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Health and Well-Being of Older People in an Era of COVID-19

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: closed (31 July 2021) | Viewed by 77941

Special Issue Editors

Faculty of Social Sciences, University of Stirling, Stirling FK9 4LA, UK
Interests: healthy ageing; well-being; caregiving; dementia care; ethnic minority ageing; rural ageing
Special Issues, Collections and Topics in MDPI journals
Faculty of Social Sciences, University of Stirling, Stirling FK9 4LA, UK
Interests: ageing; health inequalities; health behavior; cancer screening; social isolation; loneliness
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Although the epidemiology of the current global coronavirus (COVID-19) pandemic continues to emerge, those at high risk for severe illness include older adults with multimorbidity and persons living in residential care facilities (https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-at-higher-risk.html). A broad range of areas relating to the health and well-being of older people are potentially affected by the pandemic and societal responses to it. Examples of relevant issues include the impact of social distancing policies on older people, and community and neighbourhood support efforts for older citizens; the experiences of front-line health and social care providers working with older patients; coping strategies and needs among family caregivers of older adults; selfcare practices of older people to maintain personal health during lockdown; social determinants of morbidity and mortality outcomes for older COVID-19 patients; the use of telecommunications and robotic technology to help care home residents stay in touch; and factors that predict emotional resilience among older adults during the pandemic.

The goal of this Special Issue is to identify vulnerabilities and risks posed by COVID-19 to older people’s health and well-being, and its impacts on their carers. It aims to provide wide-ranging reports of the experience and effectiveness with older adults of public health strategies adopted to manage the pandemic.

Prof. Catherine Hennessy
Dr. Elaine Douglas
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • health
  • well-being
  • older adult
  • COVID-19
  • selfcare practice
  • social isolation
  • caregiving
  • communications technology
  • resilience
  • residential care facility
  • multimorbidity
  • frailty

Published Papers (16 papers)

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Research

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13 pages, 351 KiB  
Article
Age-Related Digital Divide during the COVID-19 Pandemic in China
Int. J. Environ. Res. Public Health 2021, 18(21), 11285; https://doi.org/10.3390/ijerph182111285 - 27 Oct 2021
Cited by 40 | Viewed by 5812
Abstract
China has adopted a variety of digital technologies to effectively combat the unprecedented COVID-19 pandemic. The massive utilisation of digital technologies, however, to a great extent, magnifies the age-related digital divide. This paper aims to examine the impacts of the age-related digital divide [...] Read more.
China has adopted a variety of digital technologies to effectively combat the unprecedented COVID-19 pandemic. The massive utilisation of digital technologies, however, to a great extent, magnifies the age-related digital divide. This paper aims to examine the impacts of the age-related digital divide on older adults in the context of the COVID-19 pandemic. Cases of three age-related digital divide scenarios, including older people taking public transportation, seeking medical care, as well as conducting digital transactions, are collected from Chinese official news outlets. The results indicate that the COVID-19 pandemic accelerates the pace of digital technology utilisation but exacerbates the age-related digital divide. Such an age-related digital divide has largely excluded older adults from both the real society and the virtual society. Older adults’ personal attitudes and motivations, as well as education and income, governmental policies, and family and social supports, are all major contributors to the severe impacts of the age-related digital divide on old adults during the pandemic. More measures should be adopted to bridge the age-related digital divide and build a senior-friendly e-society. Full article
(This article belongs to the Special Issue Health and Well-Being of Older People in an Era of COVID-19)
17 pages, 385 KiB  
Article
The Relationship between Ageism and Well-Being as Mediated through COVID-19-Related Experiences and Discourses
Int. J. Environ. Res. Public Health 2021, 18(19), 10490; https://doi.org/10.3390/ijerph181910490 - 06 Oct 2021
Cited by 5 | Viewed by 2934
Abstract
Both COVID-19 and ageism can have a negative impact on the well-being of older people. Yet, our knowledge on the links between COVID-19, ageism and well-being is still emerging. The present study aimed to contribute to this knowledge by exploring the lived experiences [...] Read more.
