Being a frail older person at a time of the COVID-19 pandemic

Older adults’ coping strategies during the COVID-19 pandemic – a longitudinal mixed-methods study

“…In the following, the research question arose how our cohort with increased vulnerability (older age, increased risk for neurodegenerative diseases) would cope with the pandemic longitudinally, especially the protective measures such as self-isolation and general restrictions. As it is known from the literature, adults who are at increased risk for dementia are also at increased risk for severe COVID-19 progression and accelerated cognitive decline ( Chen et al, 2023 ). To investigate the impact of the COVID-19 pandemic on our cohort, six Corona questionnaires (Coro-Q, in the following referred to as Coro-Q1 to Coro-Q6 in Tables/Figures, e.g., Coro-Q1 means Corona questionnaire No.…”

“…Although, most people had only mild to moderate diseases, a substantial minority had a higher risk for severe COVID-19 and adverse health outcomes, such as long- or post-COVID ( Abab et al, 2022 ; Subramanian et al, 2022 ). Across several countries, mortality rates increased exponentially depending on age and multimorbidity ( Bonanad et al, 2020 ; Chen et al, 2023 ). Early on, age had been identified as most significant risk factor for severe COVID-19 ( Chen et al, 2023 ) because older adults also have a higher prevalence of chronic diseases such as type 2 diabetes ( Zhu et al, 2020 ; Kompaniyets et al, 2021b ), obesity ( Kim et al, 2021 ; Kompaniyets et al, 2021a , b ), coronary heart ( Lippi and Henry, 2020 ; Kim et al, 2021 ), and neurocognitive diseases ( Rosenthal et al, 2020 ; Kim et al, 2021 ).…”

“…Across several countries, mortality rates increased exponentially depending on age and multimorbidity ( Bonanad et al, 2020 ; Chen et al, 2023 ). Early on, age had been identified as most significant risk factor for severe COVID-19 ( Chen et al, 2023 ) because older adults also have a higher prevalence of chronic diseases such as type 2 diabetes ( Zhu et al, 2020 ; Kompaniyets et al, 2021b ), obesity ( Kim et al, 2021 ; Kompaniyets et al, 2021a , b ), coronary heart ( Lippi and Henry, 2020 ; Kim et al, 2021 ), and neurocognitive diseases ( Rosenthal et al, 2020 ; Kim et al, 2021 ). For instance, it was found that mortality risk increased up to 26% for adults with Alzheimer’s disease and related dementias compared to 2019 (for adults without dementia the risk increased up to 12%, Gilstrap et al, 2022 ).…”

“…This sparked controversial debates about how to deal with an increased vulnerability for COVID-19 in older (or particularly frail) adults. It was claimed that these adults need both a special protection and isolation to minimize their risk of infection and they also need to maintain independence and autonomy to avoid negative psychological (e.g., depression, loneliness, anxiety), and physical consequences (e.g., lack of exercise, missing medical visits and using negative coping strategies, AgeUK, 2020 ; Chen, 2020 ; Promislow and Anderson, 2020 ; Chen et al, 2023 ). In Germany, point prevalence for a depressive episode in older adults was 7% (95% CI 4.4–10.6%), and for adults aged 75+ years even 17% (95% CI 9.7–26.1%, Luppa et al, 2012 ).…”

Cognitive frailty and its association with depression, anxiety and stress during the COVID‐19 pandemic among older adults in the transforming cognitive frailty into later‐life self‐sufficiency (AGELESS) study

“…3 A separate study highlights a potential frailty cascade that may have taken place during the pandemic, with frail older adults displaying increased dementia and cognitive decline. 4,5 Cognitive frailty describes co-occurring mild cognitive impairment (MCI) and frailty upon exclusion of dementia and physical disability. 6 Cognitive frailty has been associated with several adverse health outcomes even prior to the pandemic, such as increased risk of mortality, functional disability, poor quality of life, exacerbation of health conditions, dementia, disability and hospitalisation.…”