1) The COVID-19 quarantine has negatively impacted the mental and physical health of elderly people due to reduced social participation and increased isolation. It has been associated with higher rates of anxiety, depression, and decreased physical activity. 2) Recommendations to support mental health include telephone support lines, cognitive stimulation activities, limiting media exposure, and promoting resilience. For physical health, recommendations include at-home exercise programs involving both cardio and strength training. 3) While quarantine is necessary, its duration should be limited as increased social isolation can significantly impact the health of elderly populations. Alternative approaches like telehealth may help address health needs while reducing isolation.

1. 嘉基老醫病房讀書會
FM R3盧敬文
2021/4/29 Parc Sanitari Sant Joan de Déu,
Universitat de Barcelona

2. • Loneliness
• discrepancy between desired and real social relations
• 11.5% for those aged ≥60 years
• association between loneliness and depression is well
documented
• social networks
• frequency of interactions and quality and size
Loneliness  depression;
depression  loneliness?

3. Emotional loneliness  marital status
Social loneliness  social network component  depression
• tested hypotheses
(1) the role of the different social network components in
loneliness differs in individuals with or without depression
(2) the role of the different social network components in
depression differs in individuals with or without loneliness.
predict
predict

4. Methods
• Study design
• Collaborative Research on Ageing in Europe (COURAGE in
Europe) project
• Face-to-face structured interviews
• 4753  3535 participants(排除missing info, <50y/o)

5. Measurements
• Loneliness
• three-item UCLA Loneliness Scale:
“How often do you feel that you lack companionship?”
“How often do you feel left out?”
“How often do you feel isolated from others?”
• Cutoff point ≥ 6
• Social network components
(1) size of the network;
(2) frequency of contact with members of the network;
(3) quality of the network.
• Berkman–Syme Social Network Index

6. • Depression
• Composite International Diagnostic Interview (CIDI 3.0)
• Sociodemographic variables
• divided into three levels

7. Statistical analysis
• stratified study Design
• adjust for the population distribution
• Descriptive analyses
• Several logistic regression models

8. Results
female, older, previously or never married,
lower level of education, medium family income, no working
 higher probability of loneliness/depression

10. Having a small social network impacted
depression only in those people who were lonely
In non-depressed people, loneliness was more related
to marital status than size of social networks.
in those who do not feel lonely, a large social network
was associated with a higher frequency of depression.

11. • periphery of the social network (i.e., individuals with fewer
contacts)
• closely related to depression
• lack of social support
• central positions in the social network, i.e., those with a
higher number of links,
• marital status has greater influence on loneliness

12. • distinct measures of loneliness capture different
characteristics of people who suffer from it
• Strengths and limitations of the study
• cross-sectional design limited
• Inconsistencies between the distinct techniques for measuring
loneliness
• cognitive distortions
• the quality of various kinds of social interaction

13. Londrina State University (UEL) and
University North of Paraná (UNOPAR),
Londrina, Brazil

14. • Social participation
• Active participation in a religious, sports, cultural, recreational,
political, and volunteer community organizations
• protective effects
• ‘intrinsic capacity’  optimal aging
• Not only the physical activity is affected during quarantine,
but also mental health.

15. Methods
• narrative review
• Pubmed, Scielo and Google Scholar
• (‘COVID-19’, ‘coronavirus’, ‘aging’, ‘older people’, ‘elderly’, ‘social isolation’
and ‘quarantine’).
• 2019 to 2020 (May 20th)
• in English, Spanish or Portuguese
1) effect of the reduction of social participation produced by
quarantine for COVID-19 on mental and physical health in elderly
people
2) recommendations for mental and physical health of older
people during the COVID-19 quarantine.

17. Effect of the reduction of social participation produced by
quarantine for COVID-19 on mental and physical health in
elderly people
• Mental Health
• Anxiety, depression, sleep disturbances, increased level of psychological
stress
• RFs:
female,
having a negative self-perception of aging,
healthcare workers,
family and personal resources,
time devoted to COVID-19 information,
having an acquaintance or a family member infected with COVID-19
• Physical Health
• affected the number of seniors attending group physical activity
programs.
• physical activity was highly decreased

18. Recommendations for mental health and physical in older
people during COVID-19 quarantine
• Mental health
• telephone support lines or support groups
• changes on lifestyle
• cognitive stimulation
• Caregivers
• participate in adapted daily activities
• The exposure to media must be regulated
• Traumatic content
Resilience
• Health education and psychological counselling
• valuing older people’s contributions
• avoiding negative emphasis on risk

19. telematic geriatric assessment
SCORARE GA
Quarantine should be as short as possible

20. • Physical health
• 150-300 minutes per week of moderate-intensity aerobic physical
activity
• two sessions per week of muscle strength training
• exercise circuit at home with cardio and strength exercises in short
bursts of 30 seconds for up to three minutes.
• Caregivers  supervise
• at home
• telehealth

21. Discussion
• Mental health
• avian influenza
• Ebola outbreak
• SARS epidemic
• older adults are at higher risk of having mental health
concerns during isolation

22. • Physical health
• Social participation
• Better dynamic balance and muscle strength
• healthy lung function
• lower disabilities and chronic inflammation
• Replacing sedentary behavior
• with 30 minutes of light physical activity and 20 minutes of moderate to
vigorous physical activity
↓ all cause mortality
• moderate to vigorous physical activity has been associated
↓ frailty
• Limitations
cross-sectional design
no control group

23. + life-style
Relaxation