Piotr Wilk

The COVID-19 pandemic negatively impacted mental health, particularly among middle-aged and older adults, who have emerged as especially vulnerable. This scoping review synthesizes findings from 44 population-based studies retrieved from six databases, aiming to map changes in mental health outcomes during the pandemic and identify associated factors. During the global spread and response phase of the pandemic (May 2020–December 2021), a notable rise in depressive symptoms, anxiety symptoms, stress, distress, loneliness, and poor well-being was documented, highlighting a decrease in overall mental health of middle-aged and older adults. Whereas some studies from the transition period toward the endemic phase of the pandemic (2022–2023), began reporting signs of stabilization or improvement, particularly in depressive symptoms, anxiety symptoms and stress. Factors influencing these negative mental health outcomes were multidimensional (demographic, socioeconomic, health-related, behavioral, and COVID-19-related factors). Female sex, old age, being married, unemployment, lower education status, higher income, poor physical health, limited physical activity, perceived threat of COVID-19, social isolation, and lack of support were mainly associated with worsening mental health changes during the pandemic among middle-aged and older adults. However, there is little research highlighting population-level factors (COVID-19 cases, deaths, vaccination status, etc.) associated with these changes. Also, the evidence remains limited regarding mental health changes during the transition to the endemic phase, possibly due to shifts in research priorities, but it is essential to continue monitoring mental health outcomes to track long-term changes and to prepare for future public health emergencies.

Background and Aims: Inflammatory bowel disease (IBD) poses significant challenges to healthcare systems, with rising prevalence globally. To address challenges of health resource allocation and understand the geographic distribution of disease in Canada, we explored spatial mapping of IBD across Canada. Methods: Data from 2009 to 2018 Canadian Community Health Survey identified individuals with IBD. Crude and adjusted prevalence rates were calculated, and spatial dependencies were analyzed using Moran’s I. Local indicators of spatial association identified hot-spots where the prevalence of IBD was significantly different than neighboring areas. Spatial autoregressive models assessed the influence of sociodemographic factors on spatial dependencies. Results: Across 109 health regions, 492 560 individuals were included, representing 29 846 350 Canadians. Crohn’s disease and ulcerative colitis were reported in 0.38% and 0.47% of Canadians, respectively. Age and sex-standardized prevalence ranged from 742 to 1267 per 100 000. Significant dependencies among health regions were found, but dependencies were explained by the distribution of sociodemographic characteristics in a region. Conclusions: Results demonstrated significant geographic variations in the prevalence of IBD in Canada. Evidence suggests that differences in prevalence between regions are primarily driven by individual demographics rather than geographical characteristics.

Background and Aims: To understand trends in the risk of all-cause hospitalization for individuals with inflammatory bowel disease we explored age, period, and cohort effects in Canada. Methods: Repeated cross-sectional survey data from the 2005-2014 Canadian Community Health Survey linked to the Discharge Abstract Database to capture the all-cause hospitalization within three years of entry into the study for eligible individuals. Random effects two-level models estimated fixed effects for age and random effects for time periods and birth cohorts on the risk of all-cause hospitalization within three years entry into the study. Results: An estimated 197,000 individuals were eligible for study inclusion. From this, an estimated 70,140 all-cause hospitalizations occurred within three years post-entry into the study. The risk of hospitalization within three-years increased with age and across birth-cohorts, with older cohorts experiencing greater risks of hospitalization. A small temporal effect was identified for both inflammatory bowel disease groups. Within birth cohorts, the risk of hospitalization increased across ages for Crohn’s disease, but in individuals with ulcerative colitis, the risk decreased across ages, except for the two oldest birth cohorts. Conclusions: These data support the hypothesis that age effects are primarily responsible for increased risk of hospitalizations. As the prevalence of IBD continues to rise and age distribution of Canadians shifts towards an older-aged population, increasing the allocation of healthcare resources to prevent age-related risks of hospitalizations would be beneficial to reduce hospital burdens.

