Are older adults also at higher psychological risk from COVID-19?

Preventing Depression Among Older Adults With Severe Illness: The Mediating Role of Life Satisfaction and the Moderating Role of Gender

PURPOSE

The occurrence of severe illness, the risk for which increases as people age, often results in depression. The current study aimed to explore how and when severe illness leads to depression among older adults.

METHOD

Data collected from a sample of 756 older adults were analyzed using moderated mediation analysis to examine the underlying mechanism between severe illness and depression.

RESULTS

Results, as verified by a robustness check, demonstrated that life satisfaction mediated the association between severe illness and depression among older men and women, and that gender moderated the direct relationship between severe illness and depression.

CONCLUSION

The formation path of depression from severe illness among older adults varies according to gender. For men, severe illness did not directly trigger depression, but indirectly triggered depression through decreased life satisfaction; for women, severe illness not only triggered depression directly, but also indirectly triggered depression through decreased life satisfaction. Results yield theoretical and practical implications for gerontological nursing. [Journal of Gerontological Nursing, 51(2), 43-52.].

Trajectories of psychological adaptation to Chinese older internal migrants: a latent transition model

OBJECTIVES

Little is known about the heterogeneity and transitions between psychological adaptation patterns in Chinese older internal migrants. This study addressed two questions: (a) Do distinct patterns of psychological adaptation exist among Chinese older internal migrants? (b) If so, what factors predict different trajectories?

METHOD

The study drew on two waves of data and involved 405 older internal migrants into Nanjing, China. First, a latent transition analysis was performed to visualize the different patterns of psychological adaptation. Second, an ecological model of resilience was used to identify the factors explaining the differences between adaptation patterns.

RESULTS

Three main trajectories of psychological adaptation among Chinese older internal migrants over time were: recovery, stability and deterioration. Adaptation trajectories were associated with age, gender, length of stay, psychological resilience, self-esteem, family support, social participation, and living with a spouse.

CONCLUSION

Chinese older internal migrants undertake heterogeneous psychological adaptation trajectories, and their positive adaptation is closely associated with coping resources. Our data may provide references for the identification of vulnerable older internal migrants, as well as the making of targeted interventions.

Gender and remote work: associations between mental health and hours of remote work and housework

To investigate the association between hours of remote work (RWHs) and housework (HWHs), independently, as well as the combined total of work hours (WHs), with gender and mental health of remote workers during the COVID-19 pandemic. Cross-sectional study with data from the ELSA-Brasil (N = 2,318). On average, women reported more time spent on HWHs and WHs than men, while no difference was found in RWHs. Depression, anxiety and stress were more prevalent among women. Women with longer working hours (RWHs, HWHs and WHs) had higher odds of displaying anxiety or stress symptoms than men with shorter working hours. For symptoms of depression, the highest odds ratios were found only among those women with medium or long HWHs and long WHs. A gender perspective into studies of remote work effects has contributed to the recognition of health inequalities between men and women.

The psychosocial effects of the COVID-19 pandemic on Turkish older adults: is there a difference between males and females?

BACKGROUND

The COVID-19 pandemic has seriously affected older adults' social lives, physical activity, and cognitive functions. Additionally, the lockdowns have disrupted regular healthcare for patients with chronic illnesses or needing acute care. Furthermore, the pandemic has negatively affected different psychosocial influences in each country due to the various cultural characteristics, technology, health system, and financial opportunities. This study aimed to investigate the effects of COVID-19 on mood, social participation, and healthcare use in older adults living in Turkey.

METHODS

A cross-sectional study was conducted during the third wave of the COVID-19 pandemic (March-December 2021) in three medical centers in Turkey. Patients aged 60 + years without significant cognitive impairment were recruited by mail or at hospital admissions. Information on demographics, pandemic-related distancing measures, healthcare use, lifestyle, symptoms of anxiety, depression, and social participation were assessed.

