**1. Introduction**

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel virus responsible for COVID-19 infection, has caused a deadly pandemic worldwide. According to numerous independent studies, people of any age could be infected, but the number of older patients infected with COVID-19 has increased globally, causing a significant threat to the global population's life and health [1–3]. Therefore, patients in their 80s and older are the most likely to be hospitalized or die from COVID-19 [4]. The accumulating evidence indicates that infection in younger patients usually presents with mild symptoms, while in

Drózd˙ z, M.; Strzelec, B.; ˙ Sobieszcza ´nska, M.; Mazur, G. The Impact of the COVID-19 Emergency on Life Activities and Delivery of Healthcare Services in the Elderly Population. *J. Clin. Med.* **2021**, *10*, 4089. https://doi.org/10.3390/ jcm10184089

**Citation:** Agrawal, S.; Makuch, S.;

Academic Editor: Michele Roccella

Received: 23 July 2021 Accepted: 7 September 2021 Published: 10 September 2021

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**Copyright:** © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/).

the older population, it is associated with a more severe course and a significantly higher mortality rate. The risk increases in particular in older adults with comorbidities such as hypertension, cardiovascular disease, diabetes mellitus, chronic respiratory disease, and chronic kidney disease [5–8]. A significant percentage of older Europeans and Americans suffer from one or more of these chronic diseases that put them at an increased risk of infection. Chronic diseases that lead to a severe course of COVID-19 have been classified by the Centers for Disease Control and Prevention and include cancer, chronic kidney disease, chronic lung diseases, dementia, diabetes, Down syndrome, heart conditions, obesity, sickle cell anemia, diabetes, immune-weakening conditions, and immune system disorders [9]. The disruption of health services in most countries during the pandemic has posed challenges for older adults suffering from chronic diseases [10]. According to a study conducted by Addis et al., older age, among other factors, was strongly associated with an abnormal psychological impact of COVID-19 on patients with chronic disease [11]. Moreover, several studies have reported higher rates of severe COVID-19 among patients with comorbid chronic medical conditions [12,13]. Given the fact that the aging population is one of the most significant problems around the world and that there is a higher prevalence of multimorbidity and lower resistance in older patients, there is an urgent need to examine the impact of the pandemic on health care and life activities of elderly people.

The pandemic has led to a significant limitation of physical activity in the global population. It exerts an enormous impact on global health in all age groups, but it seems that the most critical adverse influence could be observed predominantly in the older population, where physical and social activity is fundamental to maintain good health. Thus, in that age group, proper physical activity is correlated with the reduction of anxiety, depression, osteoporosis, sarcopenia, and metabolic syndrome [14–21]. Moreover, physical activity is also crucial in the prevention of many comorbidities, which are often presented in older patients, such as hypertension, diabetes, cardiovascular diseases, and respiratory diseases [22]. Therefore, it is assumed that the SARS-CoV-2 pandemic exerts an adverse influence on population health not only by developing complications and increasing mortality associated with COVID-19 but also by reducing physical activity, which significantly affects health outcomes. The objective of this cross-sectional analysis was to determine the impact of the SARS-CoV-2 pandemic on the older population's behavior, life activity, and delivery of healthcare services. Moreover, we attempted to identify the factors that influence seniors' behavior during the pandemic, such as socio-demographic factors, level of education, and the presence of diseases such as coronary heart disease, diabetes, asthma, chronic obstructive pulmonary disease (COPD), heart, and kidney failure.
