Indian Journal of Health Social Work
(UGC Care List Journal)
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MENTAL HEALTH AND SOCIAL WELLBEING OF OLDER ADULTS:
PERSPECTIVES FROM COVID-19 PANDEMIC
Aksa Jan1, Saima Farhad2 & Sanjoy Roy3
1PhD Scholar at Department of Social Work, University of Delhi, 2Associate Professor at Department
of Social Work, Kashmir University, Srinagar, 3Professor and Head, Department of Social Work,
University of Delhi, Delhi
Correspondence: Aksa Jan, E-mail: aksajan1996@gmail.com
ABSTRACT
The socio demographic factors as well as personal experiences have been shown to influence
the social well-being and mental health of older adults. Irrespective of one’s socioeconomic
standing, elderly people frequently suffer from non-communicable diseases that are primarily
linked to old age and necessitate extensive medical and social care. It has been found that these
illnesses frequently cause disabilities, which have an impact on older people’s everyday activities,
social well-being, and general mental health. Further, unmet care needs for older adults with
illnesses include those pertaining to their social lives, physical and mental health, as well as the
environments in which they live and interact. Studies have shown that it is common for older
individuals to feel lonely and unsatisfied, which has an impact on their mental and social wellbeing. While the physical well-being of elderly people is heavily emphasized, their mental health
and social well-being have not received the same attention or priority by the research community.
It is in this context that this paper aims to explore how data on various aspects of COVID-19
disease and depression among older adults in India are presented. Thus, the findings from this
article aim to highlight the issues related to the mental health of older people.
Keywords: Social Well-Being, Mental Health, Older Adults, COVID 19
INTRODUCTION
As the world population grows, a major part
of it grows old as well. The growing elderly
population brings forth the issue of geriatric
mental health, which has become a major
public health concern around the world. A
report by the World Health Organization
(WHO) in 2004 stated that the prevalence of
depression in persons aged 60 years was 0.5
million in developed countries alone. Further,
it also reported 4.8 million such cases in the
developing countries. Interestingly, increased
life expectancy in India has resulted in an
increase in the older adult population between
2001 and 2011, which is anticipated to reach
324 million by 2050 (United Nations
Department of Economic and Social Affairs,
Population Division, 2020).
Biological aging is brought on by the buildup
of numerous types of molecular and cellular
damage, which over time results in a decline
in physical and mental function and increases
the risk of illness and death. The significance
of psychosocial factors cannot be ignored age, but can differ from person to person and
be influenced by various factors, including
retirement, living in suitable housing, losing
one’s spouse or other loved ones, and living
in a suitable environment (WHO, 2015). The
global population is aging at an
unprecedented rate, and it is already
recognized as a global concern. It presents
various mental health related difficulties
(depression, a common mental health
disorder, has affected over 264 million people
worldwide), which is characterized by, but is
not limited to, persistent feelings of “sadness
and worthlessness, as well as a loss of interest
or pleasure in previously rewarding or
pleasurable pursuits” (Institute of Health
Metrics and Evaluation, 2021).
Depression is currently “the third leading
cause of global disease burden and, according
to projections, will be the leading cause of
global disease burden by 2030”, further, it is
especially problematic in the elderly because
it is associated with increased “disability,
cognitive decline, morbidity, and decreased
quality of life” (WHO, 2017: Sinha et al.,
2013). According to a meta-analysis, “the
global prevalence of depressive disorders
among the elderly population ranges between
4.7% and 16%” (Padayachey et al., 2017).
Furthermore, studies reveal that India “has a
higher prevalence of geriatric depression than
other countries” and depression is a major
public health concern among the elderly
(Srivastava et al., 2021).
Elderly people have unique characteristics
such as physical limitations, weaker muscles,
and additional health conditions. They also
often have limited support from both financial
and social perspectives. These factors make
them more susceptible to mistreatment and
abuse from their own families and relatives.
Studies in geriatric mental health have shown
that elder abuse increases the risk of
depression and anxiety among older adults
(Fisher & Regan, 2006). Research has found
that the physical and social surroundings
people live in greatly affect their mental
health. In India, factors like gender,
employment status, living situation, selfreported health, multiple health conditions,
physical limitations, elder abuse, being a
victim of crime, and feeling safe in the
neighborhood are all connected to depression
among older adults. Despite the fact that
mental health and social well-being have a
substantial impact on the overall quality of life
among older adults, the research community
has given these topics a relatively inadequate
amount of attention and importance.
Historically, the emphasis on the well-being
of older people has been primarily focussed
upon their physical health and medical needs,
while their mental health and social well-being
have been disregarded (Pachana & Laidlaw,
2014). Because of this lack of attention to
detail, there is only a superficial understanding
and awareness of the intricacies and specific
challenges that older adults confront in
sustaining good mental health and social
connections. It is critical to overcome this
research gap and prioritize the mental health
and social well-being of older adults by
ensuring comprehensive and effective social
support systems.
