Physical and mental health of older people while cocooning during the COVID-19 pandemic

Abstract

Background: Cocooning or shielding, i.e. staying at home and reducing face-to-face interaction with other people, was an important part of the response to the COVID-19 pandemic for older people. However, concerns exist regarding the long-term adverse effects cocooning may have on their physical and mental health.

Aim: To examine health trajectories and healthcare utilization while cocooning in a cohort of community-dwelling people aged ≥70 years.

Design: Survey of 150 patients (55% female, mean age 80 years and mean Clinical Frailty Scale Score 4.8) attending ambulatory medical services in a large urban university hospital.

Methods: The survey covered four broad themes: access to healthcare services, mental health, physical health and attitudes to COVID-19 restrictions. Survey data were presented descriptively.

Results: Almost 40% (59/150) reported that their mental health was 'worse' or 'much worse' while cocooning, while over 40% (63/150) reported a decline in their physical health. Almost 70% (104/150) reported exercising less frequently or not exercising at all. Over 57% (86/150) of participants reported loneliness with 1 in 8 (19/150) reporting that they were lonely 'very often'. Half of participants (75/150) reported a decline in their quality of life. Over 60% (91/150) agreed with government advice for those ≥70 years but over 40% (61/150) reported that they disliked the term 'cocooning'.

Conclusions: Given the likelihood of further restrictions in coming months, clear policies and advice for older people around strategies to maintain social engagement, manage loneliness and continue physical activity and access timely medical care and rehabilitation services should be a priority.

Figure 1.

Self-reported trends in QOL, physical and mental health while cocooning. Notes: n = 150. Abbreviations: QOL, quality of life; PH, physical health and MH, mental health. Participants were asked: (1) How would you say your QOL has changed while you were cocooning? Is it Much better, better, Same/No Change, Worse or Much Worse? (2) In general, compared to before the pandemic, how would you say your physical health was while cocooning? Is it Much better, Better, Same/No Change, Worse or Much Worse? (3) In general, compared to before the pandemic, how would you say your mental heal was while cocooning? Is it Much better, Better, Same/No Change, Worse or Much Worse?

Figure 2.

Reported prevalence of loneliness, low mood, worry and anxiety while cocooning. Notes: n = 150. Participants were asked: How would you say your mobility/fitness/energy levels/sleep/diet has changed while you were cocooning? Is it Much Better, Better, Same/No Change, Worse or Much Worse?

Figure 3.

Self-reported change in physical health parameters while cocooning. Notes: n = 150. Participants were asked: How would you say your mobility/fitness/energy levels/sleep/diet has changed while you were cocooning? Is it Much Better, Better, Same/No Change, Worse or Much Worse?