How are older adults coping with the mental health effects of COVID-19?

Older adults are especially vulnerable to the effects of the COVID-19 pandemic—with higher risks of severe complications and death, and potentially greater difficulties accessing care and adapting to technologies such as telemedicine. A viewpoint article published in the Journal of the American Medical Association notes that there's also a concern that isolation during the pandemic could be more difficult for older individuals, which could exacerbate existing mental health conditions. Information gathered over the past several months suggests a much more nuanced picture, however.

"Over the spring and summer of 2020, we were struck by a number of individual studies from all over the world that reported a consistent theme: Older adults, as a group, appeared to be withstanding the strains on mental health from the pandemic better than all other age groups," said lead author Ipsit Vahia, MD, medical director of the Geriatric Psychiatry Outpatient Services and the Institute for Technology in Psychiatryat McLean Hospital. "In this article, we highlight some of these studies and discuss resilience in older adults and what factors may be driving it."

Resilience may reflect an interaction among internal factors—such as an individual's stress response, cognitive capacity, personality traits, and physical health—and external resources like social connections and financial stability. For older adults experiencing isolation during the pandemic, having more meaningful relationships seems to be more important than having more interactions with others, and maintaining these relationships may require the use of technology to connect with loved ones.

Resilience can be supported through increased physical activity, enhanced compassion and emotional regulation, and greater social connectivity. Technology can play an important role in achieving these. "It can help maintain social connectivity, provide access to care via telemedicine, and also facilitate a range of other activities that may help cope with isolation," said Vahia. "It is increasingly becoming important for clinicians to assess patients' access and proficiency with technology as a part of care."

The authors stressed that although findings from the early months of the pandemic are encouraging and provide cause for cautious optimism, they may not reflect individual realities. "Older adults are a highly diverse group, and each person's response to the stresses of the pandemic depends on a unique set of circumstances," Vahia explained. "In addition, the current studies may not reflect specific high-risk populations with unique stressors, such as those living in underserved areas or those suffering with dementia or caregivers for people with dementia."

Importantly, the pandemic continues without a defined timeline or clear end in sight. The longer-term effects of COVID-19 on older adults' mental health, especially in countries with very high rates of disease, are unclear.