Impact of COVID-19 on elderly population well-being: evidence from European countries.

The aim of this paper is to analyse the effect of COVID-19 on multidimensional well-being in the European population aged 50 and over by measuring changes in individual well-being before and after the pandemic outbreak. To capture the multidimensional nature of well-being, we consider different dimensions: economic well-being, health status, social connections and work status. We introduce new indices of change in individual well-being that measure non-directional, downward and upward movements. Individual indices are then aggregated by country and subgroup for comparison. The properties satisfied by the indices are also discussed. The empirical application is based on micro-data from waves 8 and 9 of the Survey of Health, Ageing and Retirement in Europe (SHARE), carried out for 24 European countries before the pandemic outbreak (regular survey) and in the first two years of the COVID-19 pandemic (June-August 2020 and June-August 2021). The findings suggest that employed and richer individuals suffered greater losses in well-being, while differences based on gender and education diverge from country to country. It also emerges that while the main driver of well-being changes in the first year of the pandemic was economics, the health dimension also strongly contributed to upward and downward well-being changes in the second year.

Long-term Results of Perfusion-Balloon Valvuloplasty, Without Rapid Pacing, in High-Risk Elderly Patients With Severe Aortic Stenosis: A New Space Oddity.

BACKGROUND: Percutaneous balloon aortic valvuloplasty (BAV) is actually recommended as a bridge to surgery or transcatheter aortic valve replacement in patients with severe aortic stenosis (AS) in particular clinical settings. In this pilot study, for the first time, we report our experience utilizing a nonocclusive balloon for BAV, which does not require rapid ventricular pacing (RVP), in high-risk symptomatic elderly patients with severe AS. METHODS AND RESULTS: From 2018 to 2020, a total of 30 high-risk elderly patients with heart failure due to severe AS were treated with BAV and were all prospectively included in the study. We used a perfusion-balloon valvuloplasty without RVP (True Flow; BD/Bard). Hemodynamic parameters were invasively evaluated during catheterization, before and immediately after BAV. All patients were regularly followed to detect the rate of mortality. The patients were 87.56 ± 4.10 years old and 23% were males. In the catheterization laboratory, the peak left ventricular to aortic pressure gradient significantly decreased from 55 mm Hg (interquartile range [IQR], 48.75-66.25) to 26 mm Hg (IQR, 15.7-30) immediately after balloon inflation (P<.001). The median value of percentage decrease of transaortic gradient was 56% (IQR, 50-74). At a median of 12 months (IQR, 5-27) follow-up, 12 patients (40%) died. The median time between BAV and mortality was 10.5 months (IQR, 1.75-15.5). At multivariable analysis, the only predictor of mortality was the New York Heart Association class at admission (odds ratio, 3.29; 95% confidence interval, 2.4-298.4; P<.01). CONCLUSION: This single-center pilot study represents the first evidence that perfusion-balloon valvuloplasty without RVP is a safe, valid, and durable option in high-risk, symptomatic, elderly patients with severe AS.