Both COVID-19 and ageism can have a negative impact on the well-being of older people. Yet, our knowledge on the links between COVID-19, ageism and well-being is still emerging. The present study aimed to contribute to this knowledge by exploring the lived experiences of older adults during the COVID-19 pandemic. To do so, we analyzed older persons’ subjective experiences and perceptions of ageism arising from COVID-19-related policies and discourses in two country contexts—Austria and Ireland—and the implications of these experiences for personal well-being. Based on the thematic analysis of 27 interviews with older adults, we found that participants perceived and encountered a discriminatory homogeneous representation of older people as a group. Three specific forms of this homogenization, namely stigmatization, paternalism, and scapegoating, were identified as impact on well-being. Moreover, our analysis showed how these forms of ageism challenge both the individual and social identities of older people, revealing older participants’ different attitudes in responding to this challenge. With reference to the international research literature, we discussed the impact of these experiences on the well-being of older people and the possible legal and socio-political implications of our findings. Full article
(This article belongs to the Special Issue Health and Well-Being of Older People in an Era of COVID-19)
12 pages, 3820 KiB  
Article
Would Older Adults Perform Preventive Practices in the Post-COVID-19 Era? A Community-Based Cross-Sectional Survey in China
Int. J. Environ. Res. Public Health 2021, 18(19), 10169; https://doi.org/10.3390/ijerph181910169 - 28 Sep 2021
Viewed by 1805
Abstract
During the post-COVID-19 era, preventive practices, such as washing hands and wearing a mask, remain key measures for controlling the spread of infection for older adults. This study investigated the status of preventive practices among older adults and identified the related influencing factors. [...] Read more.
During the post-COVID-19 era, preventive practices, such as washing hands and wearing a mask, remain key measures for controlling the spread of infection for older adults. This study investigated the status of preventive practices among older adults and identified the related influencing factors. Participants who were ≥60 years old were recruited nationwide. Data were collected through self-designed questionnaires, including demographic variables, knowledge, perceived vulnerability, response efficacy, anxiety and preventive practices. Descriptive statistics and chi-square tests were performed. Hierarchical logistic regression was conducted to determine the predictors. A total of 2996 participants completed this study. Of them, 2358 (78.7%) participants reported washing hands regularly in the last two weeks, and 1699 (56.7%) always wore masks outside this year. Knowledge (hand washing: OR = 1.09, p < 0.01; mask wearing: OR = 1.17, p < 0.01) and response efficacy (hand washing: OR = 1.61, p < 0.01; mask wearing: OR = 1.70, p < 0.01) were positively associated with preventive practices, whereas perceived vulnerability had a negative effect (hand washing: OR = 0.54, p < 0.01; mask wearing: OR = 0.72, p < 0.01). Knowledge, response efficacy and perceived vulnerability were found to be significant predictors of the preventive practice among older adults in the post-COVID-19 era. This study provides new insights into preventive suggestions after the peak of the pandemic and also has significant implications in improving the life quality of older adults. Full article
(This article belongs to the Special Issue Health and Well-Being of Older People in an Era of COVID-19)
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18 pages, 376 KiB  
Article
The Impact of the COVID-19 Pandemic on the Working Lives and Retirement Timing of Older Nurses in Ireland
Int. J. Environ. Res. Public Health 2021, 18(19), 10060; https://doi.org/10.3390/ijerph181910060 - 24 Sep 2021
Cited by 5 | Viewed by 2891
Abstract
COVID-19 profoundly affected Irish citizens. The effects have been especially pronounced for nurses in front-line, clinical and management roles. This article discusses the national and employer policy context relevant to nurses in Ireland. There have been staff and bed shortages in public hospitals [...] Read more.
