Experiences and priorities of older adults during the COVID-19 pandemic

Throughout the COVID-19 pandemic, older adults have been prioritized in public health campaigns to limit social interactions and 'cocoon' in their homes. This limits the autonomy of older people and may have unintended adverse consequences.

To ascertain the self-reported physical and psychological effects of 'cocooning' and the expressed priorities of older adults themselves during the pandemic.

This is a cross-sectional, survey-based study involving 93 patients aged 65 and older, attending geriatric medicine out-patient and ambulatory day hospital services or our in-patient rehabilitation units. Demographic data was obtained from the medical records. Frailty level was calculated using the Clinical Frailty Scale (CFS), and disease burden was calculated with the Charlson Comorbidity Index.

Mean age was 79.1 (range 66-96), 24% had dementia, and most were mildly frail (CFS < 5). One-third reported new feelings of depression, decreased mobility, and loss of enjoyment as a consequence 'cocooning'. Loneliness was more prevalent amongst in-patients (38% vs 9%, p > 0.001). Respondents worried more about the risks of COVID-19 to their family than themselves. Expressed priorities varied from 'enjoying life as much as possible' to 'protecting the development of children'.

Adverse consequences of 'cocooning' were commonly expressed amongst older adults. Public health policy should take into account the heterogeneity of this population and be sensitive to their self-expressed wishes and priorities.