English Longitudinal Study of Ageing COVID-19 Substudy

Lead Research Organisation: University College London
Department Name: Epidemiology and Public Health

Abstract

The COVID-19 crisis is having an unprecedented impact on people's lives from the perspectives of their health, psychological wellbeing, social activity, employment and financial circumstances. Older people are at high risk because of the presence of long-term health conditions, problems with mobility, as well as social isolation due to lower levels of internet use compared with the rest of the population. The repercussions of this crisis will be considerable and long-lasting. Research for years to come will need to understand who has been most affected economically and socially, and how policymakers can best help them in the long run. Additionally, researchers need to study the crisis now, and policymakers' responses to it, in order to make future health and social systems more resilient to such events in the future. There is a strong scientific case for collecting data in the time of the crisis within the framework of existing longitudinal data and infrastructure investments that already form a large part of the evidence base when it comes to understanding the links between health, economic welfare, family and social structures. There is an urgent need to monitor these processes in order to identify the extent of adverse experience, to learn how to promote resilience, and to inform policy. ELSA is uniquely positioned to do this for older people.

Our aim is to carry out assessments of a large well characterized sample of men and women aged over 50 who are participants in the long running English Longitudinal Study of Ageing (ELSA). We will implement an internet assessment of the complete sample (more than 9,000 people), with telephone interviews to ensure people who are not able to use the internet can participate. We will measure experiences of COVID-19, changes in financial circumstances, work and caregiving, mental and physical health, social contact and loneliness, health and social care, stress and worries. The survey will be carried out in June 2020, with a second assessment in September/October. The study will inform policy makers and researchers about the diverse impacts of COVID-19.

Publications

10 25 50

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Demakakos P (2021) Importance of population-based longitudinal studies to understanding the impact of COVID-19. in Journal of epidemiology and community health

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Iob E (2022) Mental health, financial, and social outcomes among older adults with probable COVID-19 infection: A longitudinal cohort study. in Proceedings of the National Academy of Sciences of the United States of America

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Kung CSJ (2024) Changes in well-being among socially isolated older people during the COVID-19 pandemic: An outcome-wide analysis. in Proceedings of the National Academy of Sciences of the United States of America

 
Description This funding has permitted data collection from participants in the English Longitudinal Study of Ageing during the COVID-19 pandemic. Two waves of data collection have been completed, one in June/July and the second in Nov/Dec 2020. Because of lockdown and social distancing, data were collected online or by telephone interview. The response rates have been high (around 75%). Questions were asked about a multiple aspects of the pandemic and lockdown, including COVID-19 infection, other physical health issues, mental health, quality of life, health-related behaviour, income and spending, employment, volunteering and caring, and social isolation and loneliness. Data from the first wave have been deposited in the UK Data Service, and the second wave will be deposited shortly. The survey has provided high quality data on the experience of older people during the pandemic. The data are being used by researchers throughout the world. with multiple publications from the USA and continental Europe as well as the UK.
Exploitation Route This funding has permitted data collection from participants in the English Longitudinal Study of Ageing during the COVID-19 pandemic. Two waves of data collection have been completed, one in June/July and the second in Nov/Dec 2020. Because of lockdown and social distancing, data were collected online or by telephone interview. The response rates have been high (around 75%). Questions were asked about a multiple aspects of the pandemic and lockdown, including COVID-19 infection, other physical health issues, mental health, quality of life, health-related behaviour, income and spending, employment, volunteering and caring, and social isolation and loneliness. Data from the first wave have been deposited in the UK Data Service, and the second wave will be deposited shortly. The survey has provided high quality data on the experience of older people during the pandemic. It will be analysed in detail by multiple users in the future.

