Abstract
This longitudinal study investigated gender-specific factors associated with changes in physical function among community-dwelling older adults during the COVID-19 pandemic. Although the impact of behavioral restrictions on older adults has been previously studied, few studies have examined individual-level longitudinal changes, especially with a focus on gender differences. A total of 242 older adults in Japan (111 men and 131 women) were followed from 2019 to 2021. Physical function was assessed using the Timed Up and Go (TUG) test and 5-m habitual walking speed. Associations between individual characteristics-such as education level (years), economic status, daily activity levels, and living arrangement-and changes in physical function were examined using linear mixed-effects models, adjusting for age, education level (years), economic status, and living arrangement. The results showed that among men, having less than 12 years of education level (years) and a higher pre-pandemic leisure activity score were significantly associated with a decline in TUG performance. Among women, living alone was associated with improved 5-m walking speed. These findings indicate that physical function changes during the pandemic varied by gender and were influenced by individual-level factors. The results highlight the importance of developing gender-sensitive and context-specific strategies to support older adults in maintaining physical function during public health emergencies.