Review Article

The Main Issues and Challenges Older Adults Face in the SARS-CoV-2 Pandemic: A Scoping Review of Literature


Background: The Severe Acute Respiratory Syndrome Coronavirus Disease 2019 (SARS-CoV-2) severely affects those above the age of 60 yr and those with other conditions. This study aimed to review the available evidence on older adult's issues in facing the COVID-19 pandemic.

Methods: The framework is based on scoping review of literature published from Jan 10 to Jul 31, 2020. Medline, Scopus, Web of Science, and Google Scholar databases and other sources of information, to identify grey literature, were selected for data collection. Two researchers independently screened all studies and extracted data. All types of studies published about SARS-CoV-2 and related to older adults’ issues were eligible.

Results: Overall, 210 documents were included in the final analysis. Letter to the editor was the most frequent article format (20.95%). Most of the papers were from the United States (38.09%) and published in Jun 2020 (29.52%). After content analysis, six following themes were extracted: Supporting and information sources, e-health services, access to essential supplies, Long Term Care Facilities (LTCFs), physical and mental consequences of self-isolation, neglect of older adults, ageism and age discrimination.

Conclusion: In the pandemic, there is an urgent need for interventional research and innovational implementations to address issues related to providing services for older adults. This can help older adults to maintain their physical and mental health, and reduce the spread of infection in nursing homes. Further studies focusing on the rights of the older adults are needed on all issues associated with COVID-19.