ELSA is contributing to further research related to COVID-19, including work on long-Covid. The value of the study will be enhanced by analysis of the data by other academic researchers and policy analysts.
Sectors Communities and Social Services/Policy

Digital/Communication/Information Technologies (including Software)

Financial Services

and Management Consultancy

Healthcare

URL https://www.elsa-project.ac.uk/covid-19
 
Description The ELSA Covid-19 data have been used in various government and third sector reports both nationally and internationally. For example, the data were used in the 'Wider impacts of COVID-19 on physical activity, deconditioning and falls in older adults' report by Public Health England (August 2021): https://assets.publishing.service.gov.uk/media/6114f852d3bf7f63b45df099/HEMT_Wider_Impacts_Falls.pdf Public Health England's COVID-19 Cabinet commissioned the Health Economics and Modelling Team (HEMT) to undertake work to identify the wider public health impacts of COVID-19 and carry out modelling in priority areas to quantify these impacts. One of the areas identified as high priority for further work was older people. This 'Wider impacts of COVID-19 on physical activity, deconditioning and falls in older adults' study looked at how Covid-19 has affected older people (over 65 year olds), with a focus on deconditioning and falls in the context of the potential for greater demand on health services in the absence of suitable mitigations. The report used the ELSA Covid-19 data to provide recommendations to address deconditioning and improve older adult mental and physical health while simultaneously reducing falls risk. These recommendations were aimed at: national and local public health services; preventive care services within Integrated Care Systems and Falls Prevention services elsewhere within local health and care systems; and national policy teams identifying how ageing populations can best recover from the pandemic. The Office for Health Improvement and Disparities also used the ELSA Covid-19 data in their Productive Healthy Ageing Profile: https://fingertips.phe.org.uk/profile/healthy-ageing/supporting-information/multi-morbidity. The productive healthy ageing profile provides data and further information on a wide range of topics relevant to our health as we age with indicators that can be examined at local, regional and national level. The Commonwealth Fund used the ELSA Covid-19 data in their comparative study 'The First COVID Wave: Comparing Experiences of Adults Age 50 and Older in the U.S. and Europe': https://commonwealthfund.org/publications/issue-briefs/2023/apr/first-covid-wave-experiences-adults-age-50-older-us-europe The aim of this study was to examine how US adults age 50 and older fared during the first wave of the pandemic in the summer of 2020, compared with their peers in European countries. The report focused on four adverse experiences: being infected or hospitalised with Covid-19; forgoing care; having a friend or relative die from Covid-19; and losing employment. The report found that during the first Covid-19 wave, older Americans were much more likely than their European peers to report at least one of these four adverse Covid-19 experiences. The report called for these effects to be monitored to understand the long-term impacts of adverse Covid-19 experiences on older adults to help policymakers in the U.S. and elsewhere better prepare for the next pandemic. The ELSA Covid-19 data have also been used extensively by the third sector. Age UK have used the data in several reports including their 2021 analysis that showed that 1 in 10 people aged 60+ had been eating less since the start of the pandemic: https://www.ageuk.org.uk/latest-press/articles/2021/1-in-10-1.4-million-aged-60-have-been-eating-less-since-the-start-of-the-pandemic/. Age UK also used the ELSA Covid-19 data in an evidence submission to the House of Lords COVID-19 Committee Inquiry 'Living online: the long term impact on wellbeing' https://www.ageuk.org.uk/globalassets/age-uk/documents/reports-and-publications/consultation-responses-and-submissions/active-communities/crm_dec20_age_uk_evidence_to_the_house_of_lords_covid-19_commitee_-final.pdf ELSA data were used in the evidence to show that there was not a substantial increase in digital engagement among older people particularly 75+ who are offline, despite the move to greater digitalisation during the pandemic. As well as this evidence submission, Age UK also produced the report 'Mind the digital gap: older Londoners and internet use during the pandemic' https://www.ageuk.org.uk/bp-assets/globalassets/london/documents/campaigns/mind-the-digital-gap-report.pdf ELSA Covid-19 wave 1 data were used to show that internet use is considerably lower in Londoners aged 75+ than among those aged 64-74. The report made recommendations to the Mayor of London, internet providers and local authorities with the aim of overcoming barriers to digital inclusion faced by older Londoners. The Centre for Ageing Better used the ELSA Covid-19 data in the report they commissioned called 'Community connectedness during the Covid-19 outbreak' focussing on people living in low income neighbourhoods of Greater Manchester: https://ageing-better.org.uk/sites/default/files/2022-03/community-connectedness-in-the-COVID-19-outbreak-report.pdf ELSA data were used in this report as the basis for recommendations based around community participation to bring about planned change or improvements in community life, services and/or resource leading to a reduction in avoidable inequalities, and social connectedness, resulting in healthier more cohesive communities. As part of our NIHR-funded project looking at the experiences of people with cognitive impairment and dementia during the pandemic, the ELSA Covid-19 data were extensively used. This project included a Patient & Public Involvement group, where findings were shared with people with lived experiences of cognitive impairment and/or dementia, i.e. people living with these conditions or providing care to others with it. Alongside a final project report filed with NIHR, and short film summarising the findings, the project also included a final webinar to share the findings among a broad range of stakeholders. The webinar featured remarks on the research from Lisa Cameron MP, then chair of the All Party Parliamentary Groups for both Disability and Health. Over 80 people registered to attend the webinar, with attendees from eight countries.
First Year Of Impact 2021
Sector Communities and Social Services/Policy,Healthcare
Impact Types Societal

