Zaninotto, P; Di Gessa, G; Cole, J; Steel, N; (2021) Multimorbidity, access to services and diagnosis of new health conditions during the COVID-19 pandemic. (COVID-19 reports and publications ). English Longitudinal Study of Ageing (ELSA): London, UK.

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Abstract

Excess deaths from conditions other than COVID-19 have been reported during the COVID-19 pandemic. Reduced access to health and social care services during lockdown may have disproportionately affected older people and those with multiple medical conditions. The English Longitudinal Study of Ageing COVID-19 Substudy provided an opportunity to evaluate older people’s experiences of receiving needed health and social care, and changes in reported anxiety, depression and loneliness. We found that the rates of diagnosis of new conditions during the pandemic in the second half of 2020 were substantially different from the pre pandemic rates reported in 2018 to 2019. Rates of newly diagnosed dementia dropped to below half the pre pandemic rate for reasons that are not clear. The increased isolation during lockdown may have meant that cognitive decline went unnoticed by friends and relatives, or barriers to accessing healthcare may have been experienced more by those with early dementia. Conversely, other conditions were diagnosed more frequently than before the pandemic, including arthritis, chronic lung disease, diabetes and hypertension. Again, the reasons for these increases are not clear, but fewer opportunities for physical activity and social interaction may have played a part. Those with multiple medical conditions were more likely to be unable to access healthcare, and 1 in 5 of them had a hospital operation or treatment STUDY RESULT 2 cancelled. We found that mental health worsened during the pandemic, with higher reported rates of anxiety, depression and loneliness, and again the rise was steeper for respondents with multimorbidity. These results show that older people experienced poor mental health and difficulty accessing basic health care during the pandemic, and those with multiple conditions and early dementia had the greatest difficulties. Particular attention should be paid to the health needs of these vulnerable groups as health care access improves and the backlog of cancelled and delayed care is addressed.

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