Health, wellbeing, and the impact of Corona in older adults in Dresden, Germany: the LAB60+ study

Abstract Introduction As the proportion of older people increases, it is necessary to evaluate their health and well-being to identify measures to promote healthy ageing. Moreover, the COVID-19 pandemic has impacted older adults’ health- not just through the infection itself, but also due to infection protection ordinances. Methods LAB60+ is a population-based cross-sectional study investigating, among other things, the physical and mental health of older adults. Residents of Dresden aged 60 years and older were invited to participate in the first half of 2021. Participants answered questions on their habits, health status and wellbeing, using, among others, the Short Form-8 Health Survey and the WHO wellbeing index. Results 2399 people participated in the study (40% response). Participants assessed their physical health similar to the German population. The most common chronic conditions were hypertension (54%), chronic pain (32%) and osteoarthritis (31%). 42% of the participants were overweight and 20% were obese. One-fifth did not engage in physical activity: this number increased with age and decreased socioeconomic status. Participants reported lower levels of wellbeing compared to the German population (58 vs. 67 pts.). One-third had higher levels of depressiveness and half reported an increase in their experienced loneliness due to the pandemic. 34% participated in risky alcohol consumption, but it did not markedly change during the pandemic. The greatest negative impact of the pandemic on health behaviors was physical activity: more than one-third exercised less compared to the time before the pandemic. Conclusions Physical health was comparable to the German population, while depressivity was higher, perhaps due to the pandemic. Age-appropriate interventions should especially target an increase in physical activity. It is important to take measures to reduce the possible negative effects of the pandemic, such as increased loneliness or reduced physical activity. Key messages • This is the first study on health and wellbeing on older adults (60+ years) in the city of Dresden, Germany. • The COVID-19 pandemic had a high impact on older adults’ physical activity and loneliness.

Issue: Viral hepatitis C (VH C) is a global problem of the public health. Different interventions for achieving the Global Health Sector Strategy on viral hepatitis targets (65% reduction in HCV-related deaths, 90% in new infections and 90% of infections diagnosed by 2030) were considered. Increased diagnosis and treatment rates would be required to achieve these targets in all countries, even with the introduction of high sustained viral response therapies. Description of the problem: The latest global HCV disease burden estimates showed that about 71.1 million people worldwide are viremic, corresponding to a prevalence of 1%. The prevalence of HCV is not homogenous: the WHO Eastern-Mediterranean Region is with the highest number of infected subjects (15 millions), followed by the European Region (14 million). In Bulgaria, the incidence of VH C is 0.63-1.30 at 100 000 population (2008-2020) and in Pleven region is 0.38-3.8, respectively.

Results:
Retrospective study was conducted upon epidemiological, demographic, clinical, laboratory and viral characteristics in fifty cases of VH C confirmed with positive anti-HCV, evaluated by ELISA. Thirty eight of cases were hospitalized in different clinics of the University Hospital ''Dr Georgi Stranski' '-Pleven (2017'-Pleven ( -2018 and remainders were blooddonors registered in Regional Center of Transfusion Hematology-Pleven. Surgical interventions (26.32%), blood infusions (23.68%) and hemodialysis (15.79%) were at highest risk for VH C. Twenty five hospital patients were with chronic VH C (66%), five with cirrhosis (13%) and eight (21%) with acute hepatitis C. Twenty of the patients (53%) were asymptomatic about hepatitis and were hospitalized because of different comorbidities (p < 0.0005).

Lessons:
We propose an algorithm for early diagnosis of VH C based on mandatory screening for anti-HCV in risk groups, especially before invasive procedures. The early detection of HCV infection will reduce the complications and nosocomial infections.

Key messages:
Different scenarios developed to achieve the WHO Targets in all countries assume an implementation of national policies to prevent new infections and to diagnose current infections through screening. The early detection of HCV infection will reduce the complications and nosocomial infections.

Introduction:
As the proportion of older people increases, it is necessary to evaluate their health and well-being to identify measures to promote healthy ageing. Moreover, the COVID-19 pandemic has impacted older adults' health-not just through the infection itself, but also due to infection protection ordinances. Methods: LAB60+ is a population-based cross-sectional study investigating, among other things, the physical and mental health of older adults. Residents of Dresden aged 60 years and older were invited to participate in the first half of 2021. Participants answered questions on their habits, health status and wellbeing, using, among others, the Short Form-8 Health Survey and the WHO wellbeing index.
Results: 2399 people participated in the study (40% response). Participants assessed their physical health similar to the German population. The most common chronic conditions were hypertension (54%), chronic pain (32%) and osteoarthritis (31%). 42% of the participants were overweight and 20% were obese. One-fifth did not engage in physical activity: this number increased with age and decreased socioeconomic status. Participants reported lower levels of wellbeing compared to the German population (58 vs. 67 pts.). One-third had higher levels of depressiveness and half reported an increase in their experienced loneliness due to the pandemic. 34% participated in risky alcohol consumption, but it did not markedly change during the pandemic. The greatest negative impact of the pandemic on health behaviors was physical 15th European Public Health Conference 2022 activity: more than one-third exercised less compared to the time before the pandemic.

