A recent study suggests that older adults living in care homes have a higher COVID-19 mortality risk than those living in single houses or apartment buildings.
COVID-19 had caused more than one million deaths worldwide, and older adults have a higher risk. Researchers worldwide are interested in knowing the factors that are contributing to increased mortality risk. The residential context could be crucial in understanding the spread of COVID‑19 because it shapes the contact that older adults have with individuals from within or outside the household.
The team lead by Dr. Maria Branden from Linkoping University, Sweden, in this first of its kind study, evaluated individual patient data to study how residential context could be related to COVID-19 mortality in older people (seventy years and above). They used data from the cause‑of‑death register held by the Swedish National Board of Health and Welfare to identify mortality due to COVID-19 and other reasons. They collected the data between 12 March and 8 May 2020. The study results were published in the journal Lancet Healthy Longevity.
Dr. Branden’s team observed that the residential context is a crucial factor in COVID‑19 mortality risk. Those living in care homes had the highest mortality, followed by those living in apartment blocks and a detached house. In terms of household age structure, living with working age (younger than sixty-six years old) was associated with higher mortality than living in a household with older individuals.
Additionally, strategies to protect these people must be explored, with particular attention in densely populated areas. For example, individuals of working age or younger who live with or are in frequent contact (i.e., care home workers) with the older adults must have access to adequate personal protective equipment or measures to prevent the virus’s spread. Household-level preventive measures will be needed to avoid transmission within households.
Given the higher risk of death for the older adults in close contact with younger people within the home, the researchers conclude that measures designed to protect them must consider controlling community transmission, such as family members, and care‑home visitors and employees.
The authors acknowledge that these findings might not apply to another context, as older adults in Sweden seem to live in the community more than in other countries. Moreover, only very frail elderly live-in care homes.
Branden M., Aradhya S., Kolk M., Harkonen J., Drefahl S., Malmberg B., Rostila M., Cederstrom A., Andersson G., Mussino E. Residential context and COVID-10 mortality among adults aged 70 years and older in Stockholm: a population-based, observational study using individual-level data. Lancet Healthy Longev 2020, 1: e80-88. doi.org/10.1016/S2666‑7568(20)30016-7.
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