Invited Perspective| Volume 29, ISSUE 10, P995-999, October 2021

Download started.


Ageism and the State of Older People With Mental Conditions During the Pandemic and Beyond: Manifestations, Etiology, Consequences, and Future Directions


      • What is the primary question addressed by this study?—The aim of this paper is to articulate the International Psychogeriatric Association (IPA) and the World Psychiatric Association Section of Old Age Psychiatry (WPA-SOAP) response to the call of The Independent Expert on the enjoyment of all human rights by older persons for thematic contributions in the field of ageism and discrimination.
      • What is the main finding of this study?—Ageism has been manifested in the discourse around older people as vulnerable, worthless or a burden to society as well as in measures aimed to protect older people, yet, restricting their rights and depriving them of their freedom. Older people with mental health conditions and long-term care residents have been particularly affected by ageism and discrimination during the pandemic.
      • What is the meaning of the finding?—A UN Convention for the rights of older people is required to inform and guide governments concerning the rights of older people as well as the inappropriate use of chronological age in the allocation of goods and services.


      The pandemic has put the spotlight on older people and on the topic of ageism. In early 2021, a call was made for input into the Thematic Report on Ageism and Discrimination to inform the United Nations Independent Expert on the Rights of Older Persons' forthcoming report to the 48th session of the Human Rights Council. The aim of this paper is to articulate the International Psychogeriatric Association (IPA) and the World Psychiatric Association Section of Old Age Psychiatry (WPA-SOAP) response to this call. This brief statement on ageism with a special focus on older people with mental health conditions is divided into three sections. We start by outlining the various manifestations of ageism in varied contexts and countries with a primary focus on the pandemic. Possible consequences of ageism with a focus on older people's mental health and well-being are outlined. We conclude by discussing ways to overcome ageism and reduce its occurrence, especially during times of extreme conditions.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to The American Journal of Geriatric Psychiatry
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Butler RN
        Age-Ism: another form of bigotry.
        Gerontologist. 1969; 9: 243-246
        • United Nations
        Political Declaration and Madrid Plan of Action on Aging.
        United Nations, New York2002 (Accessed on May, 22, 2021. Available at:)
      1. United Nations General Assembly: Report of the independent expert on the enjoyment of all human rights by older persons 2016. Accessed on May, 22, 2021. Available at:,Report%20of%20the%20Independent%20Expert%20on%20the%20enjoyment,human%20rights%20by%20older%20persons&text=It%20recognizes%20the%20challenges%20that,action%20to%20address%20protection%20gaps.

        • Officer A
        • de la Fuente-Núñez V
        A global campaign to combat ageism.
        Bull World Health Organ. 2018; 96: 295-296
        • Ayalon L
        • Tesch-Römer C
        Contemporary Perspectives on Ageism.
        Springer Nature, 2018
        • Bytheway B
        Ageism and age categorization.
        J Soc Issues. 2005; 61: 361-374
        • Peisah C
        • Brodaty H
        • O'Neill N
        The mental health and rights of mentally ill older people.
        Mental Health and Human Rights. Oxford University Press, 2012: 483-495
      2. United nations: principles for the protection of persons with mental illness and for the improvement of mental health care. Adopted by the United Nations General Assembly resolution 46/119 of December 1991., 1991. Accessed on May, 22, 2021: Available at:

        • Matthews FE
        • Dening T
        Prevalence of dementia in institutional care.
        Lancet. 2002; 360: 225-226
        • Nihtilä EK
        • Martikainen PT
        • Koskinen SVP
        • et al.
        Chronic conditions and the risk of long-term institutionalization among older people.
        Eur J Public Health. 2007; 18: 77-84
      3. United Nations General Assembly: Impact of the coronavirus disease (COVID-19) on the enjoyment of all human rights by older persons., 2020

        • Cohn-Schwartz E
        • Ayalon L
        Societal views of older adults as vulnerable and a burden to society during the COVID-19 outbreak: results from an Israeli nationally representative Sample.
        J Gerontol B Psychol Sci Soc Sci. 2020;
        • Kessler E-M
        • Bowen CE
        COVID ageism as a public mental health concern.
        Lancet Healthy Longev. 2020; 1: e12
        • Jimenez-Sotomayor MR
        • Gomez-Moreno C
        • Soto-Perez-de-Celis E
        Coronavirus, ageism, and Twitter: an evaluation of tweets about older adults and COVID-19.
        J Am Geriatr Soc. 2020; 68: 1661-1665
        • Xiang X
        • Lu X
        • Halavanau A
        • et al.
        Modern Senicide in the face of a pandemic: an examination of public discourse and sentiment about older adults and COVID-19 using machine learning.
        J Gerontol B Psychol Sci Soc Sci. 2021; 76: e190-e200
        • Lichtenstein B
        From “Coffin Dodger” to “Boomer Remover:” outbreaks of ageism in three countries with divergent approaches to coronavirus control.
        T J Gerontol B Psychol Sci Soc Sci. 2021; 76: e206-e212
        • Allen LD
        • Ayalon L
        It's pure panic”: the portrayal of residential care in American newspapers during COVID-19.
        Gerontologist. 2021; 61: 86-97
        • Ayalon L
        • Chasteen A
        • Diehl M
        • et al.
        Aging in times of the COVID-19 pandemic: avoiding ageism and fostering intergenerational solidarity.
        Gerontol B Psychol Sci Soc Sci. 2021; 76: e49-e52
        • Ayalon L
        There is nothing new under the sun: ageism and intergenerational tension in the age of the COVID-19 outbreak.
        Int Psychoger. 2020; 32: 1221-1224
        • Deusdad B
        COVID-19 and care homes and nursing homes crisis in Spain: ageism and scarcity of resources.
        Res Ageing Soc Policy. 2020; 8: 142-168
        • Gastmans C
        • Milisen K
        Use of physical restraint in nursing homes: clinical-ethical considerations.
        J Med Ethics. 2006; 32: 148-152
        • Ayalon L
        • Zisberg A
        • Cohn-Schwartz E
        • et al.
        Long-term care settings in the times of COVID-19: challenges and future directions.
        Int Psychoger. 2020; 32: 1239-1243
      4. Low L-F, Hinsliff-Smith K, Sinha S, et al: Safe Visiting at Care Homes During COVID-19: A Review of International Guidelines and Emerging Practices During the COVID-19 Pandemic. International Long Term Care Policy Network. Accessed on May, 22, 2021: Available at:

