SILVER Study provides insight into the challenges presented by COVID-19 to older New Yorkers

Reviewed by Emily Henderson, B.Sc.Dec 20 2022

ICAP at Columbia University Mailman School of Public Health has released results from Round Two of the SILVER Study, providing insight into the challenges presented by COVID-19 to older adults living at home in New York City. The results reveal a range of key issues – from mental health effects to access to reliable information about vaccines – that older New Yorkers have encountered in the wake of the pandemic.

This group of New Yorkers has proven extremely vulnerable to the deleterious direct and indirect effects of the COVID-19 pandemic. We found that the pandemic response exacerbated social, economic, and structural inequities that have resulted in notable negative consequences for older New Yorkers living on their own."

Abigail Greenleaf, MPH, PhD, leader of SILVER research team at ICAP

The findings from this second survey build on a prior survey entitled SARS-CoV-2 Impact on Lives and Views of Elderly Residents ("SILVER Study"), conducted in 2020 and 2021 to provide a first look at the challenges of the COVID-19 pandemic on older adults. Both the original survey and the follow-up were phone surveys of a cohort of older New Yorkers aged 70 years or older (70+) living at home – not in assisted care facilities. For the second round of SILVER, ICAP researchers invited Round One participants to participate and enriched the cohort with additional Asian older adults, a group that was underrepresented in the first data collection effort. Phone surveys for Round Two were conducted in February and March of 2022.

Key study findings included the following:

• Evidence of depression and anxiety remain higher than pre-pandemic levels. Between SILVER Round One and Round Two, reports of anxiety increased for Black, Latinx and participants who of "another race." Importantly, older New Yorkers with limited mobility and/or who did not often leave their homes were particularly vulnerable to adverse mental health outcomes.
• Fewer women compared to men indicated having access to technology and having lower confidence in their technology skills, depriving them of an important resource for communication and access to health services. .
• Black, Latinx and older New Yorkers of "another race" were mainly accessing telehealth through phone calls, whereas 70% of white participants' telehealth encounters used video.
• While access to information regarding vaccination was common, a substantial proportion of older New Yorkers had recently struggled to discern the accuracy of available information.

The researchers made specific recommendations, including prioritizing the health – and particularly the mental health – needs of older adults with limited mobility who may be more vulnerable to the effects of isolation, improving women's digital literacy, and improving older adults' ability to identify accurate and reliable sources of COVID-19 information.

"We continue to learn about the complex ways that the COVID-19 pandemic has affected – and will continue to affect – various communities," said Wafaa El-Sadr, MD, MPH, MPA, ICAP's global director and lead of the New York City Pandemic Response Institute. "The SILVER survey provides insights into how we can better meet the needs of different sectors of our society, so that, when the next health emergency strikes, they will have the support they require to stay healthy."

The SILVER survey was funded by the New York Community Trust.