en COVID 19 Original Research Original Research <strong>Background: </strong>Older adults are at higher risk for severe illness and death associated with coronavirus disease 2019 (COVID-19). As Iran was affected by COVID-19 pandemic, the elderly population soon were told to self-isolate for a very long time. We aimed to identify the coverage, efficacy, and integrity of self-isolation and its predictors in the Iranian older adults (&ge;60 years) from February 19 to 19 March 2020.<br> &nbsp;&nbsp; <strong>Methods:</strong> Quota sampling was performed to recruit respondents from 16 cities that were selected based on their population size (4, 7, and 5 cities for localities with &le;500 000, 500 000-1 000 000, and &ge;1 000 000 populations) and geographical direction (West = 4 cities; North, East, South, Center = 3 each). At least 30 respondents per locality were selected. Phone interviews of 558 respondents (out of 560; response rate = 99.6%) were performed by local trained interviewers using a validated interview form. Association between age, sex, and living condition (with family vs alone) was assessed with Pearson Chi Square and logistic regression analyses.&nbsp;&nbsp;<br> &nbsp;&nbsp; <strong>Results:</strong> Complete self-isolation was reported by 61% of the respondents. In 72%, self-isolation led to 80%-100% contact reduction. Self-isolation was broken by 26% of the respondents. Females had better self-isolation behaviors (OR adjusted: 2.3, 95% CI: 1.5, 3.3) and higher contact reduction rates (p: 0.067). They kept the integrity of self-isolation better (OR adjusted: 1.8; 95% CI: 1.2, 2.7). Those aged older than 80 years were 2.3-folds more likely to completely self-isolate than younger elderly (95% CI adjusted: 1.2, 4.3). Living alone did not significantly predict self-isolation features in the elderly.<br> &nbsp;&nbsp; <strong>Conclusion:</strong> About one third of the interviewed Iranian older adults did not adhere to important self-isolation measures, with males and younger ages showing lower adherence. With the relaxation of social distancing measures, protection measures of the elderly should be strengthened. Given that prolonged self-isolation adversely affects physical and mental health status of the elderly, it is highly recommended to think of creative and gender-specific methods that best tailor the needs of this population in Iran. Aged, COVID-19, Quarantine, Isolation, Iran 1044 1049 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-5493-2&slc_lang=en&sid=1 Mohsen Shati shati.m@iums.ac.ir2180 200319475328460063649 200319475328460063649 No Mental Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran Ali Alami alami.ali@gmu.ac.ir 200319475328460063650 200319475328460063650 No Department of Epidemiology and Biostatistics, School of Public Health, Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Iran Seyede Salehe Mortazavi mortazavi.ss@iums.ac.ir 200319475328460063651 200319475328460063651 Yes School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry) & Spiritual Health Research Center, Iran University of Medical Sciences, Tehran, Iran Sana Eybpoosh sana.eybpoosh@gmail.com 200319475328460063652 200319475328460063652 No Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran Mohammad Hassan Emamian emamian@shmu.ac.ir 200319475328460063653 200319475328460063653 No Ophthalmic Epidemiology Research Center, Shahroud University of Medical Sciences, Shahroud, Iran Manije Moghadam m.moghadam89@ Gmail.com. 200319475328460063654 200319475328460063654 No Department Of Older Adult Health, Ministry of health of Iran, Tehran, Iran