1. WHO. Director-General’s opening remarks at the media briefing on COVID 19 - 11 march 2020 (2020). Available from:
2. Wilson N, Kvalsvig A, Barnard LT, Baker MG (2020). Case-fatality risk estimates for COVID-19 calculated by using a lag time for fatality. Emerg Infect Diss, 26(6):1339-1441.
3. Ioannidis JP, Axfors C, Contopoulos-Ioannidis DG (2020). Population-level COVID-19 mortality risk for non-elderly individuals overall and for non-elderly individuals without underlying diseases in pandemic epicenters. Environ Res, 188: 109890.
4. Doshmangir L, Mahbub Ahari A, Qolipour K, et al (2020). East Asia's Strategies for Effective Response to COVID-19: Lessons Learned for Iran. Manag Strategy Health Syst, 4(4):370-373.
5. Naja F, Hamadeh R(2020). Nutrition amid the COVID-19 pandemic: a multi-level framework for action. Eur J Clin Nutr, 74(8):1117-1121.
6. Holt NR, Neumann JT, McNeil JJ, Cheng AC, Unit HE, Prahan V(2020). Implications of COVID-19 in an ageing population. Medical J Aust, 1.
7. Taube E, Kristensson J, Sandberg M, Midlöv P, Jakobsson U (2015). Loneliness and health care consumption among older people. Scand J Caring Sci, 29(3):435-443.
8. Rockwell KL, Gilroy AS (2020). Incorporating telemedicine as part of COVID-19 outbreak response systems. Am J Manag Care, 26(4):147-148.
9. Arksey H, O'Malley L(2005). Scoping studies: towards a methodological framework. Int J Soc Res Methodol, 8(1):19-32.
10. Tricco AC, Lillie E, Zarin W, et al (2018). PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med, 169(7):467-473.
11. Wexler A, Dawson L, Long M, Freed M, Ramaswamy A, Ranji U (2020). The coronavirus aid, relief, and economic security act: Summary of key health provisions. Kaiser Family Foundation, April 9. Available from: (Accessed 7 July 2020)
12. Wilson TL, Scala-Foley M, Kunkel SR, Brewster AL(2020). Fast-track Innovation: Area Agencies on Aging Respond to the COVID-19 Pandemic. J Aging Soc Policy, 32(4-5):432-438.
13. Shuyi P (2020). Why France Failed to Contain the COVID-19 Pandemic . Available from: (Accessed 5 July 2020)
14. D'Adamo H, Yoshikawa T, Ouslander JG (2020). Coronavirus disease 2019 in geriatrics and longterm care: the ABCDs of COVID‐19. J Am Geriatr Soc, 68(5):912-917.
15. INTERNATIONAL MONETARY FUND (2020). POLICY RESPONSES TO COVID-19 . Available from: (Accessed 5 July 2020)
16. (2020). COVID-19 Ministry of Health. Available from: .( Accessed 8 July 2020).
17. Merchant RA, Chen M, Ng S, Sandrasageran S, Wong B (2020). The Role of a Geriatrician has Become Even More Important in an Academic Institution during COVID-19. J Nutr Health Aging, 13:1-2.
18. Chhetri JK, Chan P, Arai H, et al (2020). Prevention of COVID-19 in older adults: A brief guidance from the International Association for Gerontology and Geriatrics (IAGG) Asia/Oceania Region. J Nutr Health Aging, 14: 1-2.
19. GOV. UK (2020). Guidance on shielding and protecting people who are clinically extremely vulnerable from COVID-19. Available from: (Accessed 8 July 2020).
20. Zubatsky M, Berg-Weger M, Morley J (2020). Using Telehealth Groups to Combat Loneliness in Older Adults Through COVID-19. J Am Geriatr Soc, 68(8): 1678-1679.
21. de Leo D, Trabucchi M (2020). COVID-19 and the Fears of Italian Senior Citizens. International Int J Environ Res Public Health, 17(10):3572.
22. Gerke, S., Stern, A. D., & Minssen, T. (2020). Germany’s digital health reforms in the COVID-19 era: lessons and opportunities for other countries. NPJ Digit Med, 3(1), 1-6.‏
23. Hollander JE, Carr BG (2020). Virtually perfect? Telemedicine for COVID-19. N Engl J Med, 382(18):1679-1681.
24. Loeb AE, Rao SS, Ficke JR, Morris CD, Riley III LH, Levin AS (2020). Departmental experience and lessons learned with accelerated introduction of telemedicine during the COVID-19 crisis. J Am Acad Orthop Surg, 1;28(11):e469-e476.
25. Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020. Public Low. No. 116–123, 134 Stat. 146: Available from: (Accessed 15 July 2020).
26. Hargittai E, Piper A. M, Morris M. R (2019). From internet access to internet skills: digital inequality among older adults. Univers Access Inf Soc, 18(4), 881-890.‏
