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Background: The COVID‐19 pandemic and associated social distancing measures have profoundly impacted society and social contact patterns, with older people disproportionately affected. Concerns have been raised about a resulting pandemic of loneliness in older people, although the current evidence is mixed. This study provides a unique perspective on the prevalence of loneliness in a population cohort of older people before the pandemic, followed up after the introduction of social restrictions. Methods: Data analysis was conducted using Wave 3 of the longitudinal Cognitive Function and Aging Study II (2018–2019) and a sub‐study focusing on experiences during the COVID‐19 pandemic (2020). The sample comprised 379 adults aged over 75 living in Cambridge, Newcastle, and Nottingham. Multivariable binary logistic regression was conducted to identify correlates of prevalent loneliness, adjusted for confounding covariates, during the pandemic. The prevalence of loneliness during the pandemic was compared to loneliness in 2018–2019. Results: Prevalence of loneliness in this sample during the pandemic was 25.1% (95% CI 20.9%–29.7%) compared to 17.2% (95% CI 13.7%–21.3%) in 2018–2019 (χ2 = 14.1, p < 0.01). Variables associated with increased odds of prevalent loneliness included: prior loneliness, living alone, female gender, living in an area of higher deprivation, frequent pre‐pandemic social contact at community groups, and separation from family during the pandemic, adjusted for age and sex. Weekly technology‐mediated contact using telephone or video calls was associated with lower odds of loneliness. Conclusions: COVID‐19 recovery plans should address loneliness in older people. Target groups should include those who have previously been lonely, people who live alone, those living in deprived areas, and those who had previously been socially active through community groups. [ABSTRACT FROM AUTHOR]

Objectives To estimate outcomes according to attained blood pressure ( BP) in the oldest adults treated for hypertension in routine family practice. Design Cohort analysis of primary care inpatient and death certificate data for individuals with hypertension. Setting Primary care practices in England (Clinical Practice Research Datalink). Participants Individuals aged 80 and older taking antihypertensive medication and free of dementia, cancer, coronary heart disease, stroke, heart failure, and end-stage renal failure at baseline. Measurements Outcomes were mortality, cardiovascular events, and fragility fractures. Systolic BP ( SBP) was grouped in 10-mmHg increments from less than 125 to 185 mmHg or more (reference 145-154 mmHg). Results Myocardial infarction hazards increased linearly with increasing SBP, and stroke hazards increased for SBP of 145 mmHg or greater, although lowest mortality was in individuals with SBP of 135 to 154 mmHg. Mortality of the 13.1% of patients with SBP less than 135 mmHg was higher than that of the reference group (Cox hazard ratio=1.25, 95% confidence interval=1.19-1.31; equating to one extra death per 12.6 participants). This difference in mortality was consistent over short- and long-term follow-up; adjusting for diastolic BP did not change the risk. Incident heart failure rates were higher in those with SBP less than 125 mmHg than in the reference group. Conclusion In routine primary care, SBP less than 135 mmHg was associated with greater mortality in the oldest adults with hypertension and free of selected potentially confounding comorbidities. Although important confounders were accounted for, observational studies cannot exclude residual confounding. More work is needed to establish whether unplanned SBPs less than 135 mmHg in older adults with hypertension may be a useful clinical sign of poor prognosis, perhaps requiring clinical review of overall care. [ABSTRACT FROM AUTHOR]