Attitudes and health behaviours of the elderly facing the COVID-19 crisis: a prospective survey in general population. – PA-COVID

Faced with health crises, the elderly are among the most at risk, as the 2003 heat wave in French has shown, excess mortality related to age being particularly marked in people living alone or in nursing homes. Even though the COVID-19 epidemic is far from over, it is more than likely that the elderly population will again be one of the most affected. Beyond the medical characteristics, specificities which relate to attitudes, psychological and social functioning contribute to this phenomenon. Apart from a crisis situation, the consequences of an illness are very different from one elderly subject to another depending on psychological resources, lifestyle, social support, adaptation of the home, accessibility of services and shops... Some studies have looked at the consequences of confinement, but none in the elderly population even though we have reasons to believe that this population is particularly vulnerable at least on 3 levels: 1) to the response to infectious agent due to its physiological characteristics; 2) because of the psychosocial characteristics which make a party even more at risk of severe repercussions of the infection (dependent persons, cognitive disorders, isolated persons, living in institutions); 3) to confinement situation due to reduced psychological adjustment capacity in the elderly.

This project consists of rapidly setting up a phone survey of 1000 elderly people in order to address the following questions:
1) What are the attitudes, the psychological and social experience of the elderly facing the COVID-19 crisis and confinement: the level of stress, anxiety, social support during confinement, access to information, to the guidelines and measures implemented by government authorities, the level of understanding and adherence to these guidelines, representations of the epidemic, access to services restricted in this context or to digital communication tools?
2) To what extent these characteristics, representations and attitudes have an impact on health, mortality (related and not related to COVID-19) and capacities for resilience in the face of this crisis?

The phone survey will take place during and post-confinement. While setting up a vast general population survey in just a few days is hardly possible, and even more so when research staff are also subject to confinement, our team has the means to do so: immediate access to population cohort studies coordinated by the team; a corpus of information already available on these subjects (health and functional indicators, medication, lifestyle, social environment, cognitive deficits, depression, etc.) which will limit the data collection to the crisis situation; prospective follow-up (availability of information before the crisis thanks to the cohorts; during and post-confinement thanks to the survey, in the longer term with prospective follow-up of the cohorts); human resources (11 psychologists will carry out telework interviews).

This epidemic being likely to repeat itself, the knowledge that we will draw from this study should help us to communicate better towards the elderly population and establish specific instructions for seniors; but also, to better target among this already at risk category of population, the most at risk ones, in order to be able to set up medico-social action plans even before Day 1 of the epidemic. Today in France, municipality services have very little means of contacting these people, most municipalities referring to "heat wave" files made up of people who have voluntarily taken the step to appear in it. Although welcome, this initiative will unfortunately be insufficient.