandemic and the importance of engagement to their resiliency and subjective well-being.Originality/valueThis paper provides original contributions to understanding how and why older adults volunteered during the Covid-19 pandemic. The social distancing measures provide a novel opportunity to enrich our understanding of the meaningfulness and value of volunteerism to older adults' lives and subjective well-being.

Longitudinal robustness of a thoracic radiographic AI model for COVID-19 severity prediction

The 'ging' of artificial intelligence/machine learning (AI/ML) models after initial development and evaluation is known to frequently occur and can pose substantial problems. When there are changes in population, disease characteristics, imaging equipment, or protocols, model performance may start to deteriorate, and the performance predicted in a research setting may no longer hold after deployment (either in a clinical setting or in further research). This data shift phenomenon is a common problem in AI/ML. We trained and evaluated a previously in-house developed AI/ML model for COVID severity prediction using two COVID-19-positive consecutive adult patient cohorts from a single institution. The first cohort was from the time that the Delta strain was dominant accounting for <95% of cases (June 24-December 11, 2021, 820 patients, 1331 chest radiographs (CXRs)) and the second cohort was from the time that the Omicron variant was dominant (Jan 1-21, 2022, 656 patients, 970 CXRs). Inclusion criteria were COVID-positivity and the availability of CXR imaging exams, in general for patients not admitted to ICU and prior to ICU admission for those patients admitted to ICU as part of their treatment. Exclusion criteria were image acquisition in ICU or the presence of mechanical ventilation. Our image-based AI/ML model was trained to predict, based on each frontal CXR from a COVID-positive patient, whether this patient would be admitted to ICU within a 24, 48, 72, or 96-hour window. The model was evaluated 1) in a cross-sectional test when trained on a subset/tested on an independent subset of the Delta cohort, 2) similarly for the Omicron cohort, and 3) in a longitudinal test when trained on the Delta cohort/tested on the Omicron cohort. Cohorts were similar in ICU admission rate and fraction of portable CXRs, while immunization rate was higher for the Omicron cohort. The model did not demonstrate signs of aging with performances in the longitudinal test being very similar to those within the Delta cohort, e.g., an area under the ROC curve in the task of predicting ICU admission within 24 hours of 0.76 [0.68;0.84] when trained/tested within the Delta cohort and 0.77 [0.73;0.80] for the longitudinal test (p>0.05). The performance within the Omicron cohort was similar as well, at 0.76 [0.66;0.84]. Our AI/ML model for COVID-severity prediction did not demonstrate signs of aging in a longitudinal test when trained on the Delta cohort and applied as-is to the Omicron cohort. © COPYRIGHT SPIE. Downloading of the is permitted for personal use only.

Facial ageing . . . and other stories

When high quality photographs of the faces of 2700 middle aged and older participants in a longitudinal study were assessed by a panel without knowledge of their chronological age and medical history, people whose perceived age was lower than their chronological age were less likely to have osteoporosis, chronic obstructive pulmonary disease, hearing loss, or cataracts. Energy expenditure and incident type 2 diabetes Data from 90 000 participants in the UK Biobank study who wore an accelerometer for seven days reveal a linear relation between the amount of energy expended during physical activity and the subsequent incidence of type 2 diabetes—even after adjusting for body mass index. A study using data for 1.5 million prescriptions of PPIs in UK general practice found an increased risk of diagnosis of an inflammatory bowel disease in the first two years after treatment started.

Remote Evidence-Based Health Promotion Programs During COVID: A National Evaluation of Reach and Implementation for Older Adult Health Equity.

INTRODUCTION.: Evidence-based health promotion programs (EBPs) support older adults where they live, work, pray, play, and age. COVID-19 placed a disproportionate burden on this population, especially those with chronic conditions. In-person EBPs shifted to remote delivery via video-conferencing, phone, and mail during the pandemic, creating opportunities and challenges for older adult health equity. METHOD.: In 2021-2022, we conducted a process evaluation of remote EBPs by purposively sampling diverse U.S. organizations and older adults (people of color, rural, and/or with disabilities). The Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) + Equity framework was used to understand program reach and implementation, including FRAME to describe adaptations for remote delivery. Analyses include descriptive statistics and thematic analysis of participant and provider surveys and interviews, and joint display tables to compare learnings. RESULTS.: Findings from 31 EBPs through 198 managers/leaders and 107 organizations suggest remote delivery increases EBP reach by improving access for older adults who are underserved. For programs requiring new software or hardware, challenges remain reaching those with limited access to-or comfort using-technology. Adaptations were to context (e.g., shorter, smaller classes with longer duration) and for equity (e.g., phone formats, autogenerated captioning); content was unchanged except where safety was concerned. Implementation is facilitated by remote delivery guidelines, distance training, and technology support; and hindered by additional time, staffing, and resources for engagement and delivery. CONCLUSIONS.: Remote EBP delivery is promising for improving equitable access to quality health promotion. Future policies and practices must support technology access and usability for all older adults.