RESULTS

A total of 343 participants were included in the study. Women had a higher rate of hypertension, symptoms of anxiety, depression, and fatigue compared to men (p < 0.05). Since the start of the pandemic, only 22.4% of non-acute healthcare appointments were conducted face-to-face. Time spent with family and friends, hope for the future, and physical activity decreased. At the same time, the experience of loneliness, the number of meals and unhealthy snacks, and the use of digital services increased. Women were also more concerned about getting coronavirus infection, transmitting the virus to others, and being discriminated against because of the infection (p < 0.05).

CONCLUSIONS

These pandemic days have had a significant psychosocial impact on Turkish older adults, especially women. As a strategy of the health care policy, easy access and follow-up to the health system should be provided, and the necessary support should be procured to minimize the detrimental effects of the pandemic on older people.

A narrative review: suicide and suicidal behaviour in older adults

Globally, suicide is a public health concern that claims the lives of many each year. The complex etiology and factors contributing to the risk of suicide make it hard to predict the likelihood of death by suicide. Suicide rates have been increasing over the past 25 years in patients aged 65 years and older, and with the expected increases in the size of the older adult population and the under-detection of suicide risk, these rates may continue to increase. To mitigate and attempt to limit this expected increase, it is important to understand the risk and protective factors of suicide in older adults. This narrative review focuses on individuals above the age of 65 and encompasses relevant peer-reviewed publications from the past 25 years to cover fatal and non-fatal suicidal behaviour. It summarizes several important risk factors for suicide and suicidal behaviors while considering how risk can be detected, assessed, prevented, and mitigated. Screening methods to detect suicide and depression in older adults were examined based on their effectiveness and suitability for use in this population. Lastly, the impacts of the COVID-19 pandemic on suicide rates in older adults were described.

"If I want to be able to keep going, I must be active." Exploring older adults' perspectives of remote physical activity supports: a mixed-methods study

Introduction

Pandemic-related public health restrictions limited older adults' physical activity programs and opportunities. Physical activity supports shifted to remote options, however, information on their adoption and effectiveness is limited. This study aims to describe the remote supports received by older adults and their perceived effectiveness. Additionally, it aims to describe facilitators and barriers to remote supports for physical activity among older adults, particularly those reliant on technology.

Methods

This study used an explanatory, sequential, mixed-methods design. Community-dwelling older adults (≥ 60 years) were recruited to partake in a web-based survey and an optional semi-structured follow-up interview informed by the COM-B model. Participant characteristics, perceived effectiveness of remote supports, and the presence and severity of barriers were described. Changes in physical activity levels before and during the pandemic were analyzed using the Wilcoxon signed-rank test. Qualitative data underwent inductive thematic analysis.

Results

Fifty seven older adults (68.3 ± 7.1 years, 43 Female) completed the survey, of which 15 participants (67.4 ± 5.8 years, 12 Female) participated in interviews. The majority were Caucasian, highly educated, and resided in Canada. Total physical activity levels showed no statistically significant change from before to during the pandemic (p = 0.74); however, at-home exercise participation and technology usage increased. Pre-recorded and real-time virtual exercise supports were perceived as most effective. Main barriers included limited contact with exercise professionals, limited access to exercise equipment or space, and decreased mental wellness. Thematic analysis identified five main themes: (i) Enabled by knowledge and resources; (ii) Diverse motivations for physical activity; (iii) Fostering participation through social connection; (iv) Supervision and safety: enabling adherence; and (v) Virtual exercise: a sustainable option with technological considerations.

Conclusion

Virtual platforms show promise in supporting older adults' physical activity at home, especially for those with limited in-person access. Our study suggests that both real-time and pre-recorded virtual exercise supports are feasible, depending on technological capacity and support. While interactive real-time virtual programs allow interaction with professionals and peers, pre-recorded programs provide timing flexibility. Further research is needed to establish best practices for safe and effective virtual exercise programming, promoting its long-term adoption for supporting a wider range of older adults.

