Not only did gyms, yoga studios, pools, adult day programs, community and senior centers all close for extended periods; many older people also undertook fewer ordinary chores and errands and may have skipped recreational pastimes.
“If you’re limiting visits to the grocery store or having groceries delivered, or not going to visit or help with your grandchildren, if you’re not meeting friends at a coffee shop — those all take a certain level of physical activity,” Dr. Beauchamp said.
Many older people did less traveling or in-person shopping; religious services, family gatherings and medical appointments moved online. “Picture how much activity we do without even thinking about it,” Dr. Hoffman said. When that changes substantially, “it adds up over six or nine months, then you have loss of balance or muscle strength, which leads to more trips and falls.”
Disparities in health and income also appear to play a role, with reduced physical conditioning and mobility more commonly reported, in both countries, by respondents in low-income categories, in fair or poor health or with multiple chronic conditions.
“Relatively healthy older adults have sufficient reserve if they reduce activity,” said Neil Alexander, a geriatrician at the University of Michigan and Ann Arbor Veterans Affairs who was not involved in the study. “High-risk people may be driving these numbers.”
Dr. Alexander also pointed out that early in the pandemic, older patients had less access to rehabilitation and other services. “It was difficult to get people into the home for occupational therapy and physical therapy,” he said. “The support services to keep people mobile and functioning were disrupted.” Now, work force shortages may be having a similar effect, he noted.
Physical function is key to living independently — the future that a great majority of older people envision for themselves. A loss of mobility and function across a considerable proportion of the senior population could mean increasing disability, a greater need for eventual long-term care, and higher Medicare and Medicaid costs.