COVID-19 profoundly affected Irish citizens. The effects have been especially pronounced for nurses in front-line, clinical and management roles. This article discusses the national and employer policy context relevant to nurses in Ireland. There have been staff and bed shortages in public hospitals since austerity policies were introduced following the global financial crisis. Government measures responding to the pandemic include initial ‘cocooning’ of older citizens, travel restrictions, changed working conditions and restricted availability of childcare. This article draws on interviews with 25 older nurses in 2021, sixteen women and nine men, aged 49 or over in Ireland. It explores older nurses’ experiences of COVID-19 and asks what are the implications for their working conditions and retirement timing intentions. A gendered political economy of ageing approach and thematic analysis reveals that while some nurses responded positively to the pandemic, some experienced adverse health impacts, stress and exhaustion; some reported a fear of contracting COVID-19 and of infecting their families; several women nurses decided to retire earlier due to COVID-19. The implications of the findings for employer and government policy and for research are discussed. Full article
(This article belongs to the Special Issue Health and Well-Being of Older People in an Era of COVID-19)
9 pages, 319 KiB  
Article
Prior Social Contact and Mental Health Trajectories during COVID-19: Neighborhood Friendship Protects Vulnerable Older Adults
Int. J. Environ. Res. Public Health 2021, 18(19), 9999; https://doi.org/10.3390/ijerph18199999 - 23 Sep 2021
Cited by 12 | Viewed by 2945
Abstract
Social networking protects mental health during a crisis. Prior contact with social organizations, friends, and non-friend neighbors may be associated with better trajectories of loneliness, depression and subjective memory during COVID-19. Regression analysis was conducted using longitudinal data from a representative sample of [...] Read more.
Social networking protects mental health during a crisis. Prior contact with social organizations, friends, and non-friend neighbors may be associated with better trajectories of loneliness, depression and subjective memory during COVID-19. Regression analysis was conducted using longitudinal data from a representative sample of n = 3105 US adults aged ≥55 in April–October 2020. Latent profile analysis was also conducted. Prior contact with friends (B = −0.075, p < 0.001), neighbors (B = −0.048, p = 0.007), and social organizations (B = −0.073, p < 0.001) predicted for better mental health during COVID-19. Three profiles were identified: Profile 1 had the best outcomes, with prior contact with social organizations (B = −0.052, p = 0.044) predicting decreasing loneliness. For Profile 2, prior ‘meeting’ contact with friends predicted decreasing loneliness (B = −0.075, p < 0.001) and better subjective memory (B = −0.130, p = 0.011). Conversely, prior contact with neighbors (B = −0.165, p = 0.010) predicted worsening loneliness among Profile 3. The COVID-19 pandemic has had a differential impact on the mental health trajectories of aging adults with social ties of different strengths. Stronger neighborhood networks are important to mitigate poor mental health outcomes among vulnerable older adults during a crisis. Older adults who are living alone and had relied on non-friend neighbors for social connectedness require additional community supports. Policy interventions are required to mitigate the mental health impact of future pandemics. Full article
(This article belongs to the Special Issue Health and Well-Being of Older People in an Era of COVID-19)
18 pages, 369 KiB  
Article
Impact of the COVID-19 Pandemic on Loneliness and Social Isolation: A Multi-Country Study
Int. J. Environ. Res. Public Health 2021, 18(19), 9982; https://doi.org/10.3390/ijerph18199982 - 23 Sep 2021
Cited by 83 | Viewed by 12823
Abstract
The COVID-19 global pandemic and subsequent public health social measures have challenged our social and economic life, with increasing concerns around potentially rising levels of social isolation and loneliness. This paper is based on cross-sectional online survey data (available in 10 languages, from [...] Read more.