Conclusions:
Physical health was comparable to the German population, while depressivity was higher, perhaps due to the pandemic. Age-appropriate interventions should especially target an increase in physical activity. It is important to take measures to reduce the possible negative effects of the pandemic, such as increased loneliness or reduced physical activity. Key messages: This is the first study on health and wellbeing on older adults (60+ years) in the city of Dresden, Germany. The COVID-19 pandemic had a high impact on older adults' physical activity and loneliness. Organisational factors of services are modifiable factors and may be associated with occurrence and severity of pressure sores. However, little investigation has been completed on this to date. The aim of this study was to assess the association of size of nursing homes and pressure sores requiring hospitalisation.

Methods:
Using the Database of Statutory Notifications from Social Care in Ireland we identified from notifications received by the regulator in 2019, the number of pressure sores that required hospitalisation from nursing homes. Association of size of service (registered beds) and the percentage of pressure sores requiring hospital treatment was investigated, using negative binomial regression, unadjusted and adjusted for provider type (company, sole trader, statutory body, unincorporated body, partnership), staff to resident ratio and distance to hospital (km), and nurse to resident ratio as a proxy for resident complexity in a further model.

Results:
598 Nursing homes were in operation in 2019. 1 was excluded for missing covariate data and 597 included for analysis. 447 submitted 2996 notifications of pressure sores, median (IQR): 3 (0 to 8). 255 pressure sores (8.51% of total) required hospitalisation. Pressure sores that required hospitalisation and size of service was positively associated, incidence rate ratio (95% confidence interval): 1.001 (1.000 to 1.002). This remained when adjusted for covariates, 1.003 (1.001 to 1.006) and additionally for nurse to staff ratio, 1.013 (1.011 to 1.016)

Conclusions:
A small but significant higher number of pressures sores required hospitalisation from larger nursing homes. The reasons for this are unknown but may include cultural differences and ability to provide continuity of care between larger and smaller nursing homes. Key messages: Larger nursing homes are associated with higher incidents of pressure sores that require hospitalisation. This association remains when adjusted for covariates and nurse to staff ratio. Reasons larger nursing homes are associated with higher incidents of pressure sores that require hospitalisation are unknown but may be influenced by their ability to provide continuity of care.

Introduction:
During the COVID pandemic, COVID-related data collected in family medicine were scarce. We aimed to monitor cantonal trends of COVID-related activity in family medicine and paediatric practices during the year 2021.

Methods:
Family physicians and paediatricians established in the canton of Vaud were invited to join an ad hoc sentinel surveillance system. Online data collection was based on daily activity reports and monthly questionnaires. In particular, participants categorized daily counts of consultations and phone calls into predefined COVID-related categories.

Results:
Thirty-seven practices contributed regularly to the system between March 20th and December 31st 2021. Out of 81'407 medical consultations, 4'950 (6.1%) were related to new COVID suspicions as defined by the Federal Office of Public Health, and 5'252 (6.4%) otherwise related to COVID. Depending on the week and the practice, between 5.6% and 26.5% of face-to-face consultations were COVID-related. In paediatrics, COVID-related activity corresponded mostly to new COVID suspicions (11.2% of on-site consultations), whereas among family physicians other COVID topics predominated (9.8% of face-to-face consultations), mainly questions about vaccination. Consultations for persisting COVID-related symptoms were stable at a low level throughout the year, and constituted less than 1% of all consultations. Most practices swabbed patients for SARS-CoV-2 tests, and an increasing proportion performed rapid antigenic tests over the year. In paediatrics, COVID-suspicions were not systematically tested.

Conclusions:
Throughout 2021, COVID-related consultations constituted an important part of family medicine and paediatric practices' activity in the canton of Vaud. Monitoring COVID-related activity in primary care during a pandemic documents how physicians translate recommendations into practice and provides health authorities with valuable information to guide public health action. Key messages: Throughout 2021, COVID-related consultations constituted an important part of family medicine and paediatric practices' activity in the canton of Vaud.
Monitoring COVID-related activity in primary care during a pandemic documents how physicians translate recommendations into daily practice.