Life before COVID: Health and habits of Ireland’s older people before crisis hit

Posted on: 17 December 2020

Researchers at the Irish Longitudinal Study on Ageing (TILDA) at Trinity College have released a comprehensive report detailing the health, social and economic circumstances of older adults in Ireland on the eve of the COVID-19 pandemic.

TILDA’s report, based on its fifth wave of data collection completed in 2018, provides a clear and informative picture of the social, financial, mental and physical state of Ireland’s ageing population before the pandemic dramatically impacted their lives. The report will serve as a useful resource for policymakers and planners tasked with identifying gaps and solutions to improve supports for older people following the unfolding of the crisis.

COVID-19 and its impact on older adults

From early 2020, the world grappled with the spread of COVID-19 and the subsequent pressures placed on health, social and economic systems worldwide. As a consequence, TILDA rapidly repurposed analyses of Wave 5 data to help inform planning and delivery of healthcare and public understanding of the health risk factors and implications of COVID-19 infection for older adults in Ireland. TILDA’s report helps to set the scene, providing strong evidence of the real experiences of adults and their families prior to the outbreak of COVID-19.

What key issues are explored in the report?

The chapters in the report cover key issues such as risk factors for COVID-19 infection, including frailty, multimorbidity (co-occurring diseases) and medication usage; the utilisation of healthcare and home care and the types of health coverage; the contributions of older people to Ireland’s society and economy; access to and use of the internet among the older population; and data on TILDA participants in nursing homes.

Frailty, chronic conditions and multimorbidity were identified early in the pandemic as major risks factors for severity of COVID-19 infection, with TILDA’s data enabling researchers to rapidly identify their prevalence in the older Irish population. Understanding the prevalence of chronic conditions (such as diabetes, hypertension or asthma), lifestyle factors that influence health across age groups and medication use is crucial for planning and delivery of healthcare during critical periods like a pandemic. Access to information is also critical for projection of future healthcare to prepare for an ageing population, and to put together with lessons from the current pandemic, to help shape and inform strategy for response to future shocks.

Key insight from the report highlights: 

  • Multimorbidity: Almost three-quarters (74%) of adults aged 58 years and older report the presence of two or more medical conditions; with 8% reporting no chronic conditions. Multimorbidity becomes increasingly prevalent as older adults age. Less than 10% of adults aged 58 years and older report no conditions, with almost 75% reporting the presence of two or more conditions.
  • Frailty: Almost one in six adults aged 58 years and older are frail, though researchers outline that frailty is not inevitable, and can even be avoided, delayed or reversed with appropriate and timely interventions.
  • Medications: Almost half of adults aged 75 years and older report regular use of five or more medications, which increases with age.
  • Healthcare: 28% of older adults have both a medical card and private health insurance; 36% have a medical card only, 27% have private health insurance only, 2% have a GP visit card only, and 8% had ‘no cover’.
  • Internet Access and Use: 80% of adults aged 58 years and older have access to the internet in their homes, with research showing internet access decreases with age.
  • 66% of adults aged 58 years and older have access to a smartphone/tablet (and so to apps). Of adults aged 58 years and older living alone, 36% do not have internet access in their homes. Those without access to internet and phones may face a higher risk of isolation due to a lack of information at their fingertips and connectivity online.
  • Contributions: Overall, 41% of adults aged 58 years and older provide regular help and/or care for spouses, relatives,(excluding grandchildren) neighbours and friends.


Dr Christine McGarrigle, co-author on the report, said:

The findings in this report provide a robust resource from which to draw to help advance future health policy in Ireland. This report addresses the influence of lifestyle and behavioural habits, such as smoking and physical exercise, which can significantly impact health outcomes in later life. It also highlights the positive impact that higher levels of exercise can have on multimorbidity and medication use, indicating that modifiable behaviours play a substantial role in healthy ageing. This report provides strong evidence to support public health initiatives that promote the adoption of positive lifestyle changes for a healthy ageing population. It also shows that older adults in Ireland can and do age well, and remain positively engaged with their communities and with society, continue to make valuable contributions to both their families and society, and that they are on the whole engaged with a range of services and activities online.

Professor Rose Anne Kenny, Principal Investigator of TILDA, said:

TILDA’s report offers a unique snapshot into the lives of Ireland’s older adults before the pandemic unfolded. This report provides an important baseline to help identify and assess the longer-term effects of the pandemic on their health and circumstances. Researchers can identify negative impacts on health and wellbeing, some positive outcomes of the crisis, such as greater resilience or improvements in digital literacy, new skills in technology or participation in new activities. This report will provide a strong baseline to contrast with TILDA’s wave six data collection in the future and can serve as a solid source to indicate how health, social and environmental transformations have affected adults aged fifty and over in Ireland.

Mary Butler TD, Minister of State at the Department of Health with responsibility for Mental Health and Older People, said:

TILDA continues to provide an invaluable contribution in building up a longitudinal profile of the health, economic and social circumstances of older Irish people, which is vital in assisting policy makers and programme planners. The Wave 5 report and data give a comprehensive picture of the older population in Ireland shortly before the arrival of the COVID-19 pandemic and will serve as an important benchmark for our resilience and recovery as a society.

To read the full report, The Older Population of Ireland on the Eve of the COVID-19 Pandemic, please visit

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