An Observational Cohort Study of Longitudinal Impacts on Frailty and Well-Being of COVID-19 Lockdowns in Older Adults in England and Spain

To reduce the spread of COVID-19, governments initiated lockdowns, limiting mobility and social interaction of populations. Lockdown is linked to health issues, yet the full impact on health remains unknown, particularly in more vulnerable groups. This study examined impact on frailty and outcomes in high and low COVID-19 risk older adults. We examined health-related behaviours and support resources participants used during lockdown(s). Lockdown impacts in two countries were compared across four time points to examine impacts of different rules. We recruited 70 participants (aged >70 years) in England and Spain. Participants were allocated to higher or lower COVID-19-risk groups based on UK NHS guidelines. They completed assessments for frailty, quality-of-life, loneliness, exercise frequency and social interaction, coping resources and perception of age-friendliness of their environment. The four assessments took place over a 7-month period. Frailty was highest at Time 1 (most severe lockdown restrictions) and significantly higher in the Spanish group. It was lower at Time 3 (lowest restrictions), but did not continue to reduce for the English participants. Perceptions of the age friendliness of the environment matched these changes. Coping resources did not mitigate changes in frailty and outcomes over time, but more frequent physical activity predicted more reduction in frailty. Lockdown had a negative impact on frailty, increasing risk of adverse events for older people, but recovery once lockdowns are eased is evidenced. Further research is required to consider longer term impacts and methods to mitigate effects of lockdown on health

‘It’s a double whammy’:A qualitative study of illness uncertainty in individuals with Parkinson’s Disease in the context of COVID-19

Objectives The purpose of this study was to explore the experiences of individuals with Parkinson's through the theoretical lens of illness uncertainty during the first UK full lockdown period (March–June 2020) put in place due outbreak of the COVID-19 pandemic. Methods Individual semi-structured interviews were carried out via telephone in May 2020 with 10 individuals with Parkinson's (six men and four women) recruited from Parkinson's UK. Interviews were recorded and transcribed verbatim, and thematic analysis was adopted to analyse the resulting data. Results Four overarching themes emerged from the interview data: (1) COVID-19 amplifying existing fears and difficulties around the uncertainty of Parkinson's; (2) practical and psychological efforts to manage uncertainty; (3) benefit-finding as a way of acknowledging the positives of lockdown; (4) risk and future management in the context of uncertainty. Discussion Participants reported a range of implicit and explicit strategies to cope with the ‘double whammy’ of uncertainty caused by having Parkinson's during a global pandemic. While these were generally successful in maintaining well-being, it is important that such successful accounts are used to help inform novel strategies and interventions targeting individuals who might need additional support

ATTITUDES AND SOCIAL COGNITION Propensities and Counterfactuals: The Loser That Almost Won

Close Counterfactuals are alternatives to reality that "almost happened." A psychological analysis of close Counterfactuals offers insights into the underlying representation of causal episodes and the inherent uncertainty attributed to many causal systems. The perception and representation of causal episodes is organized around possible focal outcomes, evoking a schema of causal forces competing over time. We introduce a distinction between two kinds of assessments of outcome probability: dispositions, based on causal information available prior to the episode; and propensities, based on event cues obtained from the episode itself. The distinction is critical to the use of almost, which requires the attribution of a strong propensity to the counterfactual outcome. The final discussion focuses on characteristic differences between psychological and philosophical approaches to the analysis of Counterfactuals, causation, and probability. The question of how people think of things that could have happened but did not has attracted increasing interest among psychologists in recent years (J. T. Our study began with an attempt to understand the psychology of assertions of the form "X almost happened," which we call close Counterfactuals. An important characteristic of such We are grateful to Maya Bar-Hillel, Baruch Fischhoff, Dale Griffin, Lenore Kahneman, Igal Kvart, Dale Miller, and Amos Tversky for helpful comments and conversations; to Anne Treisman for her insights throughout the project; and to three anonymous reviewers for useful suggestions. Correspondence concerning this article should be addressed to Daniel Kahneman, Department of Psychology, Tolman Hall, University of California, Berkeley, California 94720. assertions is that they are not expressed as a conditional with a specified antecedent, as counterfactual conditionals are. The close counterfactual does not invoke an alternative possible world, but states a fact about the history of this world-namely that things were close to turning out differently than they did. Our approach combines some elementary phenomenological observations and an equally elementary linguistic inquiry into the conditions under which close counterfactual assertions are appropriate. The genre is not unknown in psychology