Changes in depression trends during and after the COVID-19 pandemic among older adults in Korea

This study aimed to complement the previous studies conducted within a short period of time by examining the long-term trends in depression levels of older adults through a longitudinal study that includes the period following the onset of COVID-19. For analysis, this study used the data from the 12th (2017) through 16th (2021) Korea Welfare Panel Study, and 2,716 data of older adults 65 years and older were included. Variables included gender, age, equalized annual income (USD $), education background, residential area, living alone and disability status. As a result, two types of changes in depression were identified: the 'rapidly rising' type and the 'steadily increasing'. We found that the lower the equalized annual income, women, the lower the education, living in urban and living alone showed a higher likelihood of belonging to the 'rapidly rising' type. The result suggests that those at risk of depression are at much higher risk during and after the COVID-19 pandemic. It is also necessary to provide timely and effective guidelines to prevent depression in older adults when implementing policies in response to an outbreak of infectious diseases, such as COVID-19.

Impact of Cohabitation during Confinement on Older Adults' Negative Affect: What Specificity of Life as a Couple?

BACKGROUND

Social isolation is a risk factor for older adults' physical and psychological health. The beneficial effect of social connections in times of major health events is undeniable. Nevertheless, it remains unclear whether the positive effect of social support depends on the relationship type.

OBJECTIVES

This study aimed to investigate the influence of older adults' living conditions on the risk of experiencing negative affect during the first lockdown and post-lockdown.

DESIGN

An epidemiological study conducted during the COVID-19 crisis, at the time of the first lockdown, and 2 to 3 months following the lockdown.

SETTING

A subset sample of the PACOVID survey, a population-based survey of older adults.

PARTICIPANTS

Altogether, 277 participants were included into three groups depending on their living conditions: Group 1 "living alone" (n = 141); Group 2 "living with their spouse" (n = 106); Group 3 "living in cohabitation with relatives" (n = 30).

MEASUREMENTS

Mixed logistic regression analyses were used to study the change in the risk of experiencing negative affects over time according to the living conditions. The presence of negative affects during lockdown was assessed using three items from the 20-item Center for Epidemiologic Studies Depression Scale : «Do you feel sad?»; «Do you feel depressed?; «Do you feel lonely?

RESULTS

Participants living with their relatives or partner were significantly less likely to experience negative affect than those living alone during lockdown. Moreover, over time, only those living with their spouse had this lesser risk compared to those living alone.

CONCLUSIONS

These findings highlight the protective effect of social support over time and more specifically of that provided by the spouse. Couple functioning ought to be given consideration when studying the impact of health crisis situation on the mental health of older adults.

Social and Psychological Effects of COVID-19 Pandemic on Adolescents' and Young Adults' Mental Health: A Cross-Cultural Mediation Study

The ongoing pandemic has dramatically disrupted daily life, increasing the risk of developing psychiatric disorders and poor mental wellbeing. The compound effects of social, political and psychological stressors have increased psychological symptoms among adolescents and young people, with worries about COVID-19 playing a central role in the clinical course of their mental health problems caused by the pandemic. The aim of this cross-cultural study was to examine the social psychological effects of COVID-19 on adolescents' and young people's mental health and wellbeing in Ibero-American population. Participants involved 6,283 adolescents and young adults from five different Spanish-Speaking countries (83.7% female) aged between 12 and 30 years (M = 18.79; SD = 3.48). Participants completed the Worries about COVID-19 and its Consequences Scale (W-COV), the Satisfaction with Life Scale (SWLS), and the Depression, Anxiety and Stress Scale (DASS-21). Descriptive analyses, multivariate ANOVAs and Pearson correlations were performed, as well as Structural Equation Modelling (SEM) testing a mediational model. The results indicate cross-cultural difference in COVID-19 related worries, emotional symptoms and life satisfaction. Results from SEM confirmed the overall indirect effects of COVID-19 cases, political response and participants' conditions during lockdown on depression, anxiety, stress and life satisfaction mediated by COVID-19 related worries. These findings suggest that the social psychological factors underlying psychological symptoms could be partly explained by increased worries about COVID-19 and its personal, social, economic and political consequences, which may offer guidance to policy makers and health services for safeguarding youth mental well-being.

