Despite concerns that older adults would face a mental health crisis stemming from loneliness and isolation due to lockdown measures during the initial phase of the COVID-19 pandemic, several studies suggest that older adults may be more resilient to anxiety, depression, and stress than younger populations, authors wrote in an opinion piece published in JAMA1.
Both studies conducted in the United States and in other high-income countries have indicated that older adults were less likely to experience negative mental health outcomes than younger adults. The Centers for Disease Control and Prevention (CDC), for example, found that in a group of 933 participants aged 65 years and older, 6.2% reported anxiety disorder, 5.8% reported depressive disorder, and 9.2% reported trauma- or stress-related disorder (TSRD) while, a group of 731 participants aged 18 years to 24 years, 49.1% reported anxiety disorder, 52.3% reported depressive disorder and 46% reported TSRD2. A cross-sectional study in Spain found that older adults (aged 60 years to 80 years) experienced lower rates of anxiety, depression, and posttraumatic stress disorder (PTSD) than adults aged 40 years to 59 years3.
Older adults who live in a community may be especially resilient, possibly due to internal factors, such as biological stress response and personality traits, and external resources, such as social status and financial stability, the authors said.
However, these studies showcase experiences early in the pandemic, and the long-term effects of COVID-19 may have different outcomes. According to the CDC report, older adults who are members of underrepresented minority groups, have lower household income or serve as unpaid caregivers are at higher risk of experiencing negative mental health outcomes, the authors said. Individuals in certain circumstances may also be struggling more with their mental health, especially as many older adults do not have the material, social or cognitive resources, including technology, friends, and ability to exercise, that can help them cope with the stress.
The authors recommended doctors and caregivers problem-solve with given individuals and families to determine how they can obtain the resources they need, including technology that can facilitate social connections and access to mental health services. Manualized therapies, physical activity, social connectedness, compassion and “engaging in spirituality as appropriate” can also help treat chronic stress, anxiety, and prolonged grief, they said.
“Understanding the factors and mechanisms that drive this resilience [of at least some older adults] can guide intervention approaches for other older people and for other groups whose mental health may be more severely affected— eg, increasing components of wisdom like emotional regulation, empathy, and compassion. It would also be useful to consider how technology may be leveraged to this end,” the authors said.
“However, it is critical to recognize that these apparently positive early findings notwithstanding, careful monitoring and additional research will be needed to understand the psychological and mental health effects of the ongoing COVID-19 pandemic among the older population.”
Disclosure: Article authors declared honorariums from publications. Please see the original reference for a full list of authors’ disclosures.
1. Vahia IV, Jeste DV and Reynolds CF III. Older adults and the mental health effects of COVID-19. JAMA. Published online November 20, 2020. doi:10.1001/jama.2020.21753
2. Czeisler MÉ, Lane RI, Petrosky E, et al. Mental health, substance use, and suicidal ideation during the COVID-19 pandemic. MMWR Morb Mortal Wkly Rep. 2020;69(32):1049-1057. doi:10.15585/mmwr. mm6932a1
3. González-Sanguino C, Ausín B, Castellanos MA, et al. Mental health consequences during the initial stage of the 2020 coronavirus pandemic (COVID-19) in Spain. Brain Behav Immun. 2020;87: 172-176. doi:10.1016/j.bbi.2020.05.040