Older people who "shielded" during the Covid-19 pandemic were nearly twice as likely to experience symptoms of depression compared with those who did not shield, even after accounting for loneliness and having fewer social contacts, a study has found.
The report, published in the British Journal of Psychiatry, shows that staying at home throughout the pandemic, as well as shielding, were strongly associated with greater risks of depressive symptoms, anxiety, and lower quality of life.
Shielding is when a person took extra precautions to protect themselves against infection, such as avoiding crowds and staying at home as much as possible.
“When restrictions came into place in March 2020, around 3.8 million (6 per cent) people in the UK were ordered to shield, 74 per cent of whom were aged over 50. Our study is the first of its kind to look at the effect shielding had on the mental well-being of older people in England,” said lead author Dr Giorgio Di Gessa from University College London's institute of epidemiology and health care.
“We know from previous studies that the pandemic and policies restricting human interaction have posed a greater risk to mental health and well-being, especially among specific people in socioeconomic adversity, those with pre-existing poorer health, and those feeling lonely.
“In our study we therefore took all these factors into account to understand if shielding and staying at home were additional factors contributing to poorer mental health among older people.”
The research team used data from more than 5,000 people over the age of 50 who are part of the English Longitudinal Study of Ageing to investigate the effects of shielding on mental health.
The data was collected during the first eight to nine months of the pandemic. Lockdowns were in effect during two of those months.
“Our analysis supports the idea that shielding itself has been harmful, over and above other known vulnerabilities,” said Dr Di Gessa.
“One reason for this could be the psychological impact of being told so starkly of your own vulnerability and mortality and the policing of your own behaviour, and resulting anxiety and stress.”
Respondents were asked whether during April, June/July, and November/December 2020 they shielded, stayed at home (leaving only for reasons such as exercise, essential work or shopping for food) or neither.
Their mental health was then assessed by asking questions about symptoms of depression and anxiety, their well-being and quality of life.
About 28 per cent of respondents said they shielded at least once, with 5 per cent shielding throughout the first eight to nine months of the pandemic.
About a 33 per cent reported staying at home all the time, while 37 per cent neither shielded nor stayed at home.
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Among those adults who shielded at all times, in November and December 2020, 42 per cent reported elevated depressive symptoms compared with 23 per cent among those who did not shield nor stay at home.
Older people shielding throughout the period analysed in the study also reported the lowest life satisfaction and quality of life scores.
The researchers were able to account for pre-pandemic mental and physical health, as well as social contact with family and friends and loneliness during the pandemic, to better understand whether the links between shielding and poorer mental health were driven by pre-existing conditions or reduced social interactions and higher loneliness during the pandemic.
“Policymakers need to be aware of adverse consequences for the mental health and well-being of those advised to shield or stay at home,” said co-author Prof Debbie Price from the University of Manchester.
"If the long-term health and social well-being of older people is to be safeguarded, there must be careful thought given to addressing the mental health and wider needs of individuals at higher risk from Covid-19 variants, or future pandemics."
