Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India.
Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India.
Psychiatry Res. 2020 Oct;292:113369. doi: 10.1016/j.psychres.2020.113369. Epub 2020 Aug 3.
The world has endured over six months of the Coronavirus disease 2019 (COVID-19). Older adults are at disproportionate risk of severe infection and mortality. They are also vulnerable to loneliness and social exclusion during the pandemic. Age and ageism both can act as significant risk factors during this pandemic, increasing the physical as well as psychosocial burden on the elderly. A review was performed in relation to the psychosocial vulnerabilities of the older adults during the pandemic, with insights from the similar biological disasters in the past. Besides the physiological risk, morbidities, polypharmacy and increased case fatality rates, various social factors like lack of security, loneliness, isolation, ageism, sexism, dependency, stigma, abuse and restriction to health care access were identified as crucial in pandemic situation. Frailty, cognitive and sensory impairments added to the burden. Marginalization and human rights deprivation emerged as a common pathway of suffering for the elderly during COVID-19. The implications of the emergent themes are discussed in light of psychosocial wellbeing and impact on the quality of life. The authors suggest potential recommendations to mitigate this marginalization on lines of the World Health Organization (WHO)'s concept of Healthy Ageing and the United Nations (U.N.) Sustainable Development Goals.
世界已经经历了超过六个月的 2019 年冠状病毒病(COVID-19)。老年人面临着严重感染和死亡的不成比例的风险。在大流行期间,他们也容易感到孤独和社会排斥。年龄和年龄歧视都可能成为这一大流行病期间的重要风险因素,增加老年人的身体和心理社会负担。本文回顾了大流行期间老年人的心理社会脆弱性,并从过去类似的生物灾害中汲取了经验。除了生理风险、发病率、多种药物治疗和病死率上升之外,缺乏安全保障、孤独、隔离、年龄歧视、性别歧视、依赖性、耻辱感、虐待和限制获得医疗保健等各种社会因素在大流行情况下也至关重要。脆弱性、认知和感官障碍加重了负担。在 COVID-19 期间,边缘化和人权剥夺成为老年人遭受痛苦的共同途径。作者根据心理健康和对生活质量的影响,讨论了新出现主题的含义。作者建议根据世界卫生组织(WHO)的健康老龄化概念和联合国(UN)可持续发展目标,提出减轻这种边缘化的潜在建议。