The Association of Long COVID-19 Symptoms, Physical Function, and Activities of Daily Living Among Older Women

Xiaochen Zhang; Chloe Hery; Eric M McLaughlin; Nancy F Woods; Marian L Neuhouser; Holly Harris; Emily W Gower; Jean Wactawski-Wende; Aladdin H Shadyab; Robert B Wallace; Electra D Paskett

doi:10.1111/jgs.19434

The Association of Long COVID-19 Symptoms, Physical Function, and Activities of Daily Living Among Older Women

J Am Geriatr Soc. 2025 Mar 10. doi: 10.1111/jgs.19434. Online ahead of print.

Authors

Affiliations

¹ Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, USA.
² Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, Washington, USA.
³ Center for Biostatistics, The Ohio State University, Columbus, Ohio, USA.
⁴ Biobehavioral Nursing and Clinical Informatics, University of Washington, Seattle, Washington, USA.
⁵ School of Public Health, University of North Carolina, Chapel Hill, North Carolina, USA.
⁶ School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA.
⁷ Herbert Wertheim School of Public Health and Human Longevity Science and Division of Geriatrics, Gerontology, and Palliative Care, Department of Medicine, University of California San Diego, La Jolla, California, USA.
⁸ College of Public Health, University of Iowa, Iowa, Iowa, USA.

PMID: 40062652
DOI: 10.1111/jgs.19434

Abstract

Background: The impact of COVID-19 on physical function (PF) outcomes among older adults remains unclear. We examined the long-term association between COVID, PF, and Activities of Daily Living (ADLs) among women from the Women's Health Initiative (WHI).

Methods: Participants from the WHI who completed the COVID-19 survey (2021-2022) and annual survey (2022) were included. Self-reported data on COVID-19 testing and symptoms (2021-2022) were used. PF score and ADLs were evaluated pre- and post-COVID-19 survey by the 36-Item Short Form Survey PF subscale, the Lawton Instrumental Activities of Daily Living, and the Katz Index of Independence in ADL. Multivariable linear regression and logistic regression were used and adjusted for pre-COVID functioning to examine the association between COVID status, PF, and ADLs. The interaction between pre-COVID functioning and COVID status was tested.

Results: Among the 13,933 WHI participants, 71.4% were aged ≥ 80 years, and 88.6% were Non-Hispanic White. Only 8.7% tested positive for COVID-19 (n = 1210), with 35.1% having long COVID (n = 425). The most common long COVID symptoms were fatigue (18.2%), malaise (12.2%), memory problems (12.1%), and brain fog (11.2%). Women who tested COVID+ had lower PF scores (60 vs. 65, p = 0.045) and were less likely to be able to do all ADLs without help (74% vs. 79.2%, p = 0.015) compared to those who never tested COVID+. After controlling for covariates, post-COVID PF scores did not differ by COVID status (p = 0.30), although pre-COVID PF scores were significantly linked to post-COVID scores (p < 0.001). Similarly, the odds of being able to do all ADLs without any help did not differ by COVID status (p = 0.31), with pre-COVID ADLs significantly associated with post-COVID ADLs (p < 0.001).

Conclusions: In older women, after accounting for pre-COVID functional status, the association between long COVID and lower functioning became nonsignificant. Our findings highlight the importance of preserving physical functioning among older women.

Keywords: functioning; long COVID; older women; symptom cluster.

Abstract

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