The COVID-19 pandemic has been associated with a general decline in well-being. However, there is limited evidence on the effect of the pandemic on the general population, and especially among the ageing population. We assessed the overall impact of the pandemic on the well-being of middle-aged and older adults residing in 27 European countries, focusing on the time-period before summer 2021. We used a sample of 46,209 respondents from the two population-based longitudinal Corona Surveys collected during summer 2020 and summer 2021. To test our hypotheses, we used latent change score models. All analyses were stratified by sex. The COVID-19 pandemic affected middle-aged and older Europeans’ well-being irrespective of their sex. Being infected by the COVID-19 virus at the start of the pandemic had a negative impact on well-being. As expected, adults with Long COVID experienced the most pronounced decline in well-being. A novel finding was the decline in the level of well-being among adults not infected by the COVID-19 virus. Support should be provided at community levels with specific attention towards individuals with Long COVID symptoms and those infected with COVID-19 at earlier stages of the pandemic.

Background: Status epilepticus (SE) is a neurological emergency characterized by prolonged seizures. However, the incidence of first-episode SE is unclear, as estimates vary greatly among studies. Additionally, SE risk factors have been insufficiently explored. Therefore, the objectives of this study were to estimate the incidence of first-episode SE in Ontario, Canada, and estimate the associations between potential sociodemographic and health-related risk factors and first-episode SE.Methods: We conducted a population-based retrospective cohort study using linked health administrative datasets. We included individuals who completed Canada’s 2006 Census long-form questionnaire, lived in Ontario, were between 18 and 105, and had no history of SE. A Cox proportional hazards regression model was used to estimate the hazard ratios for SE within three years associated with each potential risk factor.Results: The final sample included 1,301,700 participants, 140 of whom were hospitalized or had an emergency department visit for first-episode SE during follow-up (3.5 per 100,000 person-years). Older age was the only significant sociodemographic SE risk factor (HR = 1.35, 95% CI = 1.33, 1.37), while health-related risk factors included alcohol or drug abuse (HR = 1.05, 95% CI = 1.02, 1.08), brain tumour or cancer (HR = 1.14, 95% CI = 1.12, 1.15), chronic kidney disease (HR = 1.32, 95% CI = 1.29, 1.36), dementia (HR = 1.42, 95% CI = 1.36, 1.48), diabetes (HR = 1.11, 95% CI = 1.09, 1.12), epilepsy or seizures (HR = 1.05, 95% CI = 1.01, 1.09) and stroke (HR = 1.08, 95% CI = 1.05, 1.11).Conclusion: The estimated incidence of SE in a sample of Ontario residents was 3.5 per 100,000 person-years. Older age and several comorbid conditions were associated with higher first-episode SE risk.

Background. A substantial proportion of those infected with COVID‐19 are presenting with persistent symptoms, referred to as long COVID‐19. Emerging evidence suggests that the presence of pre‐existing chronic conditions, such as diabetes, may increase the risk of long COVID‐19. Objectives. To investigate whether having pre‐existing diabetes increases the risk of developing long COVID‐19 in the population of middle‐aged and older adults (≥50 years old) in Europe, while assessing if this relationship can be accounted for or is modified by the known long COVID‐19 and diabetes risk factors (age, sex, hospitalization, pre‐existing hypertension, and weight status). Methods. A population‐based longitudinal prospective study involving a sample of respondents aged 50 years and older (n = 4,004) with probable or confirmed COVID‐19 infection from 27 countries that participated in both waves 7 and 8 of the Survey of Health, Ageing and Retirement in Europe and its 2020 and 2021 Corona Surveys. Logistic regression modeling was performed. Results. Overall, 66.8% of the respondents affected by COVID‐19 infection reported at least one long COVID‐19 symptom; 55.2% were female, and the average age was 64.6 years; 13.2% had pre‐existing diabetes. Respondents with pre‐existing diabetes had significantly higher odds of developing long COVID‐19, compared to those without diabetes (OR = 1.37; 95% CI = 1.12, 1.68). This relationship remained significant (OR = 2.00; 98% CI = 0.25, 1.14) after adjusting for sex (OR = 1.64 for females; 95% CI = 1.43, 1.88), hospitalization for COVID‐19 illness (OR = 3.19; 95% CI = 2.41, 4.23), pre‐existing hypertension (OR = 1.17; 95% CI = 1.01, 1.36), and overweight (OR = 1.31; 95% CI = 1.11, 1.56) and obese (OR = 1.77; 95% CI = 1.44, 2.19) weight status. The effect of pre‐existing diabetes on the risk of long COVID‐19 is moderated by age; it was highest at the age of 50 (OR = 2.00; 95% CI = 1.28, 3.14), and then, it declined with age. Conclusions. There is a relationship between pre‐existing diabetes and long COVID‐19, even after controlling for literature‐based confounding factors, with age having a moderating effect on this relationship.

