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Older adults with cancer are amongst the most vulnerable population to be negatively impacted by COVID-19 due to their likelihood of comorbidities and compromised immune status. Considering the longevity of the pandemic, understanding the subjective perceptions and psychosocial concerns of this population may help ameliorate the psychological aftermath.
Nearly two years into the COVID-19 pandemic, it continues to impact individuals’ lives and health systems globally. This is particularly true of older adults with cancer, who may be among the most vulnerable to the effects of COVID-19 due to their immunocompromised status and increased presence of comorbidities[1][2][3][4][5]. Older adults diagnosed with both cancer and COVID-19 face increased mortality, hospitalization, and ICU admission [3][4][5]. In addition, the COVID-19 pandemic has caused significant disruption to the cancer care system, including a shift to virtual appointments, alternative treatment offerings, postponement of surveillance scans and surgeries, and diminished supportive care and survivorship services[6][7]. Older adult cancer survivors have described barriers to cancer treatment across the pandemic, including restricted attendance of caregivers at appointments, diminished access to healthcare services, and feeling less connected to their healthcare team[8][9]. Understanding the impact of these changes on the experiences of older adults with cancer is essential to learning how best to support older adults during this time.
Public health measures meant to diminish the spread of COVID-19, such as social distancing and stay-at-home mandates, have resulted in older adults spending more time alone, which may enhance feelings of isolation and loneliness. Recent reviews suggest that COVID-19 has created considerable anxiety, irritability, feelings of paranoia, and depression amongst community-dwelling older adults and people with serious comorbidities[10]. In the face of the COVID-19 pandemic, older adults with cancer face intersecting vulnerabilities related to the physical effects of the virus, cancer-system changes, and the potentially isolating impacts of public health measures. These factors may be experienced differently by older adults with cancer, potentially exacerbating the impact of the COVID-19 pandemic on this patient population. With no clear ending of the COVID-19 pandemic in sight, understanding the psychosocial impact of the COVID-19 pandemic on older adults with cancer is crucial to provide patient- and family-centred care to this patient population.
Understanding how the pandemic has impacted older adults with cancer will help clinicians support them during subsequent waves of this pandemic, as well as plan for future pandemics. The results from the included studies were consolidated under four domains: (1) Impact of COVID-19 on Quality of Life, (2) Concerns related to COVID-19, (3) Coping with the impact of COVID-19, and (4) Recommendations for future care. The following figure illustrate the finings. Numerous factors such as, being younger than 60 years of age [11]; being a woman[12]; having several co-morbidities[11][13]; receiving active treatment, especially oral therapies [11][14]; and living in city apartments[11][12] were associated with poorer psychosocial wellbeing and increased fears and concerns towards COVID-19. Based on the results of the review, older adults were concerned by changes in their cancer care, loneliness, their disease progression, and contracting the coronavirus. Coping strategies included leaning on personal relationships, maintaining spirituality, accepting the changes associated with the pandemic, engaging in positive interpretation, and drawing on previous experience.
Figure 1 contains a visual presentation of the psychosocial impact of COVID-19 on older adults with cancer, including the factors associated with reduced QoL, major concerns amongst the population, and the adopted coping strategies.
Figure 1. Psychosocial Impact of COVID-19 among older adults with cancer.