COVID-19 has proven to be a dangerous and socially disruptive disease [1,2,3]. It is also fast evolving, producing or perpetuating a cascade of crises, ranging from the rising global mental health epidemic to surging infections amongst refugees from the conflict in Ukraine [4,5,6,7,8,9]. As of December 9, 2022, official records show that the pandemic is responsible for around 650 million infections and 7 million deaths across the world [10]. Though already sobering, these numbers are widely deemed as merely a portion of the true toll of the pandemic [1,2,3]. While no one is immune to COVID-19, older persons—individuals aged 65 and over—often bear the brunt of its consequences. In an analysis conducted by the World Health Organization, for instance, researchers estimated that approximately 82% of worldwide pandemic-related excess deaths occurred amongst older persons [11]. In addition to being susceptible to COVID-19 infections, hospitalizations, and deaths, growing evidence shows that older age and female gender are two risk factors for prolonged post-COVID syndromes [12,13,14], such as fatigue and cognitive impairment. As ageing increases susceptibility to infections in older persons, while also reducing their regenerative capacity, developments are sorely needed to treat the underlying pathologies of ageing [15,16,17]. Uniquely for women, the complex interplay between social and biological factors is also likely to play a role in their susceptibility to COVID-19, as well as the scale, scope, and severity of the health challenges they face.
Firstly, compared to their male counterparts, older women are often more likely to suffer from certain types of poor health. Research shows, for instance, that the prevalence of frailty and prefrailty amongst older women (44.8 frailty and 173.2 prefrailty cases per 1000 individuals) is significantly more severe compared to men (24.3 frailty and 129.0 prefrailty cases per 1000 individuals) [18]. Compared to older men, older women are also more likely to shoulder mental health stressors or disorders [19]. In a longitudinal study conducted in the Netherlands, researchers found that older women are 30% more likely to face depressive symptoms when compared to older men [20]. Further complicating the situation, a growing body of evidence shows that the pandemic has increased older women’s rates of mental health stress [21,22,23]. Secondly, older women face distinct health challenges arising from gender-based neglect and violence. It is estimated that approximately one in every six older women experiences abuse and/or neglect across the globe [24]. In an analysis of 3354 community-dwelling older women in the United States (US), for example, researchers found that 14% of the participants were physically and/or sexually abused [25]. Thirdly, older women are more likely to face systemic health disparities than older men. Due to the diseases or disabilities they face, a number of older women may struggle to address their health needs and daily activities [26,27,28,29].
Poor access to care, and more complex care needs resulting from longer life expectancy, may partially explain why older women often resort to institutional care in later life, as opposed to remaining in the community and ageing in familiar environments like home. In the US, for instance, pre-pandemic analysis shows that women constitute around 70.2% of the long-term residential care population [30]. Due to the shifting impacts of the pandemic, there are limited up-to-date data on how many older women are living in nursing homes. What is clear, though, is that the care and services provided by these facilities are often suboptimal. Across the pandemic, recurring investigations show that many older persons, especially those who have cognitive or physical impairments, are often being “abandoned to die” in nursing homes [31,32,33]. These factors combined, overall, reveal the degree of health disparities older persons face amid COVID-19, particularly amongst women. Despite their pronounced need for timely and effective interventions, there is a shortage of research on health solutions that are tailored to this population, especially agile and versatile ones, such as technology-based interventions, that could circumvent the unintended consequences posed by pandemic-related lockdowns or other physical distancing measures.
Technology-based interventions are defined as the adoption and application of technological tools or techniques in the design, development, and delivery of health solutions to the intended users [34], such as technology-based health interventions using readily available devices (e.g. smartphones, mobile sensors, or gaming consoles) to manage, support, or deliver accessible and affordable health solutions to persons in need of healthcare services [34]. Public health policies, such as lockdowns and social distancing, are being used to disrupt physical contact and limit interactions, with the aim of reducing virus transmission. However, because human interaction is a significant social lifeline for individuals, particularly older persons with limited mobility, the need for technology-based interventions is more pronounced. Although technology-based interventions have great potential to address health challenges older women face amid pandemics, such as COVID-19, overall, there is a shortage of evidence in the literature. Therefore, to bridge the research gap, this investigation examines the characteristics and effectiveness of technology-based interventions to address health challenges older women face amid social isolation and COVID-19.
