Many studies have sought to quantify the mental health impact of the COVID-19 pandemic on various groups of people. While early reports suggested that older adults were reporting less depression and anxiety in response to the pandemic than those in younger age groups, long-term studies have since revealed factors that increase the likelihood that older adults will face negative mental health outcomes related to the pandemic, wrote psychiatrist Ipsit V. Vahia, M.D., and research associate Hailey V. Cray, M.P.H., in an editorial published today in the American Journal of Geriatric Psychiatry. Vahia and Cray are both on the staff of McLean Hospital.
“Longitudinal data are sharpening our understanding of the long-term effects of COVID among recoverees, [those with] long COVID, … [and] people with dementia and especially their caregivers,” Vahia and Cray wrote.
The authors described several studies that point to worsening mental health reported by older adults who survived COVID-19, including higher rates of anxiety and posttraumatic stress disorder, than those who did not contract COVID-19 and persistent psychiatric symptoms reported by people with so-called “long COVID.” They also highlighted research that found behavioral and psychological symptoms in people with dementia worsened during the pandemic and the toll this has had on the mental health of the caregivers of people with dementia.
“While older adults, as a whole, may have withstood the stresses better than other groups, care at the individual level requires nuance,” Vahia and Cray wrote. “For clinicians, this will mean an additional layer of clinical assessment.” They offer several steps to consider when evaluating an older patient:
- Determine whether the patient was infected and, if so, the extent and nature of the initial COVID-19 symptoms, including neuropsychiatric symptoms.
- Establish whether the patient is experiencing any persistent symptoms and whether the cognitive status of the patient may have changed since recovery.
- Assess what caregiving responsibilities the patient may have and what support system the patient relies on; quantify the extent of the patient’s loneliness.
“It is also critical to acknowledge that the story of COVID-19 and its impact on geriatric mental health is still being written,” Vahia and Cray wrote. “As with any chronic stressor, it may be years before the true scope of mental health fallout may be evident. In the here-and-now, however, clinicians must assume the onus of adapting their approach to older adults to maximize their resilience and anticipate and mitigate COVID-induced challenges.”
For related information, see the Psychiatric News article “Are Older Adults More Resilient to Pandemic Stresses Than Assumed?”
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