Covid-19 and Aging: Challenges and Opportunities

Topic: Risk, prevention and care in population studies

Very early in the course of the Covid-19 pandemic, it became glaringly clear that older persons were at significantly increased risk of infection, severe illness, hospitalization, intensive care and respiratory support, and death. Beyond the impacts of infection, restrictions associated with measures to mitigate community transmission, and generalized fear of interacting with others have disadvantaged older persons. This seems to have evolved from the disproportionate clinical severity of Covid-19 in older persons which has lead to its misrepresentation as a “geriatric disease,” suggesting that prevention or treatment efforts in older persons are futile as death is predetermined and it is wiser to channel resources to younger groups who have more to benefit. Building on the well-established literature describing more positive emotional experience in older persons, Carstensen showed that this age-related advantage persisted during Covid-19 (17). (18), who demonstrated that although the age advantage persisted, it was somewhat diminished, which the authors saw as compatible with the theory that the age advantage reflects avoidance of negative circumstances by older persons, a strategy that becomes more difficult in a pandemic. Assessment of the dismal experience for older residents of nursing homes during the pandemic revealed several valuable lessons (19). Although it is obvious that most, if not all, nursing homes are not designed, staffed, operated, or funded to protect residents or staff during a pandemic, data emerged to suggest that the catastrophe might have been averted. A significant aspect of the disadvantage of older nursing home residents may reflect the systemic ageism discussed above and be reflected in policy decisions to steer personal protective garments and other supports preferentially to other portions of the health care sector, perhaps reflecting the view that elderly nursing home residents were a “lost cause” and not worth the investment. Such “unpacking” of the nursing home population going forward could result in better and safer care.

Key findings

• Very early in the course of the Covid-19 pandemic, it became glaringly clear that older persons were at significantly increased risk of infection, severe illness, hospitalization, intensive care and respiratory support, and death.
• Beyond the impacts of infection, restrictions associated with measures to mitigate community transmission, and generalized fear of interacting with others have disadvantaged older persons.
• This seems to have evolved from the disproportionate clinical severity of Covid-19 in older persons which has lead to its misrepresentation as a “geriatric disease,” suggesting that prevention or treatment efforts in older persons are futile as death is predetermined and it is wiser to channel resources to younger groups who have more to benefit.
• Building on the well-established literature describing more positive emotional experience in older persons, Carstensen showed that this age-related advantage persisted during Covid-19 (17).
• (18), who demonstrated that although the age advantage persisted, it was somewhat diminished, which the authors saw as compatible with the theory that the age advantage reflects avoidance of negative circumstances by older persons, a strategy that becomes more difficult in a pandemic.

Why it matters

This commentary notes that older persons were at significantly increased risk of infection, severe illness, hospitalization and death early in the COVID-19 pandemic. It discusses the misrepresentation of COVID-19 as a geriatric disease and lessons from the experience of older nursing home residents.

Study details

• Participants19
• Evidence strengthLow

Read the original

• DOI: 10.1093/gerona/glac089
• PubMed: 35789373
• Original source →
• Free full text: The Journals of Gerontology Series A →

Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).

@article{rowe2022-35789373,
  author  = {Rowe, John W.},
  title   = {{Covid-19 and Aging: Challenges and Opportunities}},
  journal = {The Journals of Gerontology Series A},
  year    = {2022},
  doi     = {10.1093/gerona/glac089},
  pmid    = {35789373},
  url     = {https://doi.org/10.1093/gerona/glac089}
}

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