Higher COVID-19 mortality among adults aged 70 years who live with youngsters

Close exposure to working-age household members and neighbours is associated with increased COVID-19 mortality among older adults. Similarly, living in a care home is associated with increased mortality, potentially through exposure to visitors and care workers, but also due to poor underlying health among care-home residents. These factors should be considered when developing strategies to protect this group.

Older adults who live with younger people, including those of working age, are at increased risk for COVID-19 mortality, according to a study in The Lancet Healthy Longevity.

Using Swedish population and death registries, researchers studied nearly 275,000 adults aged 70 or older in Stockholm. Roughly 3400 died between March and May 2020, 38% from COVID-19.

Those who lived with at least one person younger than 66 years had a 60% increased risk for COVID-19 death relative to those living with older people. In addition, those living in the most densely populated neighborhoods had a 70% higher risk than those in the least densely populated areas, and those living in care homes had over four times the risk of those in independent housing.

Commentators write, “Despite the considerable emotional and physical support that caregivers and family can offer older adults, isolating at home with younger household members appears to still confer considerable risk for COVID-19 exposure. … Household-level preventive measures will be needed to protect older adults as the pandemic continues.”

The authors concluded that close exposure to working-age household members and neighbours is associated with increased COVID-19 mortality among older adults. Similarly, living in a care home is associated with increased mortality, potentially through exposure to visitors and care workers, but also due to poor underlying health among care-home residents. These factors should be considered when developing strategies to protect this group.

Source: NEJM Journal Watch

Read the full-text article here.

Cox proportional hazard regression for death from COVID-19 and from all other causes among individuals aged 70 years and older.
All models control for individual age, sex, education, income, and country of birth. HR=hazard ratio.

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