OBJECTIVES: Self-perceptions of aging (SPA) have been shown to influence healthcare-seeking behaviors among middle-aged and older adults. Negative SPA may intensify the COVID-19 pandemic-related healthcare disruptions in this population. Therefore, this study seeks to evaluate the association between SPA and care deferrals among community-dwelling adults aged ≥50 years in the US during the COVID-19 pandemic.
METHODS: A cross-sectional study of the eligible sample was conducted using data from the 2020 wave of the Health and Retirement Study. SPA score was measured using a validated eight-item instrument with higher scores indicating negative SPA. The association between SPA and care deferrals during the COVID-19 pandemic was assessed using multivariable logistic regression adjusted for respondents’ sociodemographic and clinical characteristics, past COVID-19-related experiences, and COVID-19 worry.
RESULTS: The final sample consisted of 4,153 community-dwelling adults aged ≥50 years. 30% reported care deferrals during the COVID-19 pandemic. Among respondents who deferred care, the majority were aged 50-64 years (46.6%), females (65.4%), and White (64.5%). Most commonly reported care deferrals were dental appointments (74.5%) and physician visits (56.5%). Care deferrals were mainly due to clinic/office rescheduling or cancelling appointments (57.5%), respondent deciding the care could wait (33.8%), and COVID-19 fear (21.8%). Respondents reporting care deferrals reported higher mean SPA scores, indicating negative aging attitudes, compared those who did not defer care (Mean (SD): 3.24 (1.02) vs. 3.05 (1.04), p<0.001). After accounting for covariates, higher SPA scores were associated with significantly higher odds of care deferrals (aOR: 1.20, 95% CI: 1.11 – 1.30, p<0.001).
CONCLUSIONS: This study found that negative SPA were associated with care deferrals during the COVID-19 pandemic among community-dwelling adults aged ≥50 years. As healthcare delivery rebounds to pre-pandemic levels, the role of SPA in healthcare-seeking behaviors should be recognized. Health promotion efforts may target positive aging attitudes to encourage timely and proactive use of healthcare.