The COVID-19 global pandemic and subsequent public health social measures have challenged our social and economic life, with increasing concerns around potentially rising levels of social isolation and loneliness. This paper is based on cross-sectional online survey data (available in 10 languages, from 2 June to 16 November 2020) with 20,398 respondents from 101 different countries. It aims to help increase our understanding of the global risk factors that are associated with social isolation and loneliness, irrespective of culture or country, to support evidence-based policy, services and public health interventions. We found the prevalence of severe loneliness was 21% during COVID-19 with 6% retrospectively reporting severe loneliness prior to the pandemic. A fifth were defined as isolated based on their usual connections, with 13% reporting a substantial increase in isolation during COVID-19. Personal finances and mental health were overarching and consistently cross-cutting predictors of loneliness and social isolation, both before and during the pandemic. With the likelihood of future waves of COVID-19 and related restrictions, it must be a public health priority to address the root causes of loneliness and social isolation and, in particular, address the needs of specific groups such as carers or those living alone. Full article
(This article belongs to the Special Issue Health and Well-Being of Older People in an Era of COVID-19)
19 pages, 1435 KiB  
Article
Using Technology the Right Way to Support Social Connectedness for Older People in the Era of COVID-19
Int. J. Environ. Res. Public Health 2021, 18(16), 8725; https://doi.org/10.3390/ijerph18168725 - 18 Aug 2021
Cited by 4 | Viewed by 2688
Abstract
The restrictions imposed in response to the COVID-19 pandemic pose significant risks to the human rights of older people from limitations in how people are able to engage with their social lives and from increased risk of discrimination linked to conceptualization of COVID-19 [...] Read more.
The restrictions imposed in response to the COVID-19 pandemic pose significant risks to the human rights of older people from limitations in how people are able to engage with their social lives and from increased risk of discrimination linked to conceptualization of COVID-19 as a disease of the old. Further, COVID-19 increases risks of social isolation through public health and societal responses such as lockdowns. These responses have resulted in significant shifts in how citizens and service providers think about technology as a tool to allow people to stay socially connected. However, there are risks to the rights of older people inherent in the use of technology related to their ability to access technology and ageist assumptions that may limit engagement. The ‘Technology and Social Connectedness’ project was a pre-pandemic mixed-methods study involving evidence review, secondary analyses, and qualitative methods. Cross-dataset analyses led to evidence-based guidance to inform a rights-based approach to using technology. This paper provides analysis from the project that foregrounds a rights-based approach demonstrating how we developed the guidance within this framework and, contextualized within the pandemic response in Scotland, how that guidance can help others to protect and uphold the human rights of older people. Full article
(This article belongs to the Special Issue Health and Well-Being of Older People in an Era of COVID-19)
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19 pages, 398 KiB  
Article
Coping Strategies Used by Older Adults to Deal with Contact Isolation in the Hospital during the COVID-19 Pandemic
Int. J. Environ. Res. Public Health 2021, 18(14), 7317; https://doi.org/10.3390/ijerph18147317 - 08 Jul 2021
Cited by 3 | Viewed by 3080
Abstract
Due to the COVID-19 pandemic, many older adults have experienced contact isolation in a hospital setting which leads to separation from relatives, loss of freedom, and uncertainty regarding disease status. The objective of this study was to explore how older adults (55+) cope [...] Read more.
Due to the COVID-19 pandemic, many older adults have experienced contact isolation in a hospital setting which leads to separation from relatives, loss of freedom, and uncertainty regarding disease status. The objective of this study was to explore how older adults (55+) cope with contact isolation in a hospital setting during the COVID-19 pandemic in order to improve their physical and psychological wellbeing. The realist evaluation approach was used to formulate initial program theories on coping strategies used by (older) adults in an isolation setting. Twenty-one semi-structured interviews with older patients (n = 21) were analysed. This study revealed that both emotion-focused coping strategies as well as problem-focused coping strategies were used by older adults during contact isolation. The study also uncovered some new specific coping strategies. The results have useful implications for hospital staff seeking to improve the wellbeing of older adults in contact isolation in hospitals. Problem-focused coping strategies could be stimulated through staff performing care in a person-centred way. Trust in staff, as part of emotion-focused coping strategies, could be stimulated by improving the relationship between patients and staff. Full article
(This article belongs to the Special Issue Health and Well-Being of Older People in an Era of COVID-19)
12 pages, 316 KiB  
Article
Navigating Infodemics, Unlocking Social Capital and Maintaining Food Security during the COVID-19 First Wave in the UK: Older Adults’ Experiences
Int. J. Environ. Res. Public Health 2021, 18(14), 7220; https://doi.org/10.3390/ijerph18147220 - 06 Jul 2021
Cited by 7 | Viewed by 3363
Abstract
In March 2020, a national UK lockdown was implemented in response to rapidly rising COVID-19 infections. Those experiencing the most severe public health restrictions were ‘shielding’ groups as well as those over 70 years of age. Older age adults, many of whom were [...] Read more.