OBJECTIVE
This study’s objective is to examine the
manner in which information about the
COVID-19 disease and depression among
older adults is presented in India. The COVID19 pandemic has had a significant impact on
the mental health and social well-being of
older adults, which emphasizes the need for
a thorough understanding of the difficulties
they face. This paper seeks to shed light on
the issues surrounding older adults’ mental
health, by analyzing the data available and
providing insights for policy development and
intervention strategies.
FACTORS INFLUENCING MENTAL HEALTH AMONG OLDER ADULTS
A. Socio-demographic factors: Agerelated depression in older adults is
significantly influenced by socio-demographic
factors. For the purpose of identifying
vulnerable populations and creating focused
interventions, it is essential to understand
these socio-demographic factors. According
to research, the following socio-demographic
factors have been found to have significant
impact:
1. Economic status: Financial difficulties,
access to healthcare, and increased stressors
are found to be very common among older
adults from lower socioeconomic
backgrounds, these factors are contributing
to the emergence of depression among older
people as shown by different researches
(Anand, 2015). Poverty and financial
instability are linked to higher rates of
depressive symptoms in older people.
2. Education level: Among older adults,
outcomes in terms of mental health have been
linked to educational attainment. Better
mental health and lower rates of depression
are related to higher levels of education
(Gupta et al., 2020). Education provides
people with knowledge, abilities, and
opportunities that can improve their coping
mechanisms and resilience.
3. Living arrangements : The living
arrangements of older adults, such as
whether they live alone or with family
members, has a greater impact on their risk
of depression. Loneliness and social isolation,
which are the known risk factors for
depression, may be enhanced among older
adults who live alone (Oh et al., 2015). Living
in a caring and loving atmosphere with family
or friends, on the other hand, can act as a
buffer against depression.
4. Social support: The critical protective
factor in preventing depression among older
adults is the social support from friends,
family, and communities, including emotional,
instrumental
practical, and informational support (Patel et
al., 2020). Positive mental health outcomes
can be promoted by strong social support
networks, which can offer companionship,
support, assistance and a sense of belonging.
B. Personal experiences: Personal
experiences are also known to play an
important role in the development of
depression among older adults. These events
and personal experiences touch on many
elements of their lives and can increase their
susceptibility to depression. The personal
experiences listed below have been identified
to have a greater influence on the mental
health and social well-being of older adults.
Some of these experiences include the death
of a spouse or close friend, the loss of a job,
and physical health issues. These events in
an individual’s life can cause feelings of
loneliness, isolation, and low self-esteem, all
of which can contribute to the development
of depression among the older adults.
1. Loss of loved ones: Losing loved ones,
such as a spouse, family members, or close
friends, is a significant life event that can lead
to depression in older adults ((Kivi et al.,
2021). Bereavement can cause intense grief,
feelings of emptiness, and isolation, all of
which can contribute to the development of
depressive symptoms. As they navigate life
without their loved ones, older adults may
experience a loss of identity and purpose.
Seeking help from family, friends, or a
therapist can help older adults cope with their
loss and avoid depression. Healthcare
providers must be aware of the increased risk
of depression in older adults who have lost a
loved one and provide appropriate support and
resources. Volunteering or joining a social
group, for example, can also help older adults health. It is important to note that not all older
adults experience depression following a loss,
and the severity and duration of symptoms
can vary as there are differences across
cultures and individuals in how they cope.
cope with their loss and improve their mental
2. Social isolation and loneliness: Social
isolation and loneliness are common in older
adults and are strongly linked to depression
(Cohen-Mansfield & Perach, 2015). A lack of
social connections and meaningful
relationships can lead to feelings of emptiness
and sadness, as well as an increased risk of
depression. Besides, social isolation and
loneliness can have a negative impact on
physical health, including an increased risk of
cardiovascular disease and cognitive decline
(Cacioppo & Cacioppo, 2014). As a result, it
is critical to address social isolation and
loneliness in older adults, as well as maintain
social connections, in order to promote both
mental and physical well-being. Studies have
shown that social support can also improve
immune function and reduce inflammation in
the body, leading to better overall health
outcomes. Additionally, participating in social
activities and having a sense of purpose
through social engagement can improve
cognitive function and delay the onset of
dementia in older adults (Patel et al., 2020).
3. Life transitions and role changes: Life
transitions such as retirement, relocation, or
changes in family dynamics can have a
significant impact on the mental health of
older adults. Adjusting to new roles and
routines, as well as the loss of identity that
comes with retirement or changes in social
roles, can all contribute to depressive
symptoms (Kahana et al., 2012). These
transitions frequently necessitate adaptation
and can result in feelings of uncertainty and
loss of purpose.
