Aging & Gerontology

Although all age groups are at risk of contracting COVID-19, older people face significant risk of developing severe illness if they contract the disease due to physiological changes that come with ageing and potential underlying health conditions. Support for older people, their families and their caregivers are an essential part of the countries' comprehensive response to the pandemic. During times of isolation and quarantine, older people need safe access to nutritious food, basic supplies, money, medicine to support their physical health, and social care. Dissemination of accurate information is critical to ensuring that older people have clear messages and resources on how to stay physically and mentally healthy during the pandemic and what to do if they should fall ill.

Bereavement, isolation, loss of income and fear are triggering mental health conditions or exacerbating existing ones. Many people may be facing increased levels of alcohol and drug use, insomnia, and anxiety. Meanwhile, COVID-19 itself can lead to neurological and mental complications, such as delirium, agitation, and stroke. People with pre-existing mental, neurological or substance use disorders are also more vulnerable to SARS-CoV-2 infection ̶ they may stand a higher risk of severe outcomes and even death. Although it is currently unclear what the full extent of the effects of this pandemic will be, its negative impact on psychological well-being has become very evident. Early studies have already reported an increase in anxiety, and depression in the general population, especially those facing extended lockdowns. These effects are magnified in the elderly population due largely to stricter lockdowns, higher threat of illness, and loss of social support. Prior studies have also reported that even outside of crisis times, the elderly population have relatively high rates of depressive symptoms, which is troubling in the face of evidence that those suffering from pre-existing mental health conditions have been most affected by the negative psychological consequences of lockdowns. While increased mental health problems in the general population may already be a cause for concern, these concerns go beyond psychological well-being in the elderly. Studies have shown that depression in the elderly is linked the subsequent cognitive decline, and risk of Alzheimer's Disease. This means that while many societies now face the immediate threat of increasing mental health concerns, the long-term effects could be devastating, as depression and stress result in the older generation facing hastened cognitive decline, and increased rates of Alzheimer's Disease. This problem will likely be even further worsened by the physical limitations put on the movement of individuals outside their homes, resulting in less exercise opportunities for many individuals. Several studies have shown that exercise, even in light to moderate doses and intensities, can have a significant positive effect on cognitive function in the elderly, especially in those with cognitive impairments, or neuropsychiatric disorders. Looking at this prior research, loss of socialization, increased mental strain and general mental health problems, and decreased exercise, could have substantial negative effects on the elderly population. Although the lockdowns may be temporary, these effects are likely to be long lasting, and could pose significant risks to the quality of life of the elderly population in the coming years.

However, the changes many countries have seen come into place since the start of the COVID-19 pandemic extend far beyond loss of socialization, and increased depression. Lockdowns have resulted in a significant shift in the functioning of day-to-day life: the world has gone digital. As hospitals have filled with COVID-19 patients, access to regular healthcare for non-COVID related disorders has been interrupted. Those who do not seek care for non-COVID related disorders may be at higher risk of illness and fatality during this period. This risk is likely to disproportionately affect the elderly, who have higher rates of health problems than younger populations and are more likely to be encouraged to avoid areas where they could contract the disease. In response to this problem, there has been a significant shift in healthcare into the digital world. Telehealth, or the act of providing healthcare digitally, and remotely, has become commonplace in many countries. However, this shift has had fewer positive effects in the elderly than other populations. A recent study showed that about 40% of elderly individuals were unprepared to use telehealth resources, predominantly due to lack of skills to effectively make use of the technology. This has been further shown during the pandemic, as the group with the highest adoption of telemedicine use has been those aged 20–44, despite the fact that the elderly population generally have the highest yearly number of doctor and hospital visits. Although there have been some recent efforts to create virtual geriatric clinics to support the elderly during the pandemic, research has shown these have had varying success, and have been met with a variety of problems related to difficulties with technology use. Therefore, despite being the group most in need of telehealth solutions, the elderly community has benefited from their implementation the least.

This shift into the digital realm extends beyond just the healthcare sector. Online access to COVID-19 related news, education, grocery delivery services, group socialization, and many more services have become commonplace. The world has adapted to try and make up for the loss of access to everyday resources, and in many areas, and for many people, this has been fairly effective. However, one group likely to benefit the least from these digital alternatives are the elderly population, who have significantly lower rates of internet usage and acceptance than other age groups. This results in a worrying paradox: the population most negatively affected by the COVID-19 pandemic, are also the least likely to be able to access the resources put in place to mitigate the effects. This paradox can largely be attributed to the poor digital literacy skills found amongst the elderly population compared to younger groups, most commonly described as the digital divide.