PRB

It’s been nearly four years since COVID-19 was declared a national emergency, and researchers have learned a lot about the impact of the pandemic on older Americans—including their mental health.

The bottom line: Protecting older adults’ physical health came at a cost. As COVID-19 spread across the country, officials focused on containing the virus through unprecedented restrictions on travel and social gatherings. Many older adults were isolated from their families, friends, and caregivers to protect them from infection.

In a new issue of PRB’s Today’s Research on Aging, we look at impact of the pandemic on the mental health of older Americans and their caregivers, and how policies can improve social connections—the “medicine hiding in plain sight.” Today’s Research Aging covers research supported by the National Institute on Aging (NIA).

Here are 10 key takeaways:

1. Isolation made people feel lonelier.

The pandemic amplified longstanding problems of social isolation and loneliness among older people. And groups not usually considered at risk for social isolation—middle-aged adults, women, non-Hispanic whites, and the most educated—were the most likely to report increased loneliness.

2. Finances taxed mental health.

One-third of older Americans felt depressed and anxious during the pandemic’s early days—mainly due to economic worries. However, adults ages 65 and older (who are eligible for Medicare and Social Security) expressed fewer economic and mental health concerns than those ages 50 to 64.

3. Older Americans with impairments may have been better able to cope with the challenges of social isolation.

While older Americans with visual and/or hearing impairments demonstrated psychological resilience during the pandemic, reporting fewer depressive symptoms than they did in 2018, their peers without impairments reported an increase in depressive symptoms, suggesting that COVID-19 may have “leveled the field” among older adults.

4. Older rural residents worried less about the pandemic, despite greater challenges.

Rural residents reported more use of social media and lower levels of concern about the pandemic. Both factors may have contributed to greater vaccine skepticism and higher mortality rates among rural residents in 2021.

5. Concerns about discrimination exacerbated stress among older Black Americans.

Older Black Americans with more concerns about discrimination in medical settings and about their risks of contracting COVID-19 had higher levels of psychological distress than their peers. Black Americans’ fears are grounded in their unequal exposure to COVID-19 risks, pre-existing health conditions, and higher odds of knowing someone who had died from the virus.

6. Family caregivers faced stressful decisions and facility restrictions

Many family members and friends changed the amount of time they spent providing unpaid care to protect older adults from exposure early in the COVID-19 pandemic. Caregivers who increased their hours reported higher levels of anxiety, depressive symptoms, and signs of being overwhelmed than those whose caregiving hours stayed the same. Family and friends spend an average of 37 hours a month providing unpaid care to older adults living nursing homes, but visitor bans—aimed at protecting residents from infection—kept caregivers from entering, some for more than one year.

7. Access to the outdoors improved mental health.

Older urban residents with greater access to parks and green spaces had fewer symptoms of depression and anxiety early in the pandemic. But in 2020, many older U.S. adults limited the time they spent outdoors; nearly one in three (32%) ages 70 and older went outside less often than the year before, and 13% rarely or never left their homes.

8. For some, virtual interactions were no substitute for in-person socializing.

Phone calls, Zoom, or FaceTime gatherings became the norm for many people during the pandemic, but for some older adults, this was a mixed blessing. Less in-person contact with family and friends and more virtual contact increased the likelihood that some older adults experienced loneliness.

9. Family could be fraught, but friendships were beneficial.

Adult children and their parents reported better mental health outcomes during the pandemic when their relationships were rated as strong—with frequent contact, including virtual communication. For older adults living alone, contact with friends—as distinct from family—may also improve well-being.

10. Social connection is the “medicine hiding in plain sight.”

Having strong social networks can provide a buffer against the effects of pandemic protections and improve mental health. Policies, programs, and technologies that increase interactions between older adults and their caregivers, family members, and friends could help older adults stay connected, healthy, and active.

The U.S. Surgeon General calls for a “culture of connection” to address the “devastating impact of the epidemic of loneliness and isolation in the United States.”