In March 2020, a national UK lockdown was implemented in response to rapidly rising COVID-19 infections. Those experiencing the most severe public health restrictions were ‘shielding’ groups as well as those over 70 years of age. Older age adults, many of whom were active, independent, and socially connected were immediately instructed to stay at home, to limit all external social contact and consider contingency for maintaining personal food security and social contact. The purpose of this qualitative study was to explore the experiences of older adults during the first UK lockdown (March–June 2020), specifically how our sample reacted to public health messaging, staying food secure and drawing on available social capital within their community. Semi-structured telephone interviews were conducted with eight participants. In addition, twenty-five participants completed a qualitative ‘open-ended’ survey. The data was collated and analysed, adopting a Thematic Analysis informed approach. Three themes were identified: (1) Too Much Information, (2) The Importance of Neighbours and Connections and (3) Not Wishing to be a Burden. These findings offer a rich insight into how early lockdown measures, never witnessed since World War 2, exposed existing pre-pandemic inequalities and concerns relating to loneliness, isolation and wellbeing. The findings are of relevance to researchers, older adult advocate groups and policy makers to inform post COVID-recovery within communities to ensure healthy ageing. Full article
(This article belongs to the Special Issue Health and Well-Being of Older People in an Era of COVID-19)
14 pages, 2343 KiB  
Article
“I Could Not Manage This Long-Term, Absolutely Not.” Aging in Place, Informal Care, COVID-19, and the Neighborhood in Flanders (Belgium)
Int. J. Environ. Res. Public Health 2021, 18(12), 6482; https://doi.org/10.3390/ijerph18126482 - 16 Jun 2021
Cited by 8 | Viewed by 3231
Abstract
Public health and care policies across OECD (Organisation for Economic Co-operation and Development) countries increasingly encourage aging in place, enabled by both formal care networks, and informal (family) care and social solidarity in the neighborhood. However, little is known about how a person’s [...] Read more.
Public health and care policies across OECD (Organisation for Economic Co-operation and Development) countries increasingly encourage aging in place, enabled by both formal care networks, and informal (family) care and social solidarity in the neighborhood. However, little is known about how a person’s neighborhood might affect their aging in place. The COVID-19 crisis unintendedly offered a good opportunity to observe the neighborhood’s role in the provision of care. Since formal care services were often limited during the lockdown, informal caregiving may have increased. However, intergenerational contacts in and outside of the household were strongly discouraged by governments worldwide, adding another layer of complexity to caregiving. The aim of this qualitative study was to assess how informal caregivers in Flanders managed to provide care to their care receivers, and what role the neighborhood played in this provision of care. Sixteen qualitative Skype and telephone interviews with informal caregivers were conducted between June and December 2020 to understand their experiences and coping strategies. Overall, most respondents increased their frequency of caregiving during the first lockdown. They took on the extra care needs during the lockdown themselves, and did not actively invoke any kind of neighborhood support. The significance of the neighborhood seemingly remained limited. This was often not because no help was offered, but rather due to a sense of pride or the fear of infection, and an increased effort by family caregivers. Full article
(This article belongs to the Special Issue Health and Well-Being of Older People in an Era of COVID-19)
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26 pages, 2235 KiB  
Article
Loneliness, Wellbeing, and Social Activity in Scottish Older Adults Resulting from Social Distancing during the COVID-19 Pandemic
Int. J. Environ. Res. Public Health 2021, 18(9), 4517; https://doi.org/10.3390/ijerph18094517 - 24 Apr 2021
Cited by 28 | Viewed by 7660
Abstract
This study examined the impact of social distancing during the COVID-19 pandemic on loneliness, wellbeing, and social activity, including social support, in Scottish older adults. A mixed methods online survey was used to examine these factors during social distancing mid-lockdown, July 2020. Participants [...] Read more.
