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New research on COVID-19 risks for the elderly

Posted on 28 October 2020

Elderly people in Stockholm who live with a person of working age have a higher risk of COVID-19-death.

60 per cent higher. This is how much higher the risk of dying from COVID-19 is for individuals aged 70 and older in Stockholm County who live in the same household as a person of working age compared with the elderly who live with other old-aged individuals. Crowded living conditions are not a risk factor in themselves for the elderly, however. 

A new study led by Stockholm University in collaboration with academics from Linköping University, the European University Institute, the Institute for Futures Studies and the Karolinska Institutet has been published in the journal the Lancet Healthy Longevity.

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New research demonstrates COVID-19 risks for elderly persons in multi-generation households. Photo: Per Wilhelmsson (Shutterstock)

COVID-19 a risk in multi-generational housing

“Elderly people who live with somebody of working age, meaning somebody under the age of 66, have a much higher risk of dying from COVID-19. These findings persisted even after we took into account income, country of birth, education and other mortality in this group,” said Maria Brandén, main author of the study and Associate Professor in Sociology at the Stockholm University Demography Unit, Department of Sociology, and the Institute for Analytical Sociology at Linköping University. 

The elderly who live with younger people do not generally die earlier than other elderly people, but it is specifically the COVID-19 mortality that is higher in the group that lives in multigenerational households. This group includes all of the elderly people in Stockholm County who share households with somebody of working age, which can be either somebody from the same family or somebody who does not belong to the family. 

“It’s been discussed in the general debate that it’s dangerous to live across generational boundaries during the pandemic, and these results support this notion, which makes the findings important in themselves. The explanation of the higher mortality from COVID-19 may simply lie in the fact that these elderly individuals have a greater risk of being exposed to the virus by the people of working age who they live with, compared with the elderly people who live with other old people,” said Maria Brandén.  

Crowded living conditions not a risk factor in themselves for the elderly – but elderly housing is

Based on this study, the researchers cannot, however, say that crowded living conditions have any direct effect on the risk of dying from COVID-19 for the elderly. The elderly who live in crowded conditions indeed have a higher mortality from COVID-19 – but they also have a higher mortality from all other causes. 

“This indicates that it’s not a COVID-19 effect, but that the elderly who live in crowded conditions might more often be in poor health. I was a little surprised by this, that crowded living conditions in themselves resulted in no direct increase in risk of dying from COVID-19,” said Maria Brandén. 

Elderly people who live alone in their own housing, ie not in elderly housing, also have a higher risk of dying in COVID-19, compared with elderly people who live with other elderly people. But the group living alone also has a higher mortality rate for other reasons, which indicates that there is not a COVID-19 effect in that case either.

The study also confirms what has been reported in the media, namely that the risk of dying from COVID-19 is higher for those who live in homes for the elderly compared with those who live in regular households – a full four fold higher. However, at elderly homes, the risk of dying from other causes is also strongly elevated, which is usually attributed to those who live in elderly homes in Sweden having very poor health. 

“Our interpretation is therefore that only a small part of the higher mortality for this group can be explained by COVID-19,” said Maria Brandén.  

Protecting the elderly remains a complex challenge

In a comment on the research, EUI Professor of Sociology Juho Härkönen, a co-author on the study, states that “Taken together, the results also suggest how difficult it was to protect the elderly from the virus when it had spread widely in society. Those with frequent and close interactions with the working age population – such as those living in multigenerational households or elderly homes – were at particular risk, but the risk of dying from COVID-19 was high across living arrangements.”

Professor Härkönen also warns of the challenges in the weeks and months ahead. “Although we might be better prepared now, protecting the vulnerable from the virus can again be difficult, as the recent increases in COVID-19 deaths in many countries unfortunately show.”

The EUI acknowledges Leila Zoubir of Stockholm University for the preparation of this article.