In this blog, ELSA Project Manager, Kate Coughlin, outlines their COVID-19 response and how ELSA is in the position of being able to provide unique insights on the immediate and longer-term effects of the pandemic on the older population.
The impact of the COVID-19 pandemic on older people is stark, sadly not only in the number of deaths but also in how they are disproportionately affected by stay-at-home orders and social distancing measures. Older people are more likely to have long-term health conditions, problems with mobility, be more reliant on health and social care, and feel more socially isolated than the rest of the population. Monitoring the impact of the pandemic is vitally important to understand the extent of adverse experiences in the older population to make future health and social systems more resilient.
In response, we announced last week that ELSA has been funded through the ESRC via the UK Research and Innovation COVID-19 Rapid Response call to carry out a COVID-19 study of our ELSA participants. The strengths of longitudinal studies with their multifaceted, repeat measures over many years, often linked to other datasets, have been made even more apparent in the crisis.
ELSA has repeated measures over 18 years from more than 10,000 participants aged 50+ on the composition of their households, frequency of contact with family and others, detailed economic circumstances (income, wealth, liquid savings, self-employment status and what they spend their money on), whether or not they or their partners are ‘key workers’, social and cultural activity, caregiving responsibilities, religion, loneliness, psychological wellbeing and mental health. We also know about medical histories and the presence of ‘underlying health conditions’ that are so relevant to COVID-19 infection. ELSA is in the unique position of being able to compare more accurately than standalone studies, the immediate and longer term effects of the pandemic on the older population.
Survey design and content
ELSA participants will receive an invitation to take part through the post and to their email address (if they have one). They can complete the survey via the internet or over the telephone.
The ELSA COVID-19 survey combines new COVID-19 questions with measures used in previous ELSA waves of data collection. We have been mindful of comparability so have also been collaborating with the Wellcome Trust initiative, coordinating questionnaire content across longitudinal studies, and with international colleagues who run longitudinal ageing studies similar to ELSA.
We will collect data in seven broad areas: COVID-19 illness; other health issues; mental health; financial circumstances; work; social connections and isolation; and health behaviours.
With the COVID-19 specific questions, we are keen to understand the number of ELSA participants who have experienced symptoms, been tested for the virus or who have been hospitalised. With the inevitable time delay in obtaining this information from other linked datasets, it is vital to understand participants’ real-time experiences.
The effects of social isolation brought about by the pandemic are of particular interest to researchers and policymakers. In the ELSA COVID-19 study, we will gather data on the heterogeneity of the experience of isolation in the current circumstances and compare with the experience of those who felt socially isolated before the outbreak. This will be assessed using adapted versions of existing measures of frequency of contact with immediate family, other relatives and friends on the telephone, email, and video-calls, and quality of relationship with partner. We will also measure feelings of loneliness, internet use, watching TV, volunteering and caregiving. Mental health will be measured using the CESD depression scale, the GAD7 anxiety scale, and wellbeing measures.
Finance and work questions will look at changes in participants’ financial situation, worry about future financial security and ability to buy food, changes in income, receipt of benefits and financial assistance programmes, and expectations for the future. We will collect data on changes in work patterns, job security and perception of infection risk while working.
A further significant impact of the pandemic is the disruption in the treatment of long term health conditions, so we have included questions around access to healthcare and medications. We will also assess whether participants’ health behaviours have been impacted, asking questions on smoking, drinking alcohol, physical activity, eating behaviour, sedentary behaviour, and sleep.
We will be conducting two waves of data collection, with the second wave scheduled to start in September. This will capture changes as the crisis evolves and restrictions are relaxed or become more targeted.
The ELSA team will be releasing rapid reports and briefing papers over the next few months and will also be making the data available through the UK Data Service. The ELSA COVID-19 data will include individual identifiers for linking to the existing core ELSA dataset.
For updates on the ELSA COVID-19 study, please sign up for alerts on the ELSA website.
The impact of COVID-19 will be felt for many months and years to come. ELSA, like all longitudinal studies, will lead the way in helping us to understand the long-lasting impact of the virus in specific groups.
Kate Coughlin is ELSA Project Manager. Follow ELSA on Twitter @ELSA_Study