A National Resilience Programme will help combat the effect of COVID-19 on older people

As of this month, all four nations of the UK are increasing restrictions on daily life and business in response to the COVID-19 pandemic. While lockdowns are a challenge for us all, there are particular challenges facing people in later life, some of whom may have health issues, and who are less likely to be digitally connected than the general public.

Since the start of the pandemic, the response has been framed primarily in terms of protecting over 65s from infection. While it is important to protect those at greatest risk, a blanket policy based on age can make older people feel that they are unable to make a positive contribution to their own health and mitigating the impact of COVID-19 on their lives. With vaccines and treatments still at least a few months away, it is important to ensure that people feel more control and receive clearer guidance about how best to protect themselves.

The impact of COVID-19 increases with age and so it poses a significant threat to the health of people in older age groups. However, as physiological research into the impact of reduced daily step counts or immobilisation show, the impact of lockdowns themselves can have a damaging effect on mental and physical wellbeing. With the closure of workplaces, social spaces and recreational activities, people will spend more time in their homes, making it harder to stay physically active and reducing our chances for social interactions.

In a YouGov poll commissioned by The Physiological Society in October, almost one in three over 50s polled (32%) said they had done less physical activity during the lockdown (23 March – 4 July 2020) compared to normal. And, of those, 43% said that this was because they no longer had a reason, or had less reason, to get out of the house and be active. This data is worrying as a significant drop in physical activity levels can lead to cardiorespiratory deconditioning, muscle mass loss and body fat  gain – all of which are associated with poor health as well as increasing people’s vulnerability to COVID-19.

In a report launched in Parliament at the beginning of this month, The Physiological Society and Centre for Ageing Better called for a National COVID-19 Resilience Programme that would bring together a package of measures to support older people through the lockdown and keep them healthy and resilient over the winter. The programme would limit the negative effects of lockdown and encourage older people to take greater control of their health and wellbeing. While people in later life are not a homogenous group and have diverse levels of fitness and frailty, a universal programme would provide broad guidance specifically tailored to older age groups that would comprise the following elements:

• Encourage appropriate exercise
• Support optimised nutrition
• Enhance mental health and wellbeing
• Influence behaviour change

While this programme will not change the fact that older age groups remain particularly vulnerable to the virus, physical activity is an important factor in staying healthy and may play a role in COVID-19 resilience. A National COVID-19 Resilience Programme would give people in later life greater control and offer guidance on how to take care of themselves as the pandemic continues. This way people in older age groups can be provided with the proper tools to allow them to make their own informed decisions on their health, wellbeing and resilience.

A National COVID-19 Resilience Programme should include:

• A tailored exercise programme, targeted at older adults who have key COVID-19 risk factors (obesity, type 2 diabetes, cardiovascular disease, and sarcopenia). This can be achieved by scaling up existing small programmes such as ‘Make Movement Your Mission’;
• Clear guidance about the importance of a healthy balanced diet containing sufficient levels of protein and appropriate energy content;
• Promotion of mental health through the creation of virtual communities to counter social isolation;

Such a programme could be reinforced by relatives, friends, care workers and volunteers to successfully rebuild older people’s confidence to stay active.