It is critical to understand that depression is
not a normal part of aging and that seeking
help is essential. Access to mental health
services and depression education can help
reduce stigma and raise awareness about the
importance of seeking treatment. With the
right support, older adults can maintain their
mental health and live fulfilling lives.
Depression among older adults is frequently
misdiagnosed and mistreated, emphasizing
the importance of increased awareness and
screening in healthcare settings. We can
improve the quality of life for older adults and
reduce the burden of depression on
individuals, families, and society as a whole
by addressing these issues. Understanding the
impact of these socioeconomic factors and
personal experiences on depression among
older adults is critical for developing targeted
interventions and support systems. It is
possible to reduce the risk of depression and
promote better mental health and well-being
in older adults by addressing these factors.
Impact of COVID-19 Pandemic on Mental Health of Older Adults
The COVID-19 pandemic has had a significant
impact on people’s mental health all over the
world, with older people being particularly
vulnerable. Understanding how the pandemic
has affected depression in older adults is
critical for developing targeted interventions
and support systems. Research has shown that
the increased rates of depression among older
adults during the pandemic were caused by
social isolation, financial stress, fear of
contracting the virus, and disruptions in daily
routines. Furthermore, limited access to
mental health services and difficulty adapting
to virtual forms of communication have
exacerbated these difficulties.. The following
themes highlight the impact of the COVID-19
pandemic on depression among older adults:
A. Increased risk and vulnerability:
Because of age-related physiological changes
and a higher prevalence of underlying health
conditions, older adults are at a higher risk
of severe illness and mortality from COVID 19 (Gupta et al., 2020). Fear of contracting
the virus and its potentially severe
consequences can increase anxiety and
distress in older people, contributing to the
development or exacerbation of depressive
symptoms. Physical distancing measures can
cause social isolation and loneliness, which
can exacerbate the negative mental health
effects.
B. Social distancing measures and their
effects on social interactions and
support systems: The implementation of
social distancing measures, such as
lockdowns, quarantine, and social gathering
restrictions, has significantly disrupted social
interactions and support systems for older
adults (Lee & Terada, 2021). Reduced
opportunities for face-to-face socialization
and engagement can exacerbate feelings of
loneliness, isolation, and loss of social
support, all of which are known risk factors
for depression. Lack of social interaction can
also have a negative impact on physical health
by leading to a sedentary lifestyle and poor
eating habits. During these difficult times, it
is critical for communities to find new ways
to support and connect with older adults.
C. Disruption of routine healthcare
services and access to mental health
support: The pandemic has hampered
routine healthcare services such as regular
check-ups, non-urgent medical appointments,
and access to mental health care (Gupta et
al., 2020). Access to necessary healthcare
services, including mental health resources,
may be difficult for older adults, resulting in
unmet needs and a lack of appropriate
support for managing their mental health,
including depression.
D. Fear, anxiety, and uncertainty related
to the pandemic: The COVID-19 pandemic
has caused widespread fear, anxiety, and
uncertainty, including among the elderly. The
constant news coverage, updates on case
numbers, and changing nature of the
pandemic can all contribute to increased
stress and anxiety among older adults
(Aravena et al., 2020). These emotional
responses can increase the likelihood of
developing or exacerbating depressive
symptoms among older adults.
D. Fear, anxiety, and uncertainty related
to the pandemic: The COVID-19 pandemic
has caused widespread fear, anxiety, and
uncertainty, including among the elderly. The
constant news coverage, updates on case
numbers, and changing nature of the
pandemic can all contribute to increased
stress and anxiety among older adults
(Aravena et al., 2020). These emotional
responses can increase the likelihood of
developing or exacerbating depressive
symptoms among older adults.
E. Economic implications and financial
stress: The pandemic has had significant
economic consequences, including loss of job,
reduced income, and financial stress, all of
which can affect the mental health of older
adults and increase their risk of depression
(Lee & Terada, 2021). Meeting basic needs,
such as housing, healthcare, and daily
expenses, can be difficult for older adults,
leading to increased anxiety, distress, and
depressive symptoms. The pandemic has also
caused market volatility and decreased
retirement savings, leaving older adults with
less financial security for the future,
exacerbating their stress and anxiety levels,
making it critical for policymakers to address
these economic implications and provide
support for older adults during this difficult
time.
F. Influence of media and information
overload on mental health: Constant media
coverage and information overload related to
the pandemic can have a negative impact on
mental health, including depression, in older
adults. Misinformation, sensationalism, and
the deluge of pandemic-related news can all
contribute to increased anxiety, fear, and
distress (Aravena et al., 2020). Older adults
may be especially vulnerable to the negative
effects of excessive media consumption,
which can aggravate the symptoms of
depression among them. The COVID-19
pandemic has presented unique challenges adults’ mental health. Understanding these
specific effects is critical for developing
targeted interventions, support systems, and
mental health services to address the
increased risk of depression and promote
older adults’ well-being during and after the
pandemic.
that have had a significant impact on older
CONCLUSION
This study sheds light on the significant impact
of the COVID-19 pandemic on the mental
health and social well-being of older adults.