27. Towle M (2020). Our Elderly and COVID-19: What to Know, What to Do and How to Help At-Risk Seniors During the Coronavirus Outbreak: marin magazine; Available from: (Accessed 15 July 2020).
28. Chiara (2020). PHM Korea: statement on COVID-19 outbreak and responses in South Korea. Available from: (Accessed 15 July 2020).
29. Business Insider (2020). China took at least 12 strict measures to control the coronavirus. They could work for the US, but would likely be impossible to implement . Available from: (Accessed 5 July 2020).
30. Hoffman, G. J. Webster, N. J. Bynum, J. P. W (2020). A Framework for Aging-Friendly Services and Supports in the Age of COVID-19. J Aging Soc Policy. 32(4-5):450-459.
31. Government of Canada (2020). Canada’s COVID-19 Economic Response Plan – Overview. 2020.Available from: (Accessed 6 July 2020).
32. Gostin LO, Hodge JG (2020). US emergency legal responses to novel coronavirus: balancing public health and civil liberties. JAMA, 323(12):1131-1132.
33. Anderson RM, Heesterbeek H, Klinkenberg D, Hollingsworth TD (2020). How will country-based mitigation measures influence the course of the COVID-19 epidemic? Lancet, 395(10228):931-934.
34. Rajan S, Mckee M (2020). Learning from the impacts of COVID-19 on care homes: a pilot survey. LTCcovid, International Long-Term Care Policy Network, CPEC-LSE. 9 June 2020. Availabale from: (Accessed 5 June 2020)
35. Fahed M, Barron GC, Steffens DC (2020). Ethical and Logistical Considerations of Caring for Older Adults on Inpatient Psychiatry During the COVID-19 Pandemic. Am J Geriatr Psychiatry, 28(8): 829-834.
36. WHO (2020). Infection Prevention and Control guidance for Long-Term Care Facilities in the context of COVID-19. Available from: (Accessed 21 March 2020)
37. CDC(2020). Preparing for COVID-19 in Nursing Homes. Available from: (Accessed 5 June 2020).
38. Prime Minister of Japan and His Cabinet(2020). Government Responses on the Coronavirus Disease 2019. Available from: (Accessed 2 June 2020).
39. Jiménez-Pavón D, Carbonell-Baeza A, Lavie CJ (2020). Physical exercise as therapy to fight against the mental and physical consequences of COVID-19 quarantine: Special focus in older people. Prog Cardiovasc Dis, 63(3): 386–388
40. Tan LF, Seetharaman S (2020). Preventing the Spread of COVID‐19 to Nursing Homes: Experience from a Singapore Geriatric Centre. J Am Geriatr Soc, 68(5):942.
41. van Dyck LI, Wilkins KM, Ouellet J, Ouellet GM, Conroy ML(2020). Combating Heightened Social Isolation of Nursing Home Elders: The Telephone Outreach in the COVID-19 Outbreak Program. Am J Geriatr Psychiatry, 28(9):989-992.
42. Andrew M, Searle SD, McElhaney JE, et al (2020). COVID-19, frailty and long-term care: Implications for policy and practice. J Infect Dev Ctries, 14(5):428-432.
43. Wand APF, Zhong BL, Chiu HFK, Draper B, De Leo D (2020). COVID-19: the implications for suicide in older adults. Int Psychogeriatr, 32(10):1225-1230
44. O’Hanlon S, Inouye SK (2020). Delirium: a missing piece in the COVID-19 pandemic puzzle . Age Ageing, 49(4): 497-498.
45. Coughlin SS (2012). Anxiety and depression: linkages with viral diseases . Public Health Rev, 34:7.
46. Isaia G, Marinello R, Tibaldi V, Tamone C, Bo M (2020). Atypical presentation of Covid-19 in an older adult with severe alzheimer disease. Am J Geriatr Psychiatry, 28(7):790-791.
47. Boreskie KF, Hay JL, Duhamel TA (2020). Preventing Frailty Progression during the COVID-19 Pandemic. J Frailty Aging, 6: 1-3.
48. Wang H, Li T, Barbarino P, et al (2020). Dementia care during COVID-19. Lancet, 395(10231):1190-1191.
49. Australian Pshychological Scocity (2020). Coronavirus (COVID-19) Anxiety and Staying Mentally Healthy for Older Adults. Available from: (Accessed 9 July 2020).
50. Alzheimer's Disease international (2020). ADI offers advice and support during COVID-19 . Available from: (Accessed 8 July 2020).
51. Okolie C, Dennis M, Thomas E. S, &John A (2017). A systematic review of interventions to prevent suicidal behaviors and reduce suicidal ideation in older people. Int psychogeriatr, 29(11): 1801-1824.
52. Li W, Yang Y, Liu Z-H, et al (2020). Progression of Mental Health Services during the COVID-19 Outbreak in China. Int J Biol Sci, 16(10):1732-1738.
53. Roy J, Jain R, Golamari R, Vunnam R, Sahu N(2020). COVID-19 in the geriatric population. Int J Geriatr Psychiatry, 10.1002/gps.5389.
