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COVID-19 Impact on Older African Americans in the Minority Aging Research Study: Adherence, Self-Reported Health, and Actigraphy Data
ABSTRACT
Background:
The COVID-19 pandemic disrupted the daily lives of older adults, particularly concerning social interaction, physical activity, and sleep quality. Older African Americans were disproportionately affected yet remain underrepresented in research documenting the impact of the COVID-19 pandemic.
Objective:
This study investigated changes in adherence patterns, self-reported health, physical activity and sleep duration among older African American adults in the Minority Aging Research Study (MARS) before and after the onset of the COVID-19 pandemic using online surveys and actigraphy watch data.
Methods:
MARS is a longitudinal cohort study of older African American adults who enroll initially without dementia. We examined a subset of MARS participants enrolled in the Collaborative Aging Research using Technology (CART) initiative. Weekly online health survey responses were analyzed over a 32-week period, and actigraphy watch data were assessed over a 10-week period surrounding Illinois’s March 21, 2020 stay-at-home order. Generalized estimating equations (GEE), adjusted for age, sex, and education were used to assess changes in self-reported experiences (e.g., away from home overnight, overnight visitors, blue mood, loneliness, medication changes, falls, accidents, hospitalizations, health limitations, living space change, assistance change), and actigraphy-derived daily steps and nightly sleep.
Results:
Of 59 MARS participants (mean age 76.6 ± 6.1 years, %19 male), 43 (73%; adherent) completed at least 50% of the weekly surveys. Non-adherent participants (16; 27%) were more likely to have mild cognitive impairment (MCI) (31% vs. 7%, p = 0.03) and lower mean Mini-Mental State Examination (MMSE) scores (28.1 ± 1.4 vs. 28.9 ± 1.0, p= 0.04). GEE models (1,194 weeks from 43 participants) showed significant reductions in being away from home overnight (OR = 0.29, p < 0.0001) and having overnight visitors (OR = 0.52, p = 0.01). No significant changes were observed for other self-reported experiences. COVID-19 research restrictions and study related technical disruptions limited actigraphy data availability. Nonetheless, among 15 participants with valid data, there was a significant reduction in mean daily step count (18% decrease, from 1646 ± 1306 to 1315 ± 1149 steps, p < 0.0001), with no significant change in nightly sleep duration (7% decrease, from 7.1 ± 2.3 hours to 6.9 ± 2.3 hours, p=0.49).
Conclusions:
Despite widespread COVID-19 disruptions, older African American participants within MARS maintained a stable survey engagement, reflecting resilience in digital health participation. Participants with low survey adherence were more likely to have cognitive impairment, suggesting mild cognitive challenges may hinder sustained participation with online responses. Actigraphy data showed reduced physical activity, highlighting behavioral changes among engaged participants. Although technical issues limited data availability, the findings support the value of objective monitoring and highlight the challenges associated with temporary disruptions to the research infrastructure. Clinical Trial: N/A
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