Economic

Policy & public services

 
Description Informing Government Data and Policy on COVID-19
Geographic Reach National 
Policy Influence Type Citation in other policy documents
Impact The data from the ELSA COVID-19 Substudy has been cited in a number of Government reports on the impact of the pandemic on health, wellbeing and economic cirsumstances. The referenced report is one example
 
Description National Core Studies longitudinal population studies collaboration 
Organisation University of Bristol
Department School of Social and Community Medicine
Country United Kingdom 
Sector Academic/University 
PI Contribution The National Core Studies (NCS) were established by Sir Patrick Vallance, UK Chief Scientific Adviser, in October 2020 as part of the UK's response to the COVID-19 pandemic. Six NCS were created focussing on key areas in which the UK needed to rapidly increase research scale to respond to the near term strategic, policy and operational needs. The UKRI funded COVID-19 Longitudinal Health and Wellbeing (LHW) National Core Study aims to understand the health, social, and economic impacts of the COVID-19 pandemic by uniting established population cohorts and national anonymised electronic health records to inform policy. The longitudinal population studies involved in LHW NCS were ELSA, TwinsUK, Understanding Society, GLAD, ALSPAC, Generation Scotland, and the four UK Birth Cohort studies. After an initial "phase 0" (October 2020-March 2021), this NCS was extended for an additional 18 months. The team involved in this initiative has researchers from UCL, LSHTM, KCL, University of Edinburgh, University of York, University of Glasgow, University of Essex, University of Bristol, University of Oxford, University of Cambridge, University of West England, as well as the National Institute for Health and Care Excellence, the Bradford Institute for Health Research, and the UK Longitudinal Linkage Collaboration
Collaborator Contribution This collaboration has produced, so far, more than 30 peer-reviewed publications, two reports compiled for the Scientific Advisory Group for Emergencies (SAGE), several briefing and impact reports, as well as numerous presentation at national and international meetings and conferences.
Impact This collaboration has produced, so far, more than 30 peer-reviewed publications, two reports compiled for the Scientific Advisory Group for Emergencies (SAGE), several briefing and impact reports, as well as numerous presentation at national and international meetings and conferences.
Start Year 2020
 
Description ELSA COVID-19 Substudy overview video 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact This is a video which we made for any type of interested audience. The video gives an overview of ELSA COVID-19 Substudy and is available in the ELSA YouTube channel.
Year(s) Of Engagement Activity 2020
URL https://www.elsa-project.ac.uk/covid-19-training-videos
 
Description ESRC-GRS COVID-19 Actionable Insight Seminar 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other audiences
Results and Impact I presented data on family responses to the pandemic across generations, building on ESRC-funded research
Year(s) Of Engagement Activity 2021
 
Description Interview for national news 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact Report in the Daily Mail based on Dr Georgia Chatzi's (University of Manchester) report "Differences in subjective and objective social isolation and subjective loneliness before and during the COVID-19 pandemic."
Year(s) Of Engagement Activity 2021
URL https://www.dailymail.co.uk/wires/pa/article-9828393/Older-people-poor-areas-twice-likely-feel-lonel...
 
