**5. The effects on psychological health of elderly individuals**

The elderly individuals, particularly those older than 80 years, are at higher risk of suffering from adverse effects which can lead to a mortality rate five times the global average [105]. More than 95% of deaths due to COVID-19 in Europe and about 80% in China involve people over 60 years of age [106, 107]. Although the effects of COVID-19 on all age groups are prominent, most of the confirmed cases and deaths in particular have occurred among the elderly [108]. According to a report published by the US Centers for Disease Control and Prevention (CDC) in March 2020, more than 80% of deaths are seen in patients older than 65 years, indicating that the elderly are more vulnerable to the virus [109, 110]. In addition, China has reported that the increase in serious infection and death rate from COVID-19 depend on age. Specifically, the incidence of severe infection was found to be 19.8%, 43.2% and 81.3% in 50–64 years, 65–79 years, and 80 years and older age groups, respectively, indicating a relationship between the incidence of severe infection and age. In addition, the mortality rate for these age groups rose 1.2%, 4.5% and 18.8%, respectively [111]. The mean age of death in Korea was found to be 75.7, and reports have shown that the death rate from COVID-19 increases with age [108]. The elderly are vulnerable to serious infections and death due to weakened immune function and comorbidities caused by aging [112, 113]. In a study, 50–75% of Korean patients had underlying comorbid medical conditions such as high blood pressure, diabetes, cardiovascular disease, chronic obstructive pulmonary disease, and cancer, so they were classified as vulnerable to COVID-19 and at a high-risk group [114, 115]. Health care, emergency response and quarantine measures for the elderly become mandatory since the elderly, especially those with comorbidities, are vulnerable to epidemics. The psychological and mental health problems caused by COVID-19 among the elderly should be discussed in a broader perspective and investigated thoroughly. In particular, the individuals over the age of 60 require more effort and attention and are classified as high-risk group [116] since they are physically and mentally more susceptible than other age groups. In a recent study of the general population in China, it was found that 53.8% of the participants were moderately or severely affected psychologically and it was reported that the most common problems were severe depression (16.5%), anxiety (28.8%), and stress (8.1%) [117]. Studies have highlighted that 37.1% of the elderly have experienced depression and anxiety during the pandemic [42] and that the emotional response of individuals over 60 years is more prominent compared to other age groups [118].

Recently, besides indicators of a prolongation of the pandemic, strict measures implemented around the world such as avoidance of social activities, social distancing and isolation to prevent the spread of COVID-19 have further raised mental health concerns among the elderly. These social measures will contribute immeasurably to combat against the spread of disease. However, the mental health of the elderly requires more attention and care as they constitute the demographic group that experiences social isolation for the longest period [119]. In addition, as shown by previous studies on the elderly, social isolation measures which increase the risk of cardiovascular, autoimmune, neurological and mental health problems, and the impact of COVID-19 on elderly mental health problems need to be discussed and addressed as a public health crisis.

#### **6. Conclusion**

The new type coronavirus disease (COVID-19) has become a pandemic affecting health and well-being at global scale. In addition to its effects on physical health and socioeconomic structures, its psychological effects are increasingly being reported in the literature. The current literature suggests that those affected by COVID-19 may have a high burden of mental health problems such as depression, anxiety disorders,

#### *Perspective Chapter: Psychological Effects of COVID-19 Pandemic DOI: http://dx.doi.org/10.5772/intechopen.101498*

stress, panic attacks, irrational anger, impulsivity, somatization, sleep disorders, emotional disturbance, post-traumatic stress, suicidal tendencies. Moreover; age, gender, marital status, educational level, occupation, income, place of residence, close contact with people diagnosed with COVID-19, accompanying physical and mental health problems, exposure to news and social media about COVID-19, coping styles, stigma, psychosocial support, health communication, safe healthcare, personal protective measures, risk of contracting COVID-19, and perceived probability of survival have been identified in the literature as the factors associated with mental health problems in COVID-19. Present evidence pinpoint that a psychiatric outbreak has emerged with the COVID-19 pandemic, which will warrant the attention of the global health community. Therefore, COVID-19 should be recognized as a global public health emergency with enormous mental health implications. Future epidemiological studies should focus on the psychopathological variations and temporariness of mental health problems in different populations. However, multifaceted interventions need to be developed and adopted to address current psychosocial challenges to support mental health during the COVID-19 pandemic [120].