This study examined the impact of social distancing during the COVID-19 pandemic on loneliness, wellbeing, and social activity, including social support, in Scottish older adults. A mixed methods online survey was used to examine these factors during social distancing mid-lockdown, July 2020. Participants were asked to state whether loneliness, wellbeing, social activity, and social support had changed since pre-social distancing, and to provide details of strategies used to keep socially active. A total of 1429 adults (84% aged 60+ years) living in Scotland took part. The majority reported that social distancing regulations made them experience more loneliness and less social contact and support. Loneliness during lockdown was higher than reported norms for this age group before the pandemic. A larger social network, more social contact, and better perceived social support seemed to be protective against loneliness and poor wellbeing. Positive coping strategies reported included increasing online social contact with both existing social networks and reconnecting with previous networks, as well as increasing contact with neighbours and people in the community. This underlines the importance of addressing loneliness and social support in older adults but particularly during situations where risk of isolation is high. Full article
(This article belongs to the Special Issue Health and Well-Being of Older People in an Era of COVID-19)
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13 pages, 348 KiB  
Article
Alcohol Use and Mental Health among Older American Adults during the Early Months of the COVID-19 Pandemic
Int. J. Environ. Res. Public Health 2021, 18(8), 4222; https://doi.org/10.3390/ijerph18084222 - 16 Apr 2021
Cited by 36 | Viewed by 3829
Abstract
Poor mental health associated with the COVID-19 pandemic may prompt the utilization of various coping behaviors, including alcohol use. We aimed to investigate the relationships between mental health symptomatology and self-reported changes in alcohol consumption at the onset of the pandemic. Data were [...] Read more.
Poor mental health associated with the COVID-19 pandemic may prompt the utilization of various coping behaviors, including alcohol use. We aimed to investigate the relationships between mental health symptomatology and self-reported changes in alcohol consumption at the onset of the pandemic. Data were from the nationwide COVID-19 Coping Study of US adults aged ≥55 in April and May 2020 (n = 6548). We used population-weighted multivariable-adjusted multi-nomial logistic regression models to estimate odds ratios (ORs) for the associations between mental health (of depression, anxiety, and loneliness, each) and self-reported increased alcohol consumption (vs. no change in consumption). One in ten adults (717/6548; 11%) reported an increase in their alcohol consumption in the past week compared to their usual pre-COVID-19 drinking. Mental health symptomatology was associated with increased drinking since the pandemic onset (depression: OR = 2.66, 95% CI: 1.99–3.56; anxiety: OR = 1.80, 95% CI: 1.34–2.42; loneliness: OR = 2.45, 95% CI: 1.83–3.28). Participants who screened positive for all three mental health outcomes were substantially more likely to report increased alcohol consumption since the onset of the pandemic (OR = 3.87, 95% CI: 2.52–5.96, vs. no mental health outcomes). This study demonstrates potentially harmful changes in alcohol intake among middle-to-older aged adults experiencing mental health symptomatology during the early months of the COVID-19 pandemic. Full article
(This article belongs to the Special Issue Health and Well-Being of Older People in an Era of COVID-19)
16 pages, 357 KiB  
Article
Older Users of a Befriending Service in Ireland and the Maintenance of Personal Autonomy during the COVID-19 Pandemic
Int. J. Environ. Res. Public Health 2021, 18(6), 2788; https://doi.org/10.3390/ijerph18062788 - 10 Mar 2021
Cited by 4 | Viewed by 2918
Abstract
In the Republic of Ireland (RoI), COVID-19 public health guidelines have been most restrictive for people aged 70 and over. Such individuals are most likely to avail of befriending services offered by a network of Irish organisations. The aim of this study was [...] Read more.