        • Verbeek H
        • Gerritsen DL
        • Backhaus R
        • et al.
        Allowing visitors back in the nursing home during the COVID-19 crisis: a Dutch national study into first experiences and impact on well-being.
        JAMDA. 2020; 21: 900-904
        • Lloyd-Sherlock P
        • Sempe L
        • McKee M
        • et al.
        Problems of data availability and quality for covid-19 and older people in low-and middle-income countries.
        Gerontologist. 2021; 61: 141-144
        • Helfand BKI
        • Webb M
        • Gartaganis SL
        • et al.
        The exclusion of older persons from vaccine and treatment trials for coronavirus disease 2019—missing the target.
        JAMA Intern Med. 2020; 180: 1546-1549
        • van Gerwen M
        • Alsen M
        • Little C
        • et al.
        Risk factors and outcomes of COVID-19 in New York City; a retrospective cohort study.
        J Med Virol. 2021; 93: 907-915
        • Razai MS
        • Kankam HK
        • Majeed A
        • et al.
        Mitigating ethnic disparities in covid-19 and beyond.
        BMJ. 2021; 372
        • Bargain O
        • Aminjonov U
        Trust and compliance to public health policies in times of COVID-19.
        J Public Econ. 2020; 192104316
        • Apriceno M
        • Lytle A
        • Monahan C
        • et al.
        Prioritizing health care and employment resources during COVID-19: roles of benevolent and hostile ageism.
        Gerontologist. 2021; 61: 98-102
        • Bubar KM
        • Reinholt K
        • Kissler SM
        • et al.
        Model-informed COVID-19 vaccine prioritization strategies by age and serostatus. medRxiv [Preprint].
        Science. 2021; 71 (PMID: 33330882; PMCID: PMC7743091): 916-921
        • Levy B
        Stereotype embodiment: a psychosocial approach to aging.
        Curr Dir Psychol Sci. 2009; 18: 332-336
        • Levy BR
        • Slade MD
        • Kunkel SR
        • et al.
        Longevity increased by positive self-perceptions of aging.
        J Pers Soc Psychol. 2002; 83: 261
        • Ayalon L
        Satisfaction with aging results in reduced risk for falling.
        Int Psychogeriatr. 2016; 28: 741
        • Ettman CK
        • Abdalla SM
        • Cohen GH
        • et al.
        Prevalence of depression symptoms in US adults before and during the COVID-19 pandemic.
        JAMA Network Open. 2020; 3e2019686
        • Tang F
        • Liang J
        • Zhang H
        • et al.
        COVID-19 related depression and anxiety among quarantined respondents.
        Psychol Health. 2020; (Epub 2020 Jun 22. PMID: 32567952): 164-178
        • Ayalon L
        • Avidor S
        “We have become prisoners of our own age”: from a continuing care retirement community to a total institution in the midst of the COVID-19 outbreak.
        Age Ageing. 2021;
        • Hwang T-J
        • Rabheru K
        • Peisah C
        • et al.
        Loneliness and social isolation during the COVID-19 pandemic.
        Int Psychogeriatr. 2020; 32: 1217-1220
        • Makaroun LK
        • Bachrach RL
        • Rosland A-M
        Elder abuse in the time of COVID-19-increased risks for older adults and their caregivers.
        Am J Geriatr Psychiatry. 2020; 28: 876-880
        • Makaroun LK
        • Beach S
        • Rosen T
        • et al.
        Changes in elder abuse risk factors reported by caregivers of older adults during the COVID-19 pandemic.
        J Am Geriatr Soc. 2020; 69 (Epub 2021 Jan 5. PMID: 33349915): 602-603
        • Hamers JP
        • Bleijlevens MH
        • Gulpers MJ
        • et al.
        Behind closed doors: involuntary treatment in care of persons with cognitive impairment at home in the Netherlands.
        J Am Geriatr Soc. 2016; 64: 354-358
        • Wilson K
        The COVID-19 pandemic and the human rights of persons with mental and cognitive impairments subject to coercive powers in Australia.
        Int J Law Psychiatry. 2020; 73101605
        • Chang E-S
        • Kannoth S
        • Levy S
        • et al.
        Global reach of ageism on older persons’ health: a systematic review.
        PLoS One. 2020; 15e0220857
        • Levy BR
        • Slade MD
        • Chang E-S
        • et al.
        Ageism amplifies cost and prevalence of health conditions.
        Gerontologist. 2020; 60: 174-181
        • Burnes D
        • Sheppard C
        • Jr CRH
        • et al.
        Interventions to reduce ageism against older adults: a systematic review and meta-analysis.
        Am J Public Health. 2019; 109: e1-e9