Living well in a Pandemic: Experiences and impacts of the COVID-19 lockdowns on older adults with and without Mild Cognitive Impairment in New Zealand

Abstract

The Coronavirus (COVID-19) pandemic of 2020 resulted in many nations, including New Zealand, adopting strict restrictions, such as lockdown measures (with people largely confined to their homes for long periods of time), in an attempt to minimise the spread of the virus. Understanding the impact of these restrictions on the quality of life, life satisfaction and well-being of the population is important for planning for future pandemics. This thesis focuses on the impacts of the 2020 lockdown restrictions in New Zealand on older adults with and without mild cognitive impairment (MCI), using a mixed-methods approach. Eighteen MCI and 10 matched cognitively-healthy older adults who were part of an existing study examining predictors of ‘living well’ participated. Pre-COVID measures of life satisfaction, well-being, quality of life, social networks and loneliness were available for comparison to post-COVID lockdowns. Twenty-six of these individuals shared their experiences of the lockdowns and easing of restrictions in a semi-structured interview. MCI participants experienced an increase in the quality and quantity of interactions with family following lockdowns, whilst conversely control participants reported a reduction in number and quality of family connections. Both groups reported an increase in loneliness postpandemic and lockdowns, driven by an increase in perceived emotional loneliness. No clinically significant changes in anxiety and depression symptoms occurred for either participant group, consistent with reports of mixed emotional responses to the lockdowns. Thematic analysis identified themes encompassing connection/challenges in reconnection with others, emotional responses to the lockdown and restriction easing, impacts on activities, and concerns for cognitive decline. Difficulties maintaining relationships and managing the burden of loneliness whilst fearing for their own safety and that of others was universal. These results suggest assertive efforts to engage older adults with their communities during these crises are essential, with technology being supportive, but not sufficient at ameliorating the loss of face-to-face interaction for these populations. Indeed, it appeared more that the quality and depth of connections with others was most important to facilitate coping with the challenges of restrictions, something that digital interaction alone could not quite provide.