COVID-19 anxiety and related factors amid adjusted epidemic prevention policies: a cross-sectional study on patients with late-life depression in China

OBJECTIVES

To explore the prevalence and associated factors of COVID-19 anxiety in patients with late-life depression (LLD) during the adjustment of epidemic prevention policies in China.

DESIGN

Cross-sectional study.

SETTING

The data analysed in this study were collected from seven regions in China between November 2022 and January 2023.

PARTICIPANTS

A total of 1205 patients with LLD (aged 60-78 years) participated in the survey. They completed a social demographic assessment and the Chinese version of the five-point Coronavirus Anxiety Scale (CAS).

PRIMARY OUTCOME MEASURES

The primary outcome was the anxiety level of the participants. Patients were categorised into two groups based on their anxiety levels, one with anxiety and one without, according to CAS scores.

RESULTS

The prevalence of COVID-19 anxiety in depressed older adults was 47.3%. Regression analysis revealed that the average COVID-19 anxiety score was significantly higher among females (AOR: 2.177, 95% CI 1.201 to 3.947), widowed individuals (AOR: 3.015, 95% CI 1.379 to 6.591), patients residing at a distance from healthcare facilities (AOR: 3.765, 95% CI 1.906 to 7.438), and those who frequently experienced worry (AOR: 1.984, 95% CI 1.111 to 3.543). Conversely, the anxiety score was significantly lower among divorced individuals (AOR: 0.491, 95% CI 0.245 to 0.988), those aged 70 years and above (AOR: 0.117, 95% CI 0.064 to 0.213), patients without difficulty obtaining medication (AOR: 0.027, 95% CI 0.007 to 0.097), those living with family members (AOR: 0.080, 95% CI 0.022 to 0.282) or in nursing homes compared with those living alone (AOR: 0.019, 95% CI 0.004 to 0.087).

CONCLUSION

Women with LLD who are widowed, live far from healthcare facilities, and are prone to excessive worry are more likely to experience anxiety. It is advisable to implement appropriate preventive measures and provide psychosocial support programmes for this vulnerable group during the COVID-19 pandemic.

Psychological health among older adult women in the United States during the COVID-19 pandemic

This study examined differences in mental health in older adult women before versus during the COVID-19 pandemic. Participants who were community dwelling (N = 227) included n = 67 women aged 60-94 in the pre-pandemic group and n = 160 women aged 60-85 in the peri-pandemic group who completed self-report measures assessing mental health and quality of life (QOL). We compared mental health and QOL indices across the pre- and peri-pandemic groups. Results indicated that the peri-pandemic group reported higher anxiety (F = 4.94, p = .027) than the pre-pandemic group. No other significant differences emerged. Given the differential effects in this pandemic across SES, we conducted exploratory analyses investigating differences by income group. Controlling for education and race, within the pre-pandemic group, women with lower income reported worse physical function compared to the mid- and high-income groups. Within the peri-pandemic group, women with lower income reported worse anxiety, poorer sleep, and poorer QOL (physical function, role limitations due to physical problems, vitality, and pain) than high-income individuals. Overall, women who reported lower income reported worse mental health and QOL than those with high-income, especially during the pandemic. This indicates that income might act as a buffer for older women against negative psychological outcomes of the COVID-19 pandemic.

A longitudinal examination of the protective effect of resilience against anxiety among older adults with high COVID-related worry

This longitudinal study of community dwelling older adults (N = 453) examined consequences of COVID-related worries on changes in anxiety symptoms before relative to during the pandemic. We further evaluated if pre-COVID psychological resilience (PR) buffered the impact of COVID-related worry. Pre-COVID data were collected in September 2018. COVID-related worry and COVID anxiety symptoms were collected in October 2020 (Wave 2). Controlling for pre-COVID anxiety symptoms, we examined if COVID-related worries (e.g. I'm worried that I might die from COVID-19) were associated with increased anxiety symptoms, and whether pre-COVID PR moderated the association between COVID-related worries and prospective increases in anxiety symptoms. COVID-related worries were associated with increased anxiety symptoms (β = 0.005, p < .01), whereas pre-COVID PR was associated with a decrease in anxiety symptoms (β = -0.029, p < .05). PR moderated the association; COVID-related worries were associated with greater increases in anxiety symptoms among those with low pre-COVID PR (Model η2 = 0.35). Thus, the extent to which COVID-related worries influenced psychological health was dependent on pre-COVID levels of PR. We conclude the combined vulnerabilities of low pre-COVID PR and high COVID-related worries significantly increased the psychological consequences of COVID-19 for our sample of older adults.

