Older Adults More Resilient than First Thought

covid alert levels and mental health

As we are in another lockdown level 4, it’s perhaps time to look at the studies that were done during 2020 on the mental health and wellbeing of older adults.

Initially, experts thought that older adults would fare worse than younger people in a lockdown due to concerns around disruptions to their daily routines, isolation from friends and family, and difficulties adapting to technologies like telemedicine, zoom and even using mobile devices.

However, studies have found that older adults tend to have lower stress reactivity and generally have better emotional regulation and wellbeing than younger adults. Though the sheer scale of the pandemic means that concern remains about a mental health crisis among older adults, both those living in care and at home.

Early data suggests a much more complex picture that, counter to expectation, older adults as a group may be more resilient to the anxiety, depression, and stress-related mental health disorders characteristic of younger populations during the initial phase of the COVID-19 pandemic. Indeed at the one year mark, multiple studies have shown that older adults may be less negatively affected by mental health outcomes than other age groups.

In August 2020, the CDC published a survey, conducted June 2-30, 2020, of 5412 community-dwelling adults across the USA. They noted that the 933 participants aged 65 years or older reported significantly lower percentages of an anxiety disorder (6.2%), depressive disorder (5.8%), or trauma- or stress-related disorder (TSRD) (9.2%) than participants in younger age groups.

There are several caveats to consider about this data, given that the findings are from mid-2020. In particular, in countries like the USA, where there are very high infection rates, the long term effects of COVID-19 are not clear.

Long-term stressors can increase the rates of mental health conditions such as prolonged grief disorder, depression, and anxiety. Short term positive outcomes among older adults at the population level may not necessarily capture the variations of outcomes at the level of individuals or communities such as nursing homes and assisted living facilities.

According to the CDC report, even though older adults may have better mental health outcomes than expected, those from minorities, lower household incomes, or serve as unpaid caregivers are at disproportionally elevated risk of experiencing adverse health outcomes.

The current data does not provide perspectives on older adults like those with dementia, or those caring for a person with dementia, those residing in assisted living facilities or nursing homes.

Even considering the points raised, the early findings suggest a higher resilience in community-dwelling older adults to the mental health effects of COVID-19. As lockdowns extended, much of the initial concern about how older adults would respond to COVID-19 was how loneliness and isolation would affect this population.

Extensively documented, the negative influence of loneliness among older adults is well known. However, this reaction might be countered by a range of coping mechanisms. Older adults appeared to withstand the influence of isolation, especially with social connectedness and access to mental health care. However, despite this early resilience, older adults expressed concerns about their longer-term physical and financial wellbeing.

The COVID-19 pandemic is a unique stressor that has affected communities all around the world. Some individual studies from different countries have shown that some older adults are not experiencing disproportionately increased negative mental health consequences given the elevated risks they faced during the first few months of the COVID-19 pandemic.

Understanding the factors and mechanisms driving this resilience can guide intervention approaches for older people and other groups whose mental health may be more severely affected.