Older men may be at greater risk of contracting COVID-19 because they worry less about catching or dying from it than women their age or than younger people of both sexes, according to a new study by Sarah Barber, a gerontology and psychology researcher at Georgia State University.
This is a concern because older men are already more at risk of severe or fatal COVID-19 infections. Data from the CDC show the fatality rate of COVID-19 steadily rises with age, and that men are more at risk than women.
To test levels of worry and protective behaviors, Barber teamed with Hyunji Kim, a Georgia State doctoral student in psychology, and administered an online questionnaire assessing COVID-19 perceptions and behavior changes. The results were published by the Journals of Gerontology.
It is well established that worry is a key motivator of behavioral health changes, said Barber, including motivating people to engage in preventive health care activities such as healthy eating, exercise and timely screenings. In general, worry begins to ease with age, and is also lower among men than women.
Not only do older adults exhibit less negative emotions in their daily lives, they also exhibit less worry and fewer PTSD symptoms following natural disasters and terrorist attacks."
Sarah Barber, gerontology and psychology researcher at Georgia State University
She said that this may be because older adults have better coping strategies, perhaps gained through experience, and thus are able to regulate their emotional responses better.
Knowing that older adults tend to worry less, Barber conducted a study to see how this affected responses to the global pandemic.
"In normal circumstances," said Barber, "not worrying as much is a good thing. Everyday life is probably happier if we worry less. However, where COVID-19 is concerned, we expected that lower amounts of worry would translate into fewer protective COVID-19 behavior changes."
COVID-19 was declared a pandemic on March 11, and the questionnaire took place from March 23-31. Widespread behavioral changes were taking place, including the beginning of sheltering at home and social distancing.
All participants lived in the United States, and were primarily Caucasian with at least some college education. Participants were either aged 18-35 or aged 65-81, with 146 younger adults and 156 older adults studied.
The questionnaire assessed the perceived severity of COVID-19, such as whether respondents thought people were over-reacting to the threat of COVID-19 and whether it was similar in risk to flu. It also assessed worries about COVID-19, including how worried participants were about catching the virus themselves, dying as a result of it, a family member catching it, lifestyle disruptions, hospitals being overwhelmed, an economic recession, personal or family income declining and stores running out of food or medicine.
The questionnaire assessed behavioral changes that can reduce infection risk, from washing hands more often, to wearing a mask, avoiding socializing, avoiding public places, observing a complete quarantine or taking more care with a balanced diet and purchasing extra food or medications.
Not surprisingly, said Barber, most participants were at least moderately concerned about COVID-19, and only one individual, an older male, had "absolutely no worry at all." Also as expected, worry translated to protective behavior: more than 80 percent of participants reported washing their hands more frequently, taking more care about cleanliness, no longer shaking hands and avoiding public places. More than 60 percent of participants also reported no longer socializing with others. The participants who were most worried about COVID-19 were also the most likely to have implemented these behavior changes.
The catch was older men: compared to all other participants, older men were less worried about COVID-19, and had adopted the fewest number of behavior changes. They were relatively less likely to have worn a mask, to report having stopped touching their faces or to have purchased extra food.
Barber does not think the answer is to try to incite worry in older men. She thinks a better answer is to help them understand their risk accurately.
"Our study showed that for older men, accurate perception of risk worked as well as worry to predict preventive behaviors," she said.
If older men can be better educated about the virus, they may adopt protective behaviors even if they don't feel worried. She also notes that the survey took place "right after the pandemic was declared, and we all hope that a more accurate perception of risk has evolved over the last two months."
Either way, said Barber, older men may need a little extra coaching and attention to risk assessment and protective behaviors, both from concerned family members as well as their healthcare practitioners.
Barber, S.J & Kim, H (2020) COVID-19 Worries and Behavior Changes in Older and Younger Men and Women. The Journals of Gerontology: Series B. doi.org/10.1093/geronb/gbaa068.