Associations between COVID-19 mental impact and distress, resilience, burnout and well-being in Hong Kong community adults: A structural equation model

The COVID-19 pandemic poses substantial risks to individuals' physical and mental health and prolonged psychological responses to the pandemic could lead to emotional exhaustion. The present study aimed to examine the mediating role of COVID-19 related mental impact and distress in the relationship among resilience, burnout, and well-being. The present study recruited 500 community adults (mean age = 38.8 years, SD = 13.9; 76% females) in Hong Kong via an online survey in autumn 2021. The participants completed the Mental Impact and Distress Scale: COVID-19 (MIDc) and validated measures on resilience, burnout, and well-being. Confirmatory factor analysis was conducted to evaluate the psychometric properties of the MIDc. Direct and indirect effects of resilience on burnout and well-being via MIDc were examined via structural equation modeling. Confirmatory factor analysis supported factorial validity for the three factors of MIDc (situational impact, anticipation, and modulation). Resilience showed negative effects on the MIDc (β = -0.69, SE = 0.04, p < 0.01) and burnout (β = 0.23, SE = 0.06, p < 0.01). Burnout was positively associated with MIDc (β = 0.63, SE = 0.06, p < 0.01) and negatively associated with well-being (β = -0.47, SE = 0.07, p < 0.01). Resilience showed a significant and positive indirect effect (αβγ = 0.203, 95% CI = 0.131 to 0.285) on well-being via MIDc and burnout. The results support a potential mediating role for MIDc as psychological responses in the relationship among resilience and burnout and well-being.

Big Five personality traits and coping strategies of Italian university students during the COVID-19 pandemic first wave

Introduction

Little is known about the role personality traits may have played for university students in diminishing and compensating for the negative impact of COVID-19 in its early phases, promoting adaptive coping. University students represent a population which was consistently obliged to follow social distance rules due to the early shift of many organizations from face-to-face to online learning. Therefore, it is worth exploring whether the Big Five traits acted as risk or protective factors after the outbreak of a disaster such as the COVID-19 pandemic for Italian university students.

Methods

We involved a sample of 2,995 university students who completed an online survey in March 2020. We measured the Big Five personality traits through the Big Five Inventory-2-XS and their coping strategies through the Robust-Pandemic Coping Scale. The latter assessed four COVID-19-related coping dimensions, namely Despair (e.g., including helplessness and feeling lack of control), Aversion (e.g., referring to oppositive strategies), Proactivity (e.g., comprising problem solving and information seeking), and Adjustment (e.g., concerning reappraisal and assertiveness).

Results

Preliminarily, two Linear Mixed Models indicated that university students had higher scores in Conscientiousness, followed by Open-Mindedness, and then Agreeableness. These three traits were, in turn, higher than Extraversion and Negative Emotionality, which did not differ among them. Concerning coping, university students reacted more frequently utilizing adaptive strategies (with Proactivity used more frequently than Adjustment) rather than maladaptive strategies (with Despair higher than Aversion). A Path Analysis examining the relations between the Big Five traits and the four coping dimensions showed that Negative Emotionality can be considered as a risk factor, and that Agreeableness, Conscientiousness, and Open-Mindedness can be conceptualized as protective factors. More interestingly, we found that Extraversion entailed both a risk and a protective role for Italian university students after the outbreak of the COVID-19 pandemic.

Discussion

Notwithstanding limitations, these findings can be the basis for developing disaster preparation and prevention actions, aiming at promoting students' positive coping towards current and future disasters.