In the Republic of Ireland (RoI), COVID-19 public health guidelines have been most restrictive for people aged 70 and over. Such individuals are most likely to avail of befriending services offered by a network of Irish organisations. The aim of this study was to explore the impact of COVID-19 guidelines on befriending service users, and to develop recommended adaptations to befriending services compatible with such guidelines. A qualitative constructivist grounded theory approach was taken to the study design and analysis, using semi-structured interviews to collect data from 11 participants by telephone between May 2020 and January 2021. Results show a grounded theory describing how older users of a befriending service maintained their personal autonomy in the face of strict government guidelines. Participants described living life as usual, often contravening guidelines, and how they chose to adapt to the situation, yielding both positive and negative outcomes. Some potential adaptations were discussed to the befriending service (including a preserved focus on the social and emotional functions of the befriending relationship, and the accommodation of collaborative decision making about communicative alternatives), but ultimately it was made clear that participants would tailor the services to their own preferences. Results have implications for befriending service design and delivery, and for public health officials who wish to support the health of older adults during the COVID-19 pandemic. Full article
(This article belongs to the Special Issue Health and Well-Being of Older People in an Era of COVID-19)
16 pages, 1581 KiB  
Article
Change in Physical Activity, Sleep Quality, and Psychosocial Variables during COVID-19 Lockdown: Evidence from the Lothian Birth Cohort 1936
Int. J. Environ. Res. Public Health 2021, 18(1), 210; https://doi.org/10.3390/ijerph18010210 - 30 Dec 2020
Cited by 42 | Viewed by 5311
Abstract
(1) Objectives: The COVID-19 pandemic has disproportionately affected the lives of older people. In this study, we examine changes in physical activity, sleep quality, and psychosocial variables among older people during COVID-19 lockdown. We build on cross-sectional studies on this topic by assessing [...] Read more.
(1) Objectives: The COVID-19 pandemic has disproportionately affected the lives of older people. In this study, we examine changes in physical activity, sleep quality, and psychosocial variables among older people during COVID-19 lockdown. We build on cross-sectional studies on this topic by assessing change longitudinally. We also examined whether participant characteristics including demographic, cognitive, personality, and health variables were related to more positive or negative changes during lockdown. (2) Methods: 137 older participants (mean age 84 years) from the Lothian Birth Cohort 1936 study were included in the analysis. They completed the same questionnaires assessing physical activity, sleep quality, mental wellbeing, social support, loneliness, neighbourhood cohesion, and memory problems before (mostly 2 years earlier) and again during national lockdown. (3) Results: On average, levels of physical activity were reduced (those doing minimal physical activity increased from 10% to 19%) and perceived social support increased during lockdown (effect size drm = 0.178). More positive change in the psychosocial and behavioural outcome variables during lockdown was associated with personality traits (greater intellect, emotional stability, and extraversion) and having a higher general cognitive ability. Participants with a history of cardiovascular disease, more symptoms of anxiety, or who lived alone were more likely to experience negative changes in the outcome variables during lockdown. (4) Discussion: These results provide further insight into the experiences of older people during the COVID-19 pandemic and could help to identify those at greatest risk of negative psychosocial or behavioural changes during this time. Full article
(This article belongs to the Special Issue Health and Well-Being of Older People in an Era of COVID-19)
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13 pages, 624 KiB  
Article
Loneliness, Malnutrition and Change in Subjective Age among Older Adults during COVID-19 Pandemic
Int. J. Environ. Res. Public Health 2021, 18(1), 106; https://doi.org/10.3390/ijerph18010106 - 26 Dec 2020
Cited by 12 | Viewed by 4594
Abstract
Objectives: We examined the effect of loneliness and the role of two mediating factors, depressive symptoms and malnutrition on subjective age among older adults during the 2020 COVID-19 pandemic, and explored how the pandemic is affecting subjective age. Design: A convenience sample of [...] Read more.
