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Impact of the COVID-19 pandemic on community-dwelling older adults: A longitudinal qualitative study of participants from the Hertfordshire Cohort Study

Impact of the COVID-19 pandemic on community-dwelling older adults: A longitudinal qualitative study of participants from the Hertfordshire Cohort Study
Impact of the COVID-19 pandemic on community-dwelling older adults: A longitudinal qualitative study of participants from the Hertfordshire Cohort Study

BACKGROUND: Older adults have been especially vulnerable to adverse effects from the COVID-19 pandemic including higher mortality and more severe disease complications. At the same time, social isolation, malnutrition and physical inactivity are serious concerns among older adults. The pandemic and associated restrictions may serve to exacerbate these issues, presenting increased risks to physical and mental health. The aims of this qualitative study were: i) to explore how community-living older people in the UK experienced the first wave of the COVID-19 pandemic, specifically how it impacted their well-being and associated health behaviours; ii) to explore how older people's experiences and behaviours changed over time throughout the first wave.

METHODS: Qualitative data were collected by conducting serial telephone interviews, with an interval of approximately three months. Participants were from the Hertfordshire Cohort Study, all aged over 80 years. Discussions were audio-recorded, information related to the COVID-19 pandemic was transcribed verbatim and transcripts analysed thematically. Interviews were conducted from March to October 2020.

RESULTS: Data for twelve participants (7 men and 5 women) from a total of 35 interviews were used, comprising two or three timepoints per participant. Analysis identified five overarching themes: 1) shopping strategies and food accessibility, 2) limitations on activities and going out, 3) disruption to healthcare, 4) social and psychological repercussions, and 5) coping strategies. Findings highlight challenges associated with accessing shops, healthcare, and usual activities due to pandemic-related restrictions. Longitudinal findings showed that for some, the ongoing pandemic and related restrictions appeared to aggravate mental health issues (low mood, anxiety) over time, as well as greater feelings of isolation or loneliness, reduced activity and functional limitations; this was despite some relaxation of restrictions later on. Coping strategies used by participants included finding ways to keep busy and to do physical activity safely, maintaining social contact remotely, and having an optimistic or positive outlook, a 'do what you can' attitude.

CONCLUSIONS: Interventions are likely to be needed in the wake of the COVID-19 pandemic to support health behaviours, such as increasing physical activity, social engagement and improving mental health among community-living older adults.

1932-6203
Bloom, Ilse
af2a38ab-3255-414d-afa1-e3089ee45e3f
Zhang, Jean
437abe90-46ac-46de-8183-042c36ed3398
Hammond, Julia
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Bevilacqua, Gregorio
e93e3b18-7d1e-4da5-9fcd-e6b4637e1c2e
Lawrence, Wendy
e9babc0a-02c9-41df-a289-7b18f17bf7d8
Ward, Kate A
39bd4db1-c948-4e32-930e-7bec8deb54c7
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Dennison, Elaine M
ee647287-edb4-4392-8361-e59fd505b1d1
Bloom, Ilse
af2a38ab-3255-414d-afa1-e3089ee45e3f
Zhang, Jean
437abe90-46ac-46de-8183-042c36ed3398
Hammond, Julia
4eb0a477-0336-41cc-830d-fca3a86a36e4
Bevilacqua, Gregorio
e93e3b18-7d1e-4da5-9fcd-e6b4637e1c2e
Lawrence, Wendy
e9babc0a-02c9-41df-a289-7b18f17bf7d8
Ward, Kate A
39bd4db1-c948-4e32-930e-7bec8deb54c7
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Dennison, Elaine M
ee647287-edb4-4392-8361-e59fd505b1d1

Bloom, Ilse, Zhang, Jean, Hammond, Julia, Bevilacqua, Gregorio, Lawrence, Wendy, Ward, Kate A, Cooper, Cyrus and Dennison, Elaine M (2022) Impact of the COVID-19 pandemic on community-dwelling older adults: A longitudinal qualitative study of participants from the Hertfordshire Cohort Study. PLoS ONE, 17 (10 October), [e0275486]. (doi:10.1371/journal.pone.0275486).

Record type: Article

Abstract

BACKGROUND: Older adults have been especially vulnerable to adverse effects from the COVID-19 pandemic including higher mortality and more severe disease complications. At the same time, social isolation, malnutrition and physical inactivity are serious concerns among older adults. The pandemic and associated restrictions may serve to exacerbate these issues, presenting increased risks to physical and mental health. The aims of this qualitative study were: i) to explore how community-living older people in the UK experienced the first wave of the COVID-19 pandemic, specifically how it impacted their well-being and associated health behaviours; ii) to explore how older people's experiences and behaviours changed over time throughout the first wave.

METHODS: Qualitative data were collected by conducting serial telephone interviews, with an interval of approximately three months. Participants were from the Hertfordshire Cohort Study, all aged over 80 years. Discussions were audio-recorded, information related to the COVID-19 pandemic was transcribed verbatim and transcripts analysed thematically. Interviews were conducted from March to October 2020.

RESULTS: Data for twelve participants (7 men and 5 women) from a total of 35 interviews were used, comprising two or three timepoints per participant. Analysis identified five overarching themes: 1) shopping strategies and food accessibility, 2) limitations on activities and going out, 3) disruption to healthcare, 4) social and psychological repercussions, and 5) coping strategies. Findings highlight challenges associated with accessing shops, healthcare, and usual activities due to pandemic-related restrictions. Longitudinal findings showed that for some, the ongoing pandemic and related restrictions appeared to aggravate mental health issues (low mood, anxiety) over time, as well as greater feelings of isolation or loneliness, reduced activity and functional limitations; this was despite some relaxation of restrictions later on. Coping strategies used by participants included finding ways to keep busy and to do physical activity safely, maintaining social contact remotely, and having an optimistic or positive outlook, a 'do what you can' attitude.

CONCLUSIONS: Interventions are likely to be needed in the wake of the COVID-19 pandemic to support health behaviours, such as increasing physical activity, social engagement and improving mental health among community-living older adults.

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More information

Accepted/In Press date: 5 October 2022
Published date: 14 October 2022
Additional Information: Funding Information: This research was supported by the National Institute for Health Research through the NIHR Southampton Biomedical Research Centre and the Medical Research Council. IB is supported by the National Institute for Health Research through the NIHR Southampton Biomedical Research Centre and Southampton Academy of Research. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. We are grateful to the participants of Hertfordshire Cohort Study who took part in this study. Publisher Copyright: © 2022 Bloom et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Identifiers

Local EPrints ID: 471606
URI: http://eprints.soton.ac.uk/id/eprint/471606
ISSN: 1932-6203
PURE UUID: f4ce295f-e8a6-47e9-b3c0-674fbd6f9062
ORCID for Ilse Bloom: ORCID iD orcid.org/0000-0002-4893-1790
ORCID for Gregorio Bevilacqua: ORCID iD orcid.org/0000-0001-7819-1482
ORCID for Wendy Lawrence: ORCID iD orcid.org/0000-0003-1264-0438
ORCID for Kate A Ward: ORCID iD orcid.org/0000-0001-7034-6750
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for Elaine M Dennison: ORCID iD orcid.org/0000-0002-3048-4961

Catalogue record

Date deposited: 14 Nov 2022 18:09
Last modified: 17 Nov 2022 02:44

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Contributors

Author: Ilse Bloom ORCID iD
Author: Jean Zhang
Author: Julia Hammond
Author: Gregorio Bevilacqua ORCID iD
Author: Wendy Lawrence ORCID iD
Author: Kate A Ward ORCID iD
Author: Cyrus Cooper ORCID iD

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