Depression and anxiety in people with cognitive impairment and dementia during the COVID-19 pandemic: Analysis of the English Longitudinal Study of Ageing

BACKGROUND

Some studies have identified declines in mental health during the Coronavirus Disease 2019 (COVID-19) pandemic in different age groups, including older people. As anxiety and depression are common neuropsychiatric symptoms among people with cognitive impairment, the mental health experiences of older people during the pandemic should take cognitive function into consideration, along with assessments made prior to the pandemic. This study addresses evidence gaps to test whether changes in depression and anxiety among older people through the COVID-19 pandemic were associated with cognitive impairment. It also investigates whether associations varied according to key sources of sociodemographic inequality.

METHODS AND FINDINGS

Using data from the English Longitudinal Study of Ageing (ELSA) collected from 2018/2019 to November/December 2020, we estimated changes in depression and anxiety for people aged 50+ in England across 3 cognitive function groups: no impairment, mild cognitive impairment, and dementia. Conditional growth curve models were estimated for continuous measures over 3 time points (N = 5,286), with mixed-effects logistic regression used for binary measures. All models adjusted for demographics (age, gender, ethnicity, and cohabiting partnership), socioeconomics (education, wealth, and employment status), geography (urban/rural and English region), and health (self-rated and the presence of multimorbidity). We found that depression (measured with CES-D score) worsened from 2018/2019 to November/December 2020 for people with mild cognitive impairment (1.39 (95% CI: 1.29 to 1.49) to 2.16 (2.02 to 2.30)) or no impairment (1.17 (95%CI: 1.12 to 1.22) to 2.03 (1.96 to 2.10)). Anxiety, using a single-item rating of 0 to 10 also worsened among those with mild cognitive impairment (2.48 (2.30 to 2.66) to 3.14 (2.95 to 3.33)) or no impairment (2.20 (2.11 to 2.28) to 2.85 (2.77 to 2.95)). No statistically significant increases were found for those with dementia. Using a clinical cutoff for likely depression (CES-D ≥4), we found statistically significant increases in the probability of depression between 2018/2019 and November/December 2020 for those with no impairment (0.110 (0.099 to 0.120) to 0.206 (0.191 to 0.222)) and mild impairment (0.139 (0.120 to 0.159) to 0.234 (0.204 to 0.263)). We also found that differences according to cognitive function that existed before the pandemic were no longer present by June/July 2020, and there were no statistically significant differences in depression or anxiety among cognitive groups in November/December 2020. Wealth and education appeared to be stronger drivers for depression and anxiety, respectively, than cognitive impairment. For example, those with no impairment in the richest two-thirds scored 1.76 (1.69 to 1.82) for depression in June/July, compared to 2.01 (1.91 to 2.12) for those with no impairment in the poorest third and 2.03 (1.87 to 2.19) for those with impairment in the poorest third. Results may be limited by the small number of people with dementia and are generalizable only to people living in the community, not to those in institutional care settings.

CONCLUSIONS

Our findings suggest a convergence in mental health across cognitive function groups during the pandemic. This suggests mental health services will need to meet an increased demand from older adults, especially those not living with cognitive impairment. Further, with little significant change among those with dementia, their existing need for support will remain; policymakers and care practitioners should ensure this group continues to have equitable access to mental health support.

Rural/urban differences in mental health and social well-being among older US adults in the early months of the COVID-19 pandemic

OBJECTIVES

This study seeks to identify differences in mental health and social well-being during the early months of the COVID-19 pandemic among older adults by rural/urban location.

METHODS

We use data from the COVID-19 Coping Study, a nation-wide online study of U.S. adults aged 55 and older (n = 6,873) fielded during April-May, 2020. We investigated rural/urban differences in mental health (depressive symptoms and anxiety symptoms) and social well-being (loneliness and social isolation); concern about COVID-19; and types of social participation (e.g. phone/video calls, visits). We also used multivariable logistic regression models to assess the relationship of rurality with mental health, adjusting for socio-demographic correlates, COVID-19 history, and COVID-19 concern.

