Older Europeans’ health perception and their adaptive behavior during the COVID-19 pandemic

Background: Although older adults are more vulnerable to the COVID-19 virus, a significant proportion of them do not follow recommended guidelines concerning preventive actions during the ongoing pandemic. This paper analyses the role of biased health beliefs for adaptive health behaviour such as reduced mobility, protection in public spaces, and hygiene measures, for the population aged 50 and older in 13 European countries. Methods: Health perception is measured based on the difference between self-reported health and physical performance tests for over 24,000 individuals included in the most recent Survey of Health, Ageing and Retirement in Europe. Logistic regressions are employed to explore how over- and underestimating health are related to preventive behaviours. Results: Results suggest that older adults who underestimate their health are more likely to show adaptive behaviour related to mobility reductions. In particular, they are more likely to stay at home, shop less, and go for walks less often. By contrast, overestimating health is not significantly associated with reduced mobility. Protective behaviour in public spaces and adopting hygiene measures do not vary systematically between health perception groups. Conclusion: As health beliefs appear relevant for the adoption of preventive health behaviours related to mobility, they have serious consequences for the health and well-being of older Europeans. While adaptive behaviour helps to contain the virus, exaggerated mobility reduction in those who underestimate their health might be contributing to the already high social isolation and loneliness of older adults during the ongoing pandemic