Socio-demographic factors and personal
experiences have been identified as influential
factors affecting the mental health of older
adults. Non-communicable diseases and
disabilities further exacerbate the challenges
they face, including limitations in everyday
activities and social well-being. Moreover, the
lack of attention given to the mental health
and social well-being of older adults by the
research community has been highlighted.
The paper has also explored the data on
COVID-19 disease and depression among
older adults in India, emphasizing the need
to address these people’s mental health
needs and find workable and effective coping
mechanisms for these trying times. It is
crucial to recognize that mental health and
social well-being are essential components of
overall health and should be prioritized in
healthcare policies and interventions.
Providing adequate support and resources for
older adults can improve their quality of life
and help them cope with the challenges they
face. It is important to highlight that the
pandemic has highlighted existing disparities
in healthcare and social support for older
adults, particularly those with pre-existing
conditions and addressing these issues will
require a comprehensive approach that
considers both physical and mental health
needs.
RECOMMENDATIONS
Several recommendations emerge to address
the mental health needs of older adults during
the COVID-19 pandemic. Through policy
initiatives, governments should prioritize the
mental health of older adults, allocate
resources for mental health services, and
raise awareness to reduce stigma. Healthcare
systems should make mental health services
more accessible and age-friendly, incorporate
mental health screening into routine care, and
improve collaboration between primary care
and mental health services. Community-based
interventions and support networks, in
conjunction with tele-health services, can help
to foster social connections, reduce isolation,
and provide remote mental health care. It is
critical to empower older adults through
education and awareness about mental health
and coping strategies. Furthermore,
addressing stigma and discrimination
surrounding mental health in older adults is
crucial to encourage seeking help and
reducing barriers to care. Involving family
members and caregivers in the care process
can also improve mental health outcomes
among older adults.
IMPLICATIONS FOR FUTURE RESEARCH AND POLICY DEVELOPMENT
This is emphasizes the importance of
additional research and policy development
to address the mental health and social wellbeing of the older population. Future research
should concentrate on determining the efficacy
of various interventions in supporting the
mental health of older adults during
pandemics and other stressful situations.
Longitudinal research can aid in the
identification of factors that promote
resilience and well-being among older adults.
Policymakers should prioritize mental health
in the aging population and create
comprehensive strategies that include
preventive measures, early intervention, and readily available mental health services. The
research should also explore the effects of
social isolation and loneliness on the mental
health of older people during pandemics.
Furthermore, older adults from various
backgrounds, including those with disabilities
and those living in long-term care facilities,
have different needs and challenges. In order
to develop effective interventions and policies
that promote mental well-being among older
adults, it is critical to consider their unique
needs and challenges. Collaborations between
healthcare providers, community
organizations, and carers can also help ensure
that older adults receive the necessary mental
health support.
IMPORTANCE OF PRIORITIZING MENTAL
HEALTH AND SOCIAL WELL-BEING OF OLDER ADULTS IN SOCIETY
The COVID-19 pandemic has highlighted the
importance of prioritizing the mental health
and social well-being of older adults in society.
As the population ages, it is critical to
recognize the unique needs of older people
and ensure that their mental health receives
the same attention as their physical health.
We can improve the quality of life for older
adults and contribute to a more inclusive and
compassionate society by creating supportive
environments, promoting social connections,
and providing accessible mental health
services. Addressing mental health needs of
older adults can also have a positive impact
on their physical health and overall well-being.
It is critical to recognize that mental health is
an essential component of aging and that it
should be prioritized alongside physical health
in health care systems and policies. To
summarize, addressing the mental health
needs of older adults during and after the
COVID-19 pandemic necessitates a
multifaceted and comprehensive approach.
Understanding the factors that influence
depression, the impact of the pandemic, and implementing effective support strategies can
help older adults improve their mental health
and social connectedness. To ensure older
adults’ continued resilience, dignity, and
quality of life, society, research communities,
and policymakers must prioritize their mental
health and social well-being. This can be
accomplished by increasing funding for mental
health services, encouraging community
involvement and social activities, and
addressing systemic issues that contribute to
social isolation and loneliness in older adults.
Furthermore, healthcare providers should be
trained to recognize and address mental
health issues in older adults, and family
members and carers should be educated on
how to provide emotional support to their
loved ones. Finally, increasing access to
mental health services and resources can
assist older adults in coping with the
challenges posed by the pandemic and
improving their overall mental health
outcomes
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Conflict of interest: None
Role of funding source: None
ISSN: 2582-1393 (Online)