RESULTS

We found similar prevalence of mental health and social well-being outcomes for rural and urban respondents. Rural respondents reported lower concern about COVID-19 and more frequent use of social media than urban respondents.

CONCLUSION

Mental health and social well-being did not differ by rural/urban location in the early months of the COVID-19 pandemic. However, rural residents reported less concern about COVID-19 and more use of social media, potentially leading to greater risk of illness from the pandemic in later months.

The Buffering Role of Self-compassion in the Association Between Loneliness with Depressive Symptoms: A Cross-Sectional Survey Study Among Older Adults Living in Residential Care Homes During COVID-19

The coronavirus disease 2019 (COVID-19) pandemic is an ongoing geriatric health emergency with a substantial increase in the prevalence of medical and mental health issues, particularly among older adults living in residential care homes. The knowledge of the risk and protective factors related to the psychological impact of the COVID-19 pandemic on older adults living in residential care homes is based on limited data. This study aimed to investigate whether loneliness mediates the effects of fear generated by a pandemic on depression. Additionally, we hypothesized that self-compassion moderates the effect of loneliness on depression. A sample comprised 323 older adults (females: n = 141, males: n = 182) with mean age = 74.98 years (standard deviation = 6.59, age 65-90) completed a survey comprising the Fear of COVID-19 Scale, De Jung Gierveld Loneliness Scale, the nine-item Patient Health Questionnaire, and the Self-compassion Scale. The results revealed that the total effect of fear on depression was statistically significant, with a medium effect size (Cohen's f 2 = .14) and this association was partially mediated by loneliness (β = .11, SE = .04, P < .001, t = 2.91, 95% CI 0.04-0.19). The self-compassion also moderated the loneliness effect on depression. The findings of this study support COVID-19 evidence, indicating that a greater level of fear generated by the pandemic is linked to depression and loneliness. The findings support the notion that self-compassion mitigates the adverse effects of stressful events in older adults. Customized self-compassion programs may be effective loneliness-mitigating interventions for older adults living in residential care homes.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11469-023-01014-0.

Social loneliness and perceived stress among middle-aged and older adults during the COVID-19 pandemic

Older age has been considered a risk factor for physical and mental health during the COVID-19 pandemic, yet many middle-aged and older adults showed resilience. This cross-sectional study aimed to examine the protective factors against social loneliness and perceived stress among Turkish middle-aged and older adults. The data were collected from 464 adults aged 55 and above when the curfew restrictions were still in place. Hierarchical regression analyses revealed that resilience, life satisfaction, self-esteem, satisfaction with social support and internet use negatively predicted both social loneliness and stress. The extent of curfew measures, which were more restrictive for the elderly, did not predict social loneliness and stress. The participants living alone showed higher social loneliness and those with chronic disease reported more stress. Results highlight the significant role of protective factors in enhancing well-being and coping in old age under highly stressful situations such as the pandemic.

Depression and quality of life among Macau residents in the 2022 COVID-19 pandemic wave from the perspective of network analysis

Background

In the summer of 2022, Macau experienced a surge of COVID-19 infections (the 618 COVID-19 wave), which had serious effects on mental health and quality of life (QoL). However, there is scant research on mental health problems and QoL among Macau residents during the 618 COVID-19 wave. This study examined the network structure of depressive symptoms (hereafter depression), and the interconnection between different depressive symptoms and QoL among Macau residents during this period.

Method

A cross-sectional study was conducted between 26th July and 9th September 2022. Depressive symptoms were measured with the 9-item Patient Health Questionnaire (PHQ-9), while the global QoL was measured with the two items of the World Health Organization Quality of Life-brief version (WHOQOL-BREF). Correlates of depression were explored using univariate and multivariate analyses. The association between depression and QoL was investigated using analysis of covariance (ANCOVA). Network analysis was used to evaluate the structure of depression. The centrality index "Expected Influence" (EI) was used to identify the most central symptoms and the flow function was used to identify depressive symptoms that had a direct bearing on QoL.

