COVID-19 risk factors and predictors for handwashing, masking, and social distancing among a national prospective cohort of US older adults

Abstract

Objectives: Older adults have a disproportionately higher COVID-19 risk, however, there is limited research investigating adherence to the major COVID-19 mitigation behaviors (handwashing, masking, social distancing) for older populations. We examined COVID-19 risk factors and predictors for adherence to COVID-19 mitigation behaviors among a national sample of U.S. older adults.

Study Design: Data were retrieved for 3,257 respondents from the National Health and Aging Trends Study, a nationally representative prospective sample of U.S. Medicare beneficiaries age 65 or older. COVID-19 variables were collected in 2020, while all other data were collected in 2019.

Methods: We utilized multiple logistic regression to analyze COVID-19 risk factors and predictors for handwashing, masking, and social distancing to minimize COVID-19 spread. Missing data were imputed, and all models applied survey sampling weights.

Results: Factors significantly associated with increased odds of COVID-19 diagnosis among U.S. older adults were Hispanic ethnicity, low-income household, residential care or nursing home, and generalized anxiety disorder. We identified multiple factors significantly associated with adherence to handwashing, masking, and social distancing. Most notably, older males had a significantly lower odds of practicing all three COVID-19 mitigation behaviors, and Black older adults had a significantly higher odds of masking and handwashing.

Conclusions: When prioritizing COVID-19 prevention efforts for older adults, risk factors that should be considered are race and ethnicity, income, residential setting, and anxiety. To effectively mitigate COVID-19 disease spread, public health professionals must also recognize sociodemographic and health factors may influence whether older adults adhere to handwashing, masking, and social distancing.