A substantial proportion of individuals continue experiencing persistent symptoms following the acute stage of their Covid-19 illness. However, there is a shortage of population-based studies on Long Covid risk factors. To estimate the prevalence of Long Covid in the population of middle-aged and older Europeans having contracted Covid-19 and to assess the role of multimorbidity and socio-economic characteristics as potential risk factors of Long Covid. A population-based longitudinal prospective study involving a sample of respondents 50 years and older (n = 4,004) from 27 countries who participated in the 2020 and 2021 Survey of Health, Ageing and Retirement in Europe (SHARE), in particular the Corona Surveys. Analyses were conducted by a multilevel (random intercept) hurdle negative binomial model. Overall, 71.6% (95% confidence interval = 70.2–73.0%) of the individuals who contracted Covid-19 had at least one symptom of Long Covid up to 12 months after the infection, with an average of 3.06 (standard deviation = 1.88) symptoms. There were significant cross-country differences in the prevalence of Long Covid and number of symptoms. Higher education and being a man were associated with a lower risk of Long Covid, whilst being employed was associated with a higher risk of having Long Covid. Multimorbidity was associated with a higher number of symptoms and older age was associated with a lower number of symptoms. Our results provide evidence on the substantial burden of Long Covid in Europe. Individuals who contracted Covid-19 may require long-term support or further medical intervention, putting additional pressure on national health care systems.

Background: Containment and restriction measures introduced during the coronavirus (COVID-19) pandemic have had a negative effect on the health and well-being of individuals, regardless of whether or not they were infected by the SARS-CoV-2 virus. We assessed how the pandemic impacted the overall well-being of middle-aged and older adults residing in 27 European countries. In particular, we assessed how having COVID-19 illness or experiencing symptoms associated with Long COVID impacted change in the level of well-being. Methods: We used data from the Survey of Health, Ageing and Retirement in Europe's Corona Surveys collected in 2020 and 2021. The sample consisted of 47,964 respondents aged 50 years and older. The outcome variable was the across-time change in the repeated measures of well-being which were operationalized as two latent variables. We used structural equation modeling techniques (i.e., latent change score models) to assess the effects of the relevant risk factors (demographics, socio-economic, chronic conditions, social support) on change in the level of well-being. Results: Overall, 8% or respondents were infected by the SARS-CoV-2 virus and 73% of those who were infected reported at least one persistent symptom associated with Long COVID. The results from the analyses indicate that individuals who were affected by COVID-19 illness had a significantly larger decline in the level of well-being than those not affected by this illness and that this decline was more pronounced among those who had Long COVID. We also observed that the degree of change in the level of well-being was associated with the risk factors. Conclusions: The COVID-19 pandemic impacted the well-being of Europeans and its effects were more pronounced among those directly affected by COVID-19 illness. However, the magnitude of this effect differed across sub-groups of individuals.

Background and Objective: The increased burden of multimorbidity is impacting the lives of people worldwide, restricting the ability of individuals to live autonomously and leading to a poorer quality of life. Improving or maintaining a good quality of life can be an important coping mechanism...