Mental Health, Social Connectedness, and Fear During the COVID-19 Pandemic: A Qualitative Perspective from Older Women with HIV.

Older women with HIV (WWH) confront significant biopsychosocial challenges that may be exacerbated by the COVID-19 pandemic. Between May 2020 and April 2021, following a resiliency intervention conducted as part of a randomized parent trial, 24 cisgender WWH (M = 58 years old) completed quantitative assessments and qualitative interviews exploring the impact of COVID-19 on mental health. Qualitative data were analyzed via rapid analysis. Most participants were Black (62.5%) and non-Hispanic or Latina (87.5%). Emergent themes included (1) increased anxiety and depression; (2) a loss of social connectedness; (3) fear of unknown interactions among COVID-19, HIV, and other comorbidities; and (4) the use of largely adaptive strategies to cope with these issues. Findings suggest that older WWH face significant COVID-19-related mental health challenges, compounding existing stressors. As the pandemic persists, it will be important to assess the impact of these stressors on wellbeing, identify effective coping strategies, and provide increased support to mitigate COVID-19-related mental health issues over time. Trial Registration: ClinicalTrials.gov identifier: NCT03071887.

Thinking Beyond COVID-19: How Has the Pandemic Impacted Future Time Horizons?

Older age is reportedly protective against the detrimental psychological impacts of the COVID-19 pandemic, consistent with the theory that reduced future time extension (FTE) leads to prioritization of socioemotional well-being. We investigated whether depression severity and pandemic-related factors (regional severity, threat, social isolation) reduce FTE beyond chronological age and whether these relationships differ between younger and older adults. In May 2020, we recruited 248 adults (younger: 18-43 years, older: 55-80 years) from 13 industrialized nations. Multigroup path analysis found that depression severity was a better predictor of FTE than the reverse association in both age groups, suggesting an affective foreshortening of future time. In both age groups, older age was protective against depression severity, and younger age was associated with heightened vulnerability to the negative impacts of pandemic-related factors. Future research should consider the complex interrelationships between FTE, age, and depression severity and the potential impacts of the broader psychosocial milieu.

Melatonin and Cytokines Modulate Daily Instrumental Activities of Elderly People with SARS-CoV-2 Infection.

The Comprehensive Geriatric Assessment analyzes the health and quality of life of the elderly. Basic and instrumental daily activities may be compromised due to neuroimmunoendocrine changes, and studies suggest that possible immunological changes occur during infections in the elderly. Thus, this study aimed to analyze cytokine and melatonin levels in serum and correlate the Comprehensive Geriatric Assessment in elderly patients with SARS-CoV-2 infection. The sample consisted of 73 elderly individuals, 43 of whom were without infection and 30 of whom had positive diagnoses of COVID-19. Blood samples were collected to quantify cytokines by flow cytometry and melatonin by ELISA. In addition, structured and validated questionnaires were applied to assess basic (Katz) and instrumental (Lawton and Brody) activities. There was an increase in IL-6, IL-17, and melatonin in the group of elderly individuals with infection. In addition, a positive correlation was observed between melatonin and IL-6 and IL-17 in elderly patients with SARS-CoV-2 infection. Furthermore, there was a reduction in the score of the Lawton and Brody Scale in the infected elderly. These data suggest that the melatonin hormone and inflammatory cytokines are altered in the serum of the elderly with SARS-CoV-2 infection. In addition, there is a degree of dependence, mainly regarding the performance of daily instrumental activities, in the elderly. The considerable impact on the elderly person's ability to perform everyday tasks necessary for independent living is an extremely important result, and changes in cytokines and melatonin probably are associated with alterations in these daily activities of the elderly.