Factor affecting the activities of daily living among aging people during the COVID-19 pandemic – a structural equation modelling

Introduction
The activities of daily living (ADLs) are a set of basic skills necessary for self-care. The inability of elderly people to perform ADLs leads to dependence, insecure conditions, and poor quality of life. The COVID-19 pandemic has affected all aspects of the daily life of the elderly. This study aimed to determine the factors associated with ADLs among elderly people during the COVID-19 pandemic using structural equation modelling/path analysis.

Material and methods
It was a descriptive-analytical study which had conducted on 487 elderly people who were selected randomly to participate in the study. Data collection tools included a demographic information questionnaire, an activities of daily living questionnaire, a knee pain and personal performance questionnaire Western Ontario and McMaster Universities Osteoarthritis (WOMAC), and the falls efficacy scale, which were completed by interview and self-report methods. SPSS-22 and AMOS software were used for data analysis.

Results
Two structures of the fear of falling (FOF) and knee pain and personal performance questionnaire WOMAC had a significant role in explaining the ADL variance among the studied elderly people (p < 0.001, root mean square error of approximation = 0.063). These variables explained 64% of the ADL variance.

Conclusions
The structures of this model (FOF and WOMAC) can be used as a reference framework to design effective interventions for improving ADLs among elderly people during the COVID-19 epidemic. It is also recommended that a multi-component program be provided, which includes exercise and psychological strategies for this population during the COVID-19 pandemic through online videos, distance health programs, etc.