TILDA report shows scale of COVID crisis for Ireland's older people

Researchers at the Irish Longitudinal Study on Ageing (TILDA) have released a detailed and wide-ranging report revealing the toll of the COVID-19 crisis on the health and social circumstances of Ireland's older adults. The report was launched by Frank Feighan, TD, Minister of State for Public Health, Well Being and the National Drugs Strategy.

The TILDA COVID-19 report delves into a broad range of factors that affect the lives of adults aged 60 years and over during the first few months of the pandemic, including changes to everyday activities, social interactions, physical activity, and other behaviors, as a consequence of measures put in place to curb the spread of the virus.

The highly-anticipated report measures the effect that restrictions to reduce the spread of COVID-19 infection have had on 4,000 adults aged 60 years and older, including unmet healthcare needs, and changes to caregiving and receipt of care. TILDA's report, the most comprehensive of its kind, also examines the scale of increased loneliness and social isolation among older adults, and the impact on mental and physical health. It also describes the extent of exposure to COVID-19 among participants and their families and friends during the early months of the pandemic, and the level of concern about the virus among this at risk group.

How was the study carried out?

When the COVID-19 pandemic reached Ireland in March 2020, TILDA was uniquely positioned to document the impact that the pandemic has had on the lives of older adults, and with the support of the Health Research Board (HRB), TILDA surveyed 4,000 of its existing participants between July and November 2020.

TILDA has studied the lives of older adults in Ireland for more than 10 years and provides a rich account of the health, financial, and social state of a nationally representative sample of older adults. Almost 4,000 study participants, aged 60 years and older completed a survey questionnaire that was posted to their home. The findings of the report outline key information collected in this survey.

Key findings of the report

• Compliance: There is a high level of compliance with Government public health advice with 80% of the over-60s reporting adherence to advice on social distancing measures and engaging in protective behaviors to prevent the spread of COVID-19.
• Compliance: 62% of participants report not traveling to visit family members and 80% do not visit friends at all since the outbreak of the COVID-19 pandemic.
• Prevalence of COVID-19: Prevalence of COVID-19 among participants was 5%. This was three times higher among adults aged 60 to 69 years compared to the over 70s (6% vs. 2%).
• Impact of Pandemic: Between July and November 2020, one in 20 (5%) adults aged 60 and over have lost a family member or friend due to COVID-19 infection.
• Impact of Pandemic: Those most concerned about the pandemic live alone; are aged 70 and over (54%), are female (52%); are educated to primary level (56%), and live in rural areas (51%).
• Physical Activity: Almost one quarter (22%) of older adults in Ireland did not meet minimum recommended levels of physical activity during the COVID-19 pandemic. However, 27% report that they walk more often than they did prior to the pandemic, 17% also exercise more often at home than they did previously.
• Loneliness: 30% of older adults feel lonely at least some of the time. Increased isolation has resulted in an increase in loneliness across the population.
• Loneliness: Loneliness is associated with poorer overall quality of life and physical and mental health. Increased loneliness and social isolation due to COVID-19 restrictions have had a negative effect on the wellbeing of the population.
• Depression: 21% of adults aged 60+ report potentially clinically meaningful levels of depressive symptoms. Worryingly, this is double the prevalence of depression seen before the pandemic.
• Stress: 29% report high stress levels and 11% have moderate-to-severe anxiety levels. This represents a significant increase from before the pandemic.
• Delayed Medical Care: Almost one third (30%) of adults aged 60 and over delayed or did not get medical care they needed. 43% of participants delayed dental care, and 31% postponed an appointment with a GP. This will likely have serious consequences for the health of older adults, now and in the future.
• Caring: 15% of those aged 60 and older report that they cared for someone during the pandemic. This is more than double the proportion who reported caring in 2018 (6%). Most of this care is provided to people's spouses.

Dr. Mark Ward, Lead author of the report and Senior Research Fellow at Trinity College Dublin, said: "The lives of older adults have been severely affected by the COVID-19 pandemic. As we near the anniversary of the arrival of the virus in Ireland, it is essential that we understand how people's lives have changed and what these changes mean for their health and wellbeing. TILDA research consistently shows the importance of social activities and the bonds that come from these for older adults wellbeing. Now however, opportunities for social interactions have been denied. This TILDA report shows the extent of the changes older adults have made to their lives, including limiting social interactions, postponing medical appointments, and taking on new caring responsibilities. We also show how these changes have led to greater levels of loneliness and poorer mental health. Our hope is that the information in this report can contribute to our recovery from the pandemic and continue our efforts to make Ireland the best place in the world to grow old."

Professor Rose Anne Kenny, Principal Investigator of TILDA said: "Since the COVID-19 pandemic unfolded, we have known that this unprecedented crisis has disproportionately impacted upon the health, circumstances and wellbeing of older adults across the world. TILDA's report gives a thorough and accurate account of the scale of this impact on older adults living in Ireland to support Government and health authorities to see and address the negative impacts of the crisis. Aside from the greater susceptibility to severity of COVID-19 infection faced by older adults, the pandemic has led to a significant rise in stress, anxiety, loneliness and depression, and unveils the huge sacrifices older adults have had to make. TILDA's report shows the gaps in supports such as caregiving that must be addressed as soon as possible in order to help build back independence and resilience in older adults."

Frank Feighan, TD, Minister of State for Public Health, Well Being and the National Drugs Strategy said: "The Government is acutely aware of the impact COVID-19 has had on all of our lives, but in particular on those most at risk: older people and those with underlying conditions. This TILDA report underscores the negative impacts of the pandemic on older people's health and wellbeing. The Government is working on multiple fronts, together with our partners in the community and voluntary sector, to try to mitigate these negative impacts, through public health messaging campaigns, the ongoing provision of essential health and social care services, and the Community Call initiative among others. The rollout of the COVID-19 vaccine is bringing renewed hope to us all, and in particular those who have been most affected by the pandemic. Looking to the future, in order to provide better care and supports in the home for our older citizens, the Government is committed to establishing a new statutory scheme for the financing and regulation of home support services, which is currently being developed. The new scheme aims to ensure that everyone has equal access to home support on an affordable basis in accordance with their assessed care needs."