COVID-19 collateral damage: psychological distress and behavioral changes among older adults during the first outbreak in Stockholm, Sweden

Beridze, G.; Triolo, F.; Grande, G.; Fratiglioni, L.; Calderon-Larranaga, A.

Introduction: During the first wave of the COVID-19 pandemic, Swedish public health authorities provided recommendations for 70+ year old people. They were strongly encouraged to self-isolate but remain physically active in a safe manner. This study aimed to explore the indirect, negative effects of COVID-19 restrictions (collateral damage) by exploring to what extent adherence to such recommendations might have impacted the lives and health of older adults living in central Stockholm. Methods: An ad-hoc phone questionnaire was administered by trained staff between May and June 2020 to a random sample of older adults 68+ years old (n=1231), who had attended the regular follow-up assessment of the longitudinal Swedish National study on Aging and Care in Kungsholmen (SNAC-K) during 2016-2019. We explored three dimensions of collateral damage, namely psychological distress (feelings of worry, stress and loneliness), reductions in social and physical activities, and reductions in medical and social care use. Logistic regression models were used to test the association between age, sex, education and living arrangement, and the risk of collateral damage. Results: Vast majority of participants adhered to the recommendations, with over three quarters practicing self-isolation (n=928). Half of the sample reported psychological distress, 55.3% reported reductions in social or physical activity, and 11.3% reported decreased medical or social care use. Over three quarters of participants were affected by at least one of the three collateral damage dimensions. Female sex was the strongest sociodemographic predictor of individual as well as co-occurring dimensions of collateral damage. Conclusion: COVID-19 and its restrictions during the first half of 2020 have had a negative effect on the health and lives of a majority of elderly living in central Stockholm. Women were at a particularly higher risk of these negative consequences. We emphasize the need for predefined, evidence-based interventions to address these negative consequences.