Social Distancing Risk for Seniors
The effects of social isolation on health and well-being have long been known. In seniors, social isolation is considered a major risk factor for the development of depression and anxiety. Impact on cognitive health is increasingly seen as an additional risk.
In the midst of the COVID-19 pandemic, those who care for older patients should consider two things: the general needs and vulnerabilities of seniors, as well as the particular factors that may affect them in the age of “social distancing.”
The Danger of Social Distancing for Seniors: Loneliness
A study that followed seniors over ten years found that loneliness — identified at the beginning of the study — was predictive of 40% higher risk of developing dementia.
Important to note, loneliness was the driver of cognitive decline, not social isolation. The subjective experience of loneliness was a more potent predictor than more objective markers of social isolation. The researchers also associated other risk factors with cognitive decline, including depression, physical inactivity, smoking, and diabetes.
Fortunately, the authors consider loneliness a modifiable risk factor. We should also consider this to be the case for our current circumstances, with many cities and regions enforcing strict social-distancing and shelter-in-place policies to “flatten the curve” of the pandemic.
The Continued Importance of Cognitive Care
Individuals over 60 do face higher risks from the novel coronavirus. For their protection, nursing homes and assisted-living facilities may confine patients to their rooms. Seniors who live alone may see friends and relatives less often or not at all.
But the COVID-19 pandemic does not lessen the importance of cognitive and behavioral care.
In fact, the increase in social isolation only adds to the importance of continued assessment and care.
For example, clinical depression will heighten feelings of isolation, fear, and hopelessness. The fact that depression, anxiety, and cognitive impairment can be symptoms of the others presents further challenges.
Development or increase in symptoms of depression — at any time — are a call for action. Even when the symptoms may seem like understandable reactions to difficult times, it is still important to take those symptoms seriously and treat them vigorously.
How Clinicians and Caregivers can Help
Now, the good news. With technology, relatives and caregivers can combat loneliness. With new access to telehealth options, physicians can continue to provide comprehensive cognitive care.
We can overcome the challenges of COVID-19.