Resiliency helps older adults deal with the pandemic
A recent article in JAMA discusses why older adults appear to be coping better with loneliness and social isolation than younger adults during the COVID-19 pandemic.
Pandemics are stressful, and the loneliness that comes with isolation takes a toll on mental health.
Surveys from the Centers for Disease Control and Prevention (CDC) conducted between June 24 and June 30, 2020, found that 40.9% of respondents experienced at least one mental or behavioral health condition. These ranged from symptoms of anxiety, depression, and trauma to starting or increasing substance use.
While all humans need social contact, some cope better with less contact than others.
Young and old
Social deprivation, the reduction or prevention of levels of social interaction considered normal depending on culture, is particularly harmful for adolescents.
A 2020 review of studies investigating social isolation and loneliness, published between January 1, 1946, and March 29, 2020, found that these factors strongly predicted later depression in children, adolescents, and young adults.
Additionally, loneliness correlated with an increased risk of mental health problems up to 9 years later in life.
An April 2020 article from the European Paediatric Association investigated adolescent mental health during the COVID-19 pandemic. The researchers reviewed data from preliminary studies in China and found that those aged 3–18 were more clingy, distracted, irritable, and fearful of asking coronavirus-related questions. They also had trouble sleeping, poor appetites, and separation problems.
Young adults are also vulnerable to the psychological effects of social isolation. An October 2020 study found that in a group of 564 adults aged 22–29 years, 60.7% of whom were female, loneliness increased between January and April–May. This effect was more prevalent in females, as were increased symptoms of depression.
Social isolation can also cause physical symptoms, such as a weakened immune system, an increased risk of diabetes, and an increased risk of death.
A 2016 study found a strong link between a poor social life and an elevated risk of inflammation during adolescence.
In older adults, a lack of social interaction is linked to a greater risk of hypertension, compared with diabetes.
The CDC cite 2020 estimates that one-third of adults aged 45 or older feel lonely, and almost 1 in 4 adults 65 or older are socially isolated. This is associated, they report, with health risks, including higher rates of depression, anxiety, and suicide.
However, while older adults may be experiencing significant social isolation from loved ones, this may not necessarily translate into worsening mental health, according to a recent Viewpoint article in JAMA.
Older adults less severely affected
A group of researchers at institutions in Massachusetts, California, and Pennsylvania looked at early data from several global studies on older adults and mental health during the pandemic.
While older adults are considered a vulnerable population for severe COVID-19 and related mortality, the researchers found that these adults were less negatively affected by mental health strain than younger adults.
One report from the CDC, for example, concluded that older adults were less likely to start or increase substance use and less likely to think about suicide.
Of course, these findings do not apply to every older adult. In the same report, the CDC acknowledge that adults from marginalized groups or low-income households, and those who provided unpaid caregiving services were more likely to experience adverse health effects.
This is consistent with other evidence of higher levels of anxiety, depression, stress, and post-traumatic stress disorder in people of color, compared with white people, during the COVID-19 pandemic.
Factors affecting resiliency in older adults
Based on the evidence, the authors suggest that older adults better withstand the mental health strains of the pandemic thanks to increased resilience and a drive to stay connected with others.
They explain that some global studies have shown that resilience is linked to maintaining meaningful relationships with others and access to mental health care.
“However, despite this early resilience, older adults expressed concerns about their longer-term physical and financial well-being,” the authors caution.
Resilience might also be linked with wisdom. The analysis found that having wisdom is associated with higher levels of compassion and less loneliness.
Improving resiliency
The researchers observe that increased access to technology could improve resiliency in some older adults who do not have smartphones, for example.
“Many older adults do not have the resources required to deal with the stress of COVID-19. This may include material (e.g., lack of access to smart technology), social (e.g., few family members or friends), or cognitive or biological (e.g., inability to engage in physical exercise or participate in activities or routines) resources.”
Increasing access to technology and related education may help older adults maintain social relationships and boost their engagement with mental health services.
Written by Jocelyn Solis-Moreira on December 6, 2020 — Fact checked by Hilary Guite, FFPH, MRCGP
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