Bell, 70, is among millions of older adults who have grappled with long covid — a population that has received little attention even though research suggests seniors are more likely to develop the poorly understood condition than younger or middle-aged adults.
Long covid refers to ongoing or new health problems that occur at least four weeks after a covid infection, according to the Centers for Disease Control and Prevention. Much about the condition is baffling: There is no diagnostic test to confirm it, no standard definition of the ailment and no way to predict who will be affected. Common symptoms, which can last months or years, include fatigue, shortness of breath, an elevated heart rate, muscle and joint pain, sleep disruptions, and problems with attention, concentration, language and memory — a set of difficulties known as brain fog.
Ongoing inflammation or a dysfunctional immune response may be responsible, along with reservoirs of the virus that remain in the body, small blood clots or residual damage to the heart, lungs, vascular system, brain, kidneys or other organs.
Only now is the impact on older adults beginning to be documented. In a study published in the journal BMJ, researchers estimated that 32 percent of older adults in the United States who survived covid infections had symptoms of long covid up to four months after infection — more than double the 14 percent rate an earlier study found in adults ages 18 to 64. (Other studies suggest symptoms can last much longer, for a year or more.)
The BMJ study examined more than 87,000 adults 65 and older who had covid infections in 2020, drawing on claims data from UnitedHealth Group’s Medicare Advantage plans. It included symptoms that lasted 21 days or more after an infection, a shorter period than the CDC uses in its long covid definition. The data encompasses both older adults who were hospitalized because of covid (27 percent) and those who were not (73 percent).
A study released last month from the CDC found that 1 out of every 4 older adults who survived covid experienced at least 1 of 26 common symptoms associated with long covid, compared with 1 out of every 5 people between the ages of 18 and 64.
The higher rate of post-covid symptoms in older adults is probably because of a higher incidence of chronic disease and physical vulnerability in this population — traits that have led to a greater burden of serious illness, hospitalization and death among seniors throughout the pandemic.
“On average, older adults are less resilient. They don’t have the same ability to bounce back from serious illness,” said Ken Cohen, a co-author of the study and executive director of translational research for Optum Care. Optum Care is a network of physician practices owned by UnitedHealth Group.
For older individuals affected by long covid, the consequences can be devastating: the onset of disability, the inability to work, reduced ability to carry out activities of daily life, and a lower quality of life.
But in many seniors, long covid is hard to recognize.
“The challenge is that nonspecific symptoms such as fatigue, weakness, pain, confusion and increased frailty are things we often see in seriously ill older adults. Or people may think, ‘That’s just part of aging,’ ” said Charles Thomas Alexander Semelka, a postdoctoral fellow in geriatric medicine at Wake Forest University.
Ann Morse, 72, of Nashville, was diagnosed with covid in November 2020 and recovered at home after a trip to the emergency room and follow-up home visits from nurses every few days. She soon began having trouble with her memory, attention and speech, as well as sleep problems and severe fatigue. Although she has improved somewhat, several cognitive issues and fatigue still persist.
“What was frustrating was I would tell people my symptoms and they’d say, ‘Oh, we’re like that too,’ as if this was about getting older,” she told me. “And I’m like, but this happened to me suddenly, almost overnight.”
Bell, a singer-songwriter in Nashville, had a hard time getting adequate follow-up attention after spending two weeks in an ICU and an additional five weeks in a nursing home receiving rehabilitation therapy.
“I wasn’t getting answers from my regular doctors…