Experts say that confinement can have consequences for all people, but especially for those whose previous situation was already more delicate, regardless of their age. In the case of older people, in particular, the effect on their health of such a prolonged confinement will be directly related to their state before starting. Raúl Vaca, psychogerontologist and member of the Board of Directors of the Spanish Society of Geriatrics and Gerontology (SEGG), points out that “confinement will be especially complicated for those whose previous situation was of greater vulnerability or fragility when presenting one or more pathologies”.
This confinement can have consequences on a physical level (loss of muscle mass, worsening of some pathologies, etc.); at the cognitive level (loss or alterations in our cognitive capacities if not stimulated correctly); on an emotional level (appearance of anxious or depressive symptoms, fears of the new situation …); at the behavioral level (modification of sleep patterns, alteration of nutritional habits, among others); or at the social level (loss of relationships or increased isolation).
Mari Cruz Rodríguez Oroz, director of the Neurology department of the Clínica Universidad de Navarra and specialist in Parkinson’s disease and neurodegenerative diseases, explains that this prolonged confinement, in patients who have some neurological disease, such as Alzheimer’s disease or Parkinson’s, will promote “more difficulty in moving, a greater number of contractures in the joints, more difficulty in the extension of the same, it will even harm their balance. The plasticity of the brain and the musculoskeletal system of older people is not the same as that of a young person. “
In those older people who have pathologies associated with cognitive deterioration, it is necessary to differentiate between healthy people, even if they are elderly, and those who already had some type of pathology. In older people with mild cognitive impairment, Dr. Rodríguez Oroz points out that “what has happened is that they previously went to cognitive stimulation therapy, in groups or individually, and during this time, some patients have not attended this type of therapies. How this could have affected them, it is not yet known, but it is very important that the centers implement this service, safely, to this population at risk ”. As for the elderly with a slightly more advanced cognitive decline, Rodríguez Oroz points out that there has been no setback in these patients due to the weeks we have spent in confinement, “although coexistence may have been more complicated and its management, on the part of their relatives, more difficult ”.
Raúl Vaca considers it necessary to offer alternatives or advice to avoid, as far as possible, the appearance of these problems linked to the confinement of people with cognitive impairment. “It is important to establish balanced and organized routines that include cognitive stimulation activities, physical exercises and emotional support, to try to explain the situation to you, adapting the information to your comprehension capacity.”
The confinement has made, according to explains Raquel Pedrero-Chamizo, professor of the Faculty of Sciences of Physical Activity and Sport-INEF of the Polytechnic University of Madrid and researcher of the ImFINE group, “that people slow down their pace of life to levels that could be compared to that of a hospitalized person ”, due to the lack of physical activity that has led to loss of muscle mass and functional deterioration, deterioration in the energy-metabolic balance and also in cardiovascular function.
The specialist lists three factors as the main ones affected. The first would be the loss of muscle mass. Maintaining a strong musculature is necessary to protect and prevent joint stability, as well as reduce joint pain and prevent wear and tear, but with confinement there has been a loss of muscle mass and strength, and these losses can reach alarm levels and it is known by the term sarcopenia. The second factor, to highlight, would be the loss of bone mass (osteopenia), mainly due to the lack of physical activity and together with the decrease in hours of sun exposure, a fundamental aspect to be able to fix calcium to the bones. The third and last factor would be the decrease in aerobic capacity, understood as the decrease in maximum oxygen consumption (maximum VO2), an excellent indicator of a person’s state of health and which decreases considerably with lack of physical activity. “Hence, on these first walks when we go out we feel more tired and fatigued, it costs us more to move and we gasp for a little walk or activity, compared to two months ago,” adds this researcher.
Dr. Ignacio Ara, professor at the University of Castilla-La Mancha (UCLM) and member of the Center for Biomedical Research in the Fragility and Healthy Aging Network (CIBERFES) of the Carlos III Health Institute and vice president of the Physical Activity and Health Network EXERNET, points out that it is difficult to make an exact assessment of this muscle loss in older people, because “it depends not only on whether you are a man or a woman but also on the starting point and the speed of the loss during confinement. The latter will be highly determined by both their lifestyle and diet. “
Ara declares that “in this type of group there is no useful” generic routine “for all people. Older people often have osteoarticular problems of a very different nature and level, so the same exercise can be positive for one person and counterproductive for another. ” Individualization based on the characteristics and conditions of people is what would be required in these cases. In any case, continues Dr. Ignacio Ara, “it is important to pay attention to the alarms / symptoms that the body transmits to avoid problems. The absence of pain, control during the execution and, above all, safety during the practice of the exercises is always the priority, especially when there is no supervision. Apart from this, it is important to convey to our elders the idea that it is necessary to move, start the body, fight sedentary lifestyle and fight to stay as active as possible. The real danger is not moving. “
To these problems, psychological ones can be added. Dr. Raúl Vaca believes that “fears or anxious symptoms related to the possibility of contracting the disease, including post-traumatic stress, may also appear. In addition, it is probable that the person experiences some feeling of guilt for having overcome the disease, especially if someone they know has died from it.