Dear Editor

Pandemics can have significant psychological effects such as anxiety, insomnia and depression (1). The novel coronavirus (COVID-19) and factors such as the lack of accurate information about the virus, the risk of virus transmission to individuals and family members, and the lack of a definitive drug to treat it, increase the psychological effects of the elderly (2). COVID-19 pandemic is known as an adult problem and therefore encourages older people to separate from younger people, thus creating an age difference in understanding the consequences of COVID-19 (1).

A recent study reported that at lateadulthood social isolation has a more considerable risk of anxiety and depression (3). Also due to ongoing quarantines cannot reach their outpatient clinics in order to obtain their monthly prescriptions, these results in perception of lack of treatment and exacerbation of pre-existing psychiatric symptoms (4). Increased suicidal ideations and attempts consequent to stress, on the background of the already existing suicidality risk in the elderly, is an added concern (5).

Elderly individuals may be more exposed to these complications because they are vulnerable and sensitive (1). There are several reasons why the elderly constitutes an especially vulnerable people in disaster, for example: advanced age itself is a pre-disposing factor to physical and mental health issues. Older people generally have only a close circle of friends and family with whom they routinely interact. There is the problem of access to medicines and health facilities, as the elderly may have physical problems that make this difficult. The flow of information about epidemics may be a source of anxiety and stress in the elderly (2). Also the elderly who are not good financial situation have more mental health problems (6).

According to the stated cases to improve the mental health conditions of the elderly, the tips should be considered. Including:

• Interventions, such as using online mental health services and online social support (7).
• Telephonic contacts with friends, family, health caregivers, and voluntary organizations while isolation period during the COVID-19 pandemic, can give the elderly hope (7).
  • Using telemedicine services which can
    help to take care of the elderly during their seclusion (7).
  • Access to general and psychiatric medical care, healthy contact with family, access to relevant and updated information, and respecting their personal space are important components of mental health care in the elderly (8).
  • It is helpful to change the lifestyle of the elderly and perform daily activities. Activities such as music, painting, and literature enrich their daily lives (9).
  • Exercise can be helpful for controlling major depressive disorder (MDD) and other psychiatric disorders and chronic diseases. Many physiological mechanisms involved in the endocrine axis and immune function can be improved with regular exercise, reducing both the severity of mental disorders and the possible severity of COVID-19 infection (9).
  • Other family members should take some time to talk to older members of the family and get involved in some of their daily routines (10).
  • Stores offer special hours for the elderly, such as the early hours of the day.
  • Government and non-governmental organizations should cooperate in delivering the equipment and medicines needed by the elderly.
  • Giving financial aid will help to create peace of mind and a sense of financial security in the elderly (2).
  • Allocating a hot-line for the elderly to call if necessary.
  • Giving the right information through the media can be helpful in reducing their
    anxiety (11).
  • Health policy makers have an important role to play in overcoming these barriers, and their cooperation will provide high-quality and timely psychological services to the elderly (4).

  In short, the health of the elderly needs more attention, especially when public health emergencies occur. In such cases, the society
  and professionals must take the necessary interventions to reduce the psychological impact in the elderly (12).

  Funding source

  None.

  Conflict of interest

  The authors declare no conflict of interest.

  Authors' contribution

  All authors contributed to this project and article equally. All authors read and approved the final manuscript.