The elderly health profile and health services access during 2020-2021. Results from Passi d’Argento

Background: The COVID-19 pandemic has affected the community in multiple health, economic, social and cultural aspects and the impact was stronger among the over-65s. PASSI d’Argento (PdA) surveillance system monitors the effects on physical activity, partecipation in social life and healthcare renunciation due to fear of Covid contagion or services interruption. Methods: Since 2016, PdA has been continuously collecting information on health, behavioural risk factors, quality of life and the care and assistance needs of eldely people. Data is collected through an anonymous and standardised questionnaire. Physical activity is assessed with the Physical Activity Scale for Elderly, an internationally validated instrument that considers all types of activities commonly performed by elderly. High PASE values correspond to high levels of physical activity. Results: The percentage of physically active elderly decreased significantly during the pandemic, from 39% (CI95% 38.3-39.8) in 2016-2019 to 35% (CI95% 33.7-36.4) in 2020-2021. The decline is greater among people with economic difficulties (44.4% to 37.5), women (from 36.7% to 33.5%), among those with chronic deseases (from 37% to 31%) or sensory impairment (from 31.3% to 27.5%). Participation in social life declines significantly from 23.1% (95% CI 22.5.1-23.8) in the pre-covid period to 142 (95% CI 13.2-15.1) in 2020-2021. The pandemic develops in a context where inequalities in prevention and care already exist; 32% of elderly declared difficulties in accessing health services in 2016-2019. During pandemic period 28% of the over-65s gave up at least one medical or diagnostic examination with a risk of delayed in diagnosis and treatment. Conclusions: PdA shows the importance of monitoring the strong impact of emergency on several aspects of elderly population to riorganize the local health system organization, implement targeted interventions and improve the health services’ offers to reduce inequalities