Description Interview for national news 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Media (as a channel to the public)
Results and Impact Report in The Evening Standard based on Dr Georgia Chatzi's (University of Manchester) report "Differences in subjective and objective social isolation and subjective loneliness before and during the COVID-19 pandemic."
Year(s) Of Engagement Activity 2021
URL https://www.standard.co.uk/news/uk/england-university-college-london-women-elsa-adults-b947770.html
 
Description Interview for national news 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact News story in the Telegraph based on Dr Paola Zaninotto's report: "Multimorbidity, access to services and diagnosis of new health conditions during the COVID-19 pandemic."
Year(s) Of Engagement Activity 2021
URL https://www.telegraph.co.uk/news/2021/06/18/one-eight-over-50s-had-operation-cancelled-last-year/
 
Description Interview for national news 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact Report in The Independent based on Dr Georgia Chatzi's (University of Manchester) report "Differences in subjective and objective social isolation and subjective loneliness before and during the COVID-19 pandemic."
Year(s) Of Engagement Activity 2021
URL https://www.independent.co.uk/news/uk/home-news/older-elderly-lonely-isolated-lockdown-b1890791.html
 
Description Interview for national news 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact ITV news report based on Dr Georgia Chatzi's (University of Manchester) report "Differences in subjective and objective social isolation and subjective loneliness before and during the COVID-19 pandemic."
Year(s) Of Engagement Activity 2021
URL https://www.itv.com/news/granada/2021-07-27/older-people-in-poorer-areas-twice-as-likely-to-be-lonel...
 
Description Presentation on COVID-19 and inequality to French economists 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact This online presentation was part of the Journées de l'Economie and addressed socioeconomic inequalities in mental health during the pandemic
Year(s) Of Engagement Activity 2021
 
Description Presentation to UCL staff, undergraduates, postgraduates 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Postgraduate students
Results and Impact More than 50 UCL staff and students attended an online seminar given by Dr Paola Zaninotto "The experiences of older people during the COVID-19 pandemic in England"
Year(s) Of Engagement Activity 2021
 
Description Press release 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Media (as a channel to the public)
Results and Impact WalesOnline news story based on Dr Georgio Di Gessa's published analysis: Pre-pandemic mental health and disruptions to healthcare, economic, and housing outcomes during COVID -19: evidence from 12 UK longitudinal studies
Year(s) Of Engagement Activity 2021
URL https://www.walesonline.co.uk/news/uk-news/depression-linked-higher-risk-pandemic-21718003
 
Description Press release 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact Press release titled 'People with prior mental ill health hit harder by pandemic disruption' from a published analysis led by a member of my team, Dr Giorgio Di Gessa.
Year(s) Of Engagement Activity 2021
URL https://www.elsa-project.ac.uk/post/people-with-prior-mental-ill-health-hit-harder-by-pandemic-disru...
 
Description Talk to the British Society of Gerontology 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Dr Paola Zaninotto gave the presentation "The English Longitudinal Study of Ageing (ELSA): recent developments and findings from the COVID-19 substudy" as part of the session "Research into Ageing Update: Longitudinal ageing studies" for the British Society of Gerontology conference.
Year(s) Of Engagement Activity 2021
 
Description Webinar to the OECD concerning socioeconomic inequalities in mental health during the COVID-19 pandemic 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact This Webinar was part of a series run by the OECD on experiences during the pandemic, and stimulated international policy briefings
Year(s) Of Engagement Activity 2021
URL https://www.oecd.org/wise/events/covid-and-inequality-webinars.htm