54. age UK (2020). Age UK Advice Line. Available from: (Accessed 10 July 2020).
55. Piquero AR, Riddell JR, Bishopp SA, Narvey C, Reid JA, Piquero NL (2020). Staying Home, Staying Safe? A Short-Term Analysis of COVID-19 on Dallas Domestic Violence. Am J Crim Justice, 14:1-35.
56. McNamara TK, Gonzales E (2011). Volunteer transitions among older adults: The role of human, social, and cultural capital in later life. J Gerontol B Psychol Sci Soc Sci, 66(4):490-501.
57. Petretto DR, Pili R (2020). Ageing and COVID-19: What is the Role for Elderly People? Geriatrics (Basel), 5(2): 25.
58. Monahan, C, Macdonald J, Lytle A, Apriceno M, Levy S. R (2020). COVID-19 and ageism: How positive and negative responses impact older adults and society. Am Psychol, 75(7): 887-896.
59. Goodman-Casanova JM, Dura-Perez E, Guzman-Parra J, Cuesta-Vargas A, Mayoral-Cleries F (2020). Telehealth Home Support During COVID-19 Confinement for Community-Dwelling Older Adults With Mild Cognitive Impairment or Mild Dementia: Survey Study. J Med Internet Res, 22(5): e19434.
60. Lloyd-Sherlock PG, Kalache A, McKee M, Derbyshire J, Geffen L, Casas FG (2020). WHO must prioritise the needs of older people in its response to the covid-19 pandemic. BMJ, 368:m1164.
61. Bergman YS, Cohen-Fridel S, Shrira A, Bodner E, Palgi Y (2020). COVID-19 health worries and anxiety symptoms among older adults: the moderating role of ageism. Int Psychogeriatr, 1-5.
62. Fraser S, Lagacé M, Bongué B, et al (2020). Ageism and COVID-19: What does our society's response say about us? Age Ageing, 49(5): 692-695
63. Grover S, McClelland A, Furnham, A (2020). Preferences for scarce medical resource allocation: Differences between experts and the general public and implications for the COVID-19 pandemic. Br J Health Psychol, 20: e12439.
64. Public Health England (2020). Guidance for the public on the mental health and wellbeing aspects of coronavirus (COVID-19) England. Available from: (Accessed 10 July 2020).
65. Brooke J, Jackson D (2020). Older people and COVID‐19: Isolation, risk and ageism. J Clin Nurs, 29(13-14): 2044-2046.
66. Farrell TW, Ferrante LE, Brown T, et al (2020). AGS Position Statement: Resource Allocation Strategies and Age-Related Considerations in the COVID-19 Era and Beyond. J Am Geriatr Soc 68(6):1136-1142.
67. Young HM, Quinn W, Brassard A, Gualtieri C, Reinhard S (2020). COVID-19 Pandemic Spurs Policy Changes Benefiting Older Adults. J Gerontol Nurs, 46(6):19-23.
68. Ilgaz A, Gözüm S (2019). Health promotion interventions for older people living alone: a systematic review. Perspect Public Health, 139(5):255-263.
69. Jnr BA (2020). Use of Telemedicine and Virtual Care for Remote Treatment in Response to COVID-19 Pandemic. J Med Syst, 44(7): 132.
70. Society AG (2020). American Geriatrics Society Policy Brief: COVID‐19 and Nursing Homes. J Am Geriatr Soc, 68(5):908-911.
71. Nathavitharana RR, Patel PK, Tierney DB, et al (2020). Innovation and Knowledge Sharing Can Transform COVID-19 Infection Prevention Response. J Hosp Med, 15(5):299-301.
72. Dobbs D, Peterson L, Hyer K (2020). The Unique Challenges Faced by Assisted Living Communities to Meet Federal Guidelines for COVID-19. J Aging Soc Policy, 32(4-5): 334-342.
73. Gardner W, States D, Bagley N (2020). The coronavirus and the risks to the elderly in long-term care. J Aging Soc Policy, 32(4-5):310-315.
74. Koenig HG (2020). Ways of protecting religious older adults from the consequences of COVID-19. Am J Geriatr Psychiatry, 28(7):776-779.
75. Joosten-Hagye D, Katz A, Sivers-Teixeira T, Yonshiro-Cho J (2020). Age-friendly student senior connection: students' experience in an interprofessional pilot program to combat loneliness and isolation among older adults during the COVID-19 pandemic. J Interprof Care, 34(5):668-671.
IssueVol 49 No 12 (2020) QRcode
SectionReview Article(s)
Older adults SARS-CoV-2 Nursing homes Mental health Review

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
MOBASSERI K, AZAMI-AGHDASH S, KHANIJAHANI A, KHODAYARI-ZARNAQ R. The Main Issues and Challenges Older Adults Face in the SARS-CoV-2 Pandemic: A Scoping Review of Literature. Iran J Public Health. 2020;49(12):2295-2307.