COVID-19 Associated Suicidal Ideation in Older Adults: Two Case Reports With a Review of the Literature

Abstract

The COVID-19 pandemic may profoundly harm the mental health and emotional well- being of many older adults. Public health interventions to minimize the spread of the virus have had the unintended consequences of worsening social isolation, financial stress, and unemployment. Results of early research efforts assessing the impact of these interventions on the mental health of older adults have been mixed. Available findings suggest that a subset of community-dwelling older adults have been less negatively impacted than younger adults, while people of color, the poor, residents of nursing homes and other communal living environments, and those living with dementia and their caregivers are more likely to suffer from COVID-related health problems. This manuscript describes two older adults for whom COVID-19 associated stresses caused significant worsening in their psychiatric illnesses, including the emergence of suicidal ideation, summarizes the literature on the impact of interactions between psychosocial stresses and biological factors on the mental health and well-being of older adults, and discusses interventions to help older adults whose mental health has worsened due to COVID-19. Timely and accurate diagnosis, prompt provision of individualized care using both pharmacologic and psychotherapeutic interventions, adoption of new technologies that permit care to be provided safely at a distance and which allow for virtual social interactions, coupled with ongoing advocacy for policy changes that address significant health care disparities and provide older adults continued access to health care and relief from financial hardship, will help older adults remaining as healthy as possible during the pandemic.

Suicidal ideation and its related factors among older adults: a population-based study in Southwestern Iran

“…A longitudinal study across the pandemic waves in UK reported an increased rate of suicidal thoughts, especially among young female adults and those with preexisting mental health problems [ 28 ]. There have also been case reports of COVID-related suicides among older adults with a history of preexisting mental illnesses [ 29 ].…”

Communication challenges in social isolation, subjective cognitive decline, and mental health status in older adults: A scoping review (2019–2021)

“…These 29 articles are included in this scoping review. Studies and other publications were quantitative studies ( n = 11; Azevedo et al, 2021; Barguilla et al, 2020; Chamberlain et al, 2020; Degen et al, 2021; El Haj et al, 2020; 2021; Pereiro et al, 2021; Tam et al, 2021; van Maurik et al, 2020; Xiang et al, 2021; Yu et al, 2021), qualitative studies ( n = 5; Alsawy et al, 2020; Biggs et al, 2019; Kontos et al, 2021; Steele et al, 2020; Talbot & Briggs, 2021), reviews ( n = 6; Iodice et al, 2021; Kimura et al, 2020; Morina et al, 2021; Ryoo et al, 2020; Simonetti et al, 2020; Soytas, et al, 2021), editorials or commentaries ( n = 4; Canevelli et al, 2020; Edelman et al, 2020; Hampel & Vergallo, 2020; Soares et al, 2020), and case studies ( n = 3; Asthana et al, 2021; Le Vasseur, 2021; Shea et al, 2020) (Figure 1).…”

The social problems of older adults during the COVID-19 pandemic

“…Notably, research shows that, at young ages, such changes induced by stress in the structure and function of the prefrontal cortex (PFC) may not be permanent, but aging is associated with a decline in neuronal plasticity and resilience to the potentially detrimental impact of stress-induced changes in the PFC such as a decrease and shrinkage in synaptic density through a loss in dendritic spines (33,34). This evidence suggests that the neurobiological changes induced by stress are more inclined to have a long-lasting impact on older patients (31).…”