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The impact of long Covid on older adults is just beginning to be documented. Photo: Shutterstock

Coronavirus: Long Covid-19 symptoms among elderly dismissed as ‘just part of ageing’ – new study

  • The impact on older adults is just beginning to be documented in the largest study of its kind published in leading medical journal, the BMJ
  • Symptoms can last months or years, they include fatigue, shortness of breath, elevated heart rate, muscle and joint pain, sleep disruptions, and ‘brain fog’

Millions of older adults who have grappled with long Covid – a demographic that has received little attention even though research suggests seniors are more likely to develop the poorly understood condition than younger or middle-aged adults.

Long Covid refers to ongoing or new health problems that occur at least four weeks after a Covid infection, according to the US Centres for Disease Control and Prevention. Much about the condition is baffling: There is no diagnostic test to confirm it, no standard definition of the ailment, and no way to predict who will be affected.

Common symptoms, which can last months or years, include fatigue, shortness of breath, an elevated heart rate, muscle and joint pain, sleep disruptions, and problems with attention, concentration, language, and memory – a set of difficulties known as brain fog.

Ongoing inflammation or a dysfunctional immune response may be responsible, along with reservoirs of the virus that remain in the body, small blood clots, or residual damage to the heart, lungs, vascular system, brain, kidneys, or other organs.

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Only now is the impact on older adults beginning to be documented. In the largest study of its kind, published recently in the world’s leading medical journal, the BMJ, researchers estimated that 32 per cent of older adults in the US who survived Covid infections had symptoms of long Covid up to four months after infection – more than double the 14 per cent rate an earlier study found in adults ages 18 to 64.

Other studies suggest symptoms can last much longer, for a year or more.

The BMJ study examined more than 87,000 adults 65 and older who had Covid infections in 2020, drawing on claims data from UnitedHealth Group’s Medicare Advantage plans. It included symptoms that lasted 21 days or more after an infection, a shorter period than the CDC uses in its long Covid definition. The data encompasses both older adults who were hospitalised because of Covid (27 per cent) and those who were not (73 per cent).

The higher rate of post-Covid symptoms in older adults is most likely due to a higher incidence of chronic disease and physical vulnerability in this population – traits that have led to a greater burden of serious illness, hospitalisation, and death among seniors throughout the pandemic.

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“On average, older adults are less resilient. They don’t have the same ability to bounce back from serious illness,” said Dr Ken Cohen, a co-author of the study and executive director of translational research for Optum Care – a network of doctors’ practices owned by UnitedHealth Group.

Applying the study’s findings to the latest data from the CDC suggests that up to 2.5 million older adults may have been affected by long Covid. For those individuals, the consequences can be devastating: the onset of disability, the inability to work, reduced ability to carry out activities of daily life, and a lower quality of life.

But in many elderly people, long Covid is difficult to recognise.

“The challenge is that nonspecific symptoms such as fatigue, weakness, pain, confusion, and increased frailty are things we often see in seriously ill older adults. Or people may think, ‘That’s just part of ageing,’” said Dr Charles Thomas Alexander Semelka, a postdoctoral fellow in geriatric medicine at Wake Forest University, North Carolina.

US research showed 32 per cent of older adults had symptoms of long Covid up to four months after infection. Photo: Shutterstock

James Jackson, director of long-term outcomes at Vanderbilt’s Critical Illness, Brain Dysfunction, and Survivorship Centre in Nashville, runs several long Covid support groups and has worked with hundreds of patients. He estimates that about a third of those who are older have some degree of cognitive impairment.

“We know there are significant differences between younger and older brains. Younger brains are more plastic and effective at reconstituting, and our younger patients seem able to regain their cognitive functioning more quickly,” he said.

In extreme cases, Covid infections can lead to dementia. That may be because older adults who are severely ill with Covidare at high risk of developing delirium – an acute and sudden change in mental status – which is associated with the subsequent development of dementia, said Dr Liron Sinvani, a geriatrician and an assistant professor at Northwell Health’s Feinstein Institutes for Medical Research in New York.

Older patients’ brains also may have been injured from oxygen deprivation or inflammation. Or disease processes that underlie dementia may already have been underway, and a Covid infection may serve as a tipping point, hastening the emergence of symptoms.

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