Objectives: We examined the effect of loneliness and the role of two mediating factors, depressive symptoms and malnutrition on subjective age among older adults during the 2020 COVID-19 pandemic, and explored how the pandemic is affecting subjective age. Design: A convenience sample of 201 older adults aged 65 and over was interviewed. Using bootstrapping, we tested the strength and significance of the indirect effect of depressive symptoms and malnutrition (mediators) on the relationship between feelings of loneliness and subjective age. Results: The relationship between feelings of loneliness and subjective age during the COVID-19 pandemic was mediated by malnutrition, but not by depressive symptoms. In addition, the participants felt older during the COVID-19 pandemic compared with the preceding period. Conclusions: An association was found among feelings of loneliness, malnutrition, and subjective age. To overcome these feelings in times of crisis like the pandemic, it is essential to develop new communication methods (technologies for managing and addressing the needs of the older population; technologies to encourage social engagement, and technologies for managing and providing remote medical services) for and with older adults that are effective in reducing loneliness, and to promote good nutrition. Possible practical solutions include new social network technologies for reducing loneliness combined with continued reliance on phone communication as an intervention of psychological support to promote a healthy lifestyle and prevent malnutrition. Full article
(This article belongs to the Special Issue Health and Well-Being of Older People in an Era of COVID-19)
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Review

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17 pages, 1104 KiB  
Review
Telehealth Use in Geriatrics Care during the COVID-19 Pandemic—A Scoping Review and Evidence Synthesis
Int. J. Environ. Res. Public Health 2021, 18(4), 1755; https://doi.org/10.3390/ijerph18041755 - 11 Feb 2021
Cited by 78 | Viewed by 9685
Abstract
Introduction: Globally, the COVID-19 pandemic has affected older people disproportionately. Prior to the pandemic, some studies reported that telehealth was an efficient and effective form of health care delivery, particularly for older people. There has been increased use of telehealth and publication of [...] Read more.
Introduction: Globally, the COVID-19 pandemic has affected older people disproportionately. Prior to the pandemic, some studies reported that telehealth was an efficient and effective form of health care delivery, particularly for older people. There has been increased use of telehealth and publication of new literature on this topic during the pandemic, so we conducted a scoping review and evidence synthesis for telehealth use in geriatric care to summarize learning from these new data. Methods: We searched PubMed, Embase, and the World Health Organization’s COVID-19 global research database for articles published between 1 January and 20 August 2020. We included 79 articles that met our inclusion criteria. The information collected has been synthesized and presented as descriptive statistics. Strengths, weaknesses, opportunities, and threats (SWOT) have also been discussed. Results: The articles included in our review provide some evidence of effective provision of preventive, curative, and rehabilitative telehealth services for older people, but they highlight a greater focus on curative services and are mostly concentrated in high-income countries. We identified convenience and affordability as the strengths of telehealth use in geriatric care. Weaknesses identified include the inability of telehealth to cater to the needs of older people with specific physical and cognitive limitations. While the threats of increasing inequity and the lack of standardization in the provision of age-friendly telehealth services remain, we identified opportunities for technologic advancements driven by simplicity and user-friendliness for older people. Conclusion: Telehealth offers futuristic promise for the provision of essential health care services for older people worldwide. However, the extent of these services via telehealth appears to be currently limited in low and low-middle income countries. Optimizing telehealth services that can be accessed by older people requires greater government investments and active engagement by broader participation of older people, their caregivers, physicians and other health care providers, technology experts, and health managers. Full article
(This article belongs to the Special Issue Health and Well-Being of Older People in an Era of COVID-19)
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