Cocooning has had big impact on health

40% of older people have worse mental health
  • Deborah Condon

The practice of cocooning has had a major impact on the mental and physical health of many older people during the COVID-19 pandemic, a new Irish study has revealed.

According to the findings, a significant number of people reported poorer health and a decline in their overall quality of life.

From early on in the pandemic, people at increased risk of catching the virus, such as older people and those with certain health conditions, were asked to cocoon. This involves staying at home and reducing face-to-face interactions with others.

People were essentially told to have no contact with anyone unless essential, for example, if they required some kind of care. The overall aim of this was to prevent at-risk groups from getting COVID-19. However, there are concerns about the long-term impact this could have on both mental and physical health.

Researchers at Trinity College Dublin (TCD) and St James's Hospital in Dublin set out to assess this further. They surveyed 150 patients with an average age of 80 years, focusing on four main themes - access to healthcare services, mental health, physical health and attitudes to COVID restrictions.

The study found that almost 40% of participants reported that their mental health was worse or much worse since they started cocooning, while over 40% said they had experienced a decline in their physical health.

Some 50% reported a decline in their overall quality of life.

Over 57% said they were lonely at least some of the time, while 12% said they were lonely "very often".

Almost 70% said they exercised less frequently or not at all when cocooning.

However, the study also found that despite these findings, 60% of participants said they agreed with the Government's advice about cocooning. Around 25% did not agree with it.

Meanwhile, around 18% said they had not sought medical attention for an illness while cocooning, which they otherwise would have, had they not been cocooning. Half of those who did not seek medical attention said it was because they were afraid of catching COVID.

Other findings included:
-57% had a scheduled healthcare-related visit cancelled while cocooning
-Almost 40% reported a decline in their mobility since cocooning, with 8% reporting their mobility as "much worse"
-29% reported a decline in their quality of sleep, while 19% reported a worse diet
-20% said they had not left their house at all since being advised to cocoon
-51% were not in favour of virtual clinics over the phone or via videocall.

According to the study's senior author, consultant geriatrician at St James's, Dr Robert Briggs, these findings highlight the "potential secondary impact of the COVID-19 pandemic on older people".

"While cocooning is important and reduces the likelihood of older people becoming unwell with COVID-19, there may be important adverse impacts on the health of those who cocoon that also need to be addressed.

"Given the possibility of further waves of COVID-19, with the likelihood of ongoing restrictions despite the rollout of vaccines, clear policies and advice for older people around strategies to maintain social engagement, manage loneliness and continue physical activity should be a priority," he explained.

Meanwhile, according to the study's first author, Dr Laura Bailey, a specialist registrar in geriatric medicine at St James's Hospital, it is particularly concerning that one in six older people "who were acutely unwell did not seek medical attention, often for fear of contracting COVID-19".

"We must give a clear message to older people that when you are unwell, you should seek medical attention, and that hospitals and general practices have appropriate infection control practices in place and continue to deal with non-COVID-19-related medical issues," she commented.

The study is published in the Quarterly Journal of Medicine and can be viewed here.


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