In response to the public-health need to recognize risk factors for excess mortality related to the COVID-19 pandemic, the study was aimed to identify potential risk factors for 29 months all-cause mortality before the COVID-19 pandemic and during the first fourteen months of the pandemic (first and second phase) among older people in Poland with special attention to health, unhealthy living conditions and social characteristics.
A cross-sectional study: Elder neglect and self-neglect – challenges for formal and informal caregivers and the medical and social professional care system was conducted in Małopolska Region in Poland in 2017; 1,976 face-to-face interviews were performed among individuals aged 65 or older randomly selected from the general population. A structured questionnaire was used to collect information. Such determinants like place of residence, characteristics of unhealthy living arrangements (lack of: bathroom, toilet in the house, kitchen, hot water, refrigerator, washing machine, damaged household appliances and coal heating; dust, dirt, as well as living space in square meters per person -overcrowded houses/flats) were defined as potential risk factors in relation to gender, age, marital status, level of education, personal net monthly income in PLN (less than or equal to 950 PLN (the first quartile); more than 950 PLN). Abuse neglect and self-neglect were measured using developed authors instruments: Self-Reported Neglect Scale (SRNS); the whole assessment of self-neglect was performed using three scales: The Self-Reported Self-Neglect Scale (SRSNS), The Objective Assessment of the Level of Self-Neglect – Physical Appearance (OALSN-PA) scale and The Objective Assessment of the Level of Self-Neglect – Standards of Living Arrangements (OALSN-SLA). Higher scores on the scales indicated a higher level of symptoms of abuse, neglect or self-neglect.
Information about deaths was obtained from the State Systems Department; presented results are based on the Cox proportional hazard models.
In conclusion, groups of older people at risk of all-cause mortality in the second phase of the COVID-19 pandemic were markedly different than in the first phase. Observed all-cause mortality patterns during the pandemic were different to a great extent from those from the pre-pandemic time.