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Why are the elderly more at risk of death from novel coronavirus?

Older people are more likely to be severely ill if they catch the novel coronavirus (COVID-19).

The latest government advice is that people who are particularly vulnerable, such as anyone over the age of 70, must be stringent in following social distancing measures.

But why are the elderly particularly susceptible? Dr Claire Steves, a Clinical Senior Lecturer for the School of Life Course Sciences in the Faculty of Life Sciences and Medicine, has an interest in the interactions between physical and mental health in ageing, and explains why.

Why are the elderly more at risk?

We know people who are very physically active and don’t have existing medical problems are generally much more resilient to viruses, and this probably will turn out to be true of this new coronavirus. However, on average, older people are more at risk because their immune system is not so efficient at fighting, their lung function is reduced. This is very important when it comes to chest infections. They are more likely to have diseases like heart disease and diabetes.

What are the changes to the ‘average’ older person that makes them more susceptible?

The first change is to the immune system – in the innate immune system and the adaptive immune system. The adaptive immune system has specific antibodies that the body makes to specific viruses to help clear them.  This system tends to become a bit untargeted and under effective in the average person with age.

The second change is in the respiratory system. The lungs in older people become stiffer and less capacious, and the muscles in the chest wall become weaker.  This is thought to be partly because of accumulated damage, such as smoking pollution, and partly due to central ageing leading to the buildup of senescent cells that cannot divide any more but secrete signals which lead to damage.

The third change is the accumulation of other diseases which are more likely the longer you have been on the planet – particularly cardiovascular disease – which effects the heart’s ability to cope with infection; diabetes – which in the case of coronavirus is much aggravated by the virus, causing sugars to go sky high which effects all cells functions; and kidney problems as kidney function, like lung function tends to decline with age and so impairs the ability of the body to handle water, which appears to be really important in coronavirus patients.

What can the elderly do to help their mental health at this time?

We know that social isolation is not good for mental health. The advice is to isolate socially! If you are not already - get online, get access to a smart phone. Make sure you call your friends and neighbours- they will be keen to help! They might also need you. Now is a time for connecting with each other not physically, but mentally and we are lucky to have the technology to do it. Don’t be scared - give it a go.

Second, do as much as you can physically. Exercise with music or a video, and if you have access to a garden get out in it- it’s spring and just the time to turn your hand to growing vegetables. Doing positive things like that can really help.

How can we convince older people who want to keep socialising to stay indoors?

It’s certainly not easy. We’ve all got to help each other understand this and keep each other safe. But for sure, don’t be mistaken - it’s quite clear that we need to do this for the sake of us all. By working together and really supporting each other we might find we have more strength in our society than we realised. 

Dr Claire Steves offered more advice on supporting older people on ITV's This Morning.

In this story

Claire  Steves

Claire Steves

Senior Clinical Lecturer

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