Impact of COVID-19 Pandemic on Health Services Provided to Elderly Population in Saudi Arabia
Authors: AlHefdhi Hayfa , Alkahtani Faten , Shamakhi Fatemah , Alrazhi Fayzah , Alqahtani Anhar , Alsharaif Abeer , Habtar Sara 
Published: July 2021

Background:
Pandemics are not becoming infrequent events anymore. It is estimated that over 12,000 outbreaks have occurred since the year 1980, thanks to ease of travel and change in land use (Smith et al., 2014; Joes et al., 2008). The current coronavirus disease of 2019 (COVID-19) pandemic have exposed the lack of preparedness in well-connected, economically stable, developed countries. All aspects of life have changed dramatically. COVID-19 infection affects older adults with higher morbidity and mortality and those with chronic underlying medical disorders [Zhang et al., 2020]. There is an indirect effect of COVID-19 pandemic on elderly, related to quarantine and social isolation. Prolonged social isolation leads to several neurological, psychological, and medical morbidities in the elderly [Plagg et al., 2020]. On the other hand, hospital-based and community-based medical care for acute and chronic diseases was disrupted substantially during the pandemic, adding to the suffering endured by older adults. Such impact received little focus in contemporary research, especially in Saudi Arabia.

Objectives:
The main aim of our current investigation is to evaluate the impact of quarantine and medical care disruption on geriatric health during the COVID-19 pandemic in Saudi Arabia.

Materials and Methods:
We surveyed the elderly population in Saudi Arabia using a pre-designed electronic online questionnaire in Arabic language. The items were developed by collaborating with practicing family physicians, geriatricians affiliated to King Khalid University, and with service users. The link to the questionnaire was released unto social media and the elderly -and their carers- were encouraged to participate in the study. We collected sociodemographic as well as clinical data. A pilot study was conducted for a period of two months before the final version of the research tool was released. We utilized χ2 tests to evaluate the effect of categorical demographic and clinical variables. Statistical tests were 2-tailed. Significance level was set at probability (type 1 error) = 0.05. The statistical software used was SPSS, Version V27 for Windows. The study received approval from the Ethics committee in King Khalid University.

Results:
A total of (n = 297) Saudi elderly persons were included in the survey, of whom (n = 35, 11.8%) were men and (n = 262, 88.2%) were women. (n = 190, 64.0%) were between 65 and 74 years of age and (n = 107, 36.0%) were 75 or older. The most frequently encountered health problem was Diabetes Mellitus in (n = 126, 42.4%) followed by hypertension in (n = 117, 39.4%). (n = 117, 39.4%) reported having their urgent care needs delayed because of fear of COVID-19 infection. (n = 164, 55.2%) reported that the pandemic posed a negative effect on their mood, and further (n = 108, 36.4%) had their physical activities negatively affected. Treatment plan was impaired in (40, 13.5%) of the participants. In independent subjects (n = 24, 32.9%) were not enjoying daily activities post-pandemic, compared to (n = 63, 34.1%) who were partially dependent and (n = 7, 17.9%) who were totally dependent on others (P = 0.037).

Conclusion:
We surveyed a sample of elderly people in Saudi Arabia to explore their experience of interruption in healthcare services. We found 21% did not receive their medications and 39.4% had their urgent needs delayed. Physical activities, mood and enjoyment sense were all impaired. We should take into account the disruption in health services provision caused by the current COVID-19 pandemic when planning for post-pandemic geriatric healthcare.