Results

A total 1,008 participants were included in this study. The overall prevalence of depression was 62.5% (n = 630; 95% CI = 60.00-65.00%). Having depression was significantly associated with younger age (OR = 0.970; p < 0.001), anxiety (OR = 1.515; p < 0.001), fatigue (OR = 1.338; p < 0.001), and economic loss (OR = 1.933; p = 0.026). Participants with depression had lower QoL F (1, 1,008) =5.538, p = 0.019). The most central symptoms included PHQ2 ("Sad Mood") (EI: 1.044), PHQ4 ("Fatigue") (EI: 1.016), and PHQ6 ("Guilt") (EI: 0.975) in the depression network model, while PHQ4 ("Fatigue"), PHQ9 ("Suicide"), and PHQ6 ("Guilt") had strong negative associations with QoL.

Conclusion

Depression was common among Macao residents during the 618 COVID-19 wave. Given the negative impact of depression on QoL, interventions targeting central symptoms identified in the network model (e.g., cognitive behavioral therapy) should be developed and implemented for Macau residents with depression.

Analyzing the role of resilience and life satisfaction as mediators of the impact of COVID-19 worries on mental health

The aim of this study was to test whether resilience and life satisfaction (two traditional protective factors) mediate between COVID-19 related worries and the development of symptoms of depression, anxiety, and stress in adolescents and young adults. Participants involved 392 adolescents and young adults (70.20% female) aged between 12 and 25 years (M = 17.05 years, SD = 3.08). Participants completed the COVID-19 related worries scale, the CD-RISC to analyse resilience, the Satisfaction with Life Scale, and the Depression, Anxiety, and Stress Scales-21 to study emotional symptoms. Descriptive analyses and Pearson correlations were conducted, together with a structural equation modeling testing a mediational model and multigroup invariance. Results show that resilience and life satisfaction play a mediating role in the relation between the COVID-19 related worries and emotional symptoms (depression, anxiety, and stress). This study highlights the role of protective factors on adolescents' and young adults' emotional symptoms during the COVID-19 pandemic.

Frailty and Mental Health Disorders Before and During COVID-19 Occurrence in Older Population in Iran: A Longitudinal Repeated-Measures Study

PURPOSE

Iranians' worry over the number of older patients negatively impacted by COVID-19 surged dramatically throughout the 5 waves of the COVID-19 pandemic, which lasted from January 2020 to September 2021. The goal of this research was to assess the physical and mental health of Iranian older persons throughout the COVID-19 pandemic's major waves.

METHODS

The health condition of 507 older persons with a positive examination for COVID-19 illness was assessed before and throughout the 5 waves of coronavirus in south Iran in analytical and hybrid longitudinal research.

RESULTS

The primary consequences of COVID-19 incidence on frailty and mental health issues were revealed in this investigation. Using a linear mixed model, we found a reduction of 0.33 in loneliness (β = -.33, 95% CI -0.39 to -0.26) during the COVID-19 pandemic. The probabilities of becoming depressed, anxious, or frail rose 4.61 (95% CI: 3.77-5.63), 1.85 (95% CI: 1.52-2.24), as well as 1.42 (95% CI: 1.17-1.42) time, subsequently, with COVID-19 occurrence, according to the mixed logistic models. Furthermore, the influence of COVID-19 incidence on loneliness result differs by gender; for depression, it varies by education; and for anxiety, it changes by comorbidities and living independently.

CONCLUSION

The COVID-19 pandemic significantly impacts the mental health and frailty of older persons with the positive COVID-19 situation, and this scenario is gender-based too.

Anxiety and loneliness among older people living in residential care facilities or receiving home care services in Sweden during the COVID-19 pandemic: a national cross-sectional study

BACKGROUND

Older people were subjected to significant restrictions on physical contacts with others during the COVID-19 pandemic. Social distancing impacts older people's experiences of anxiety and loneliness. Despite a large body of research on the pandemic, there is little research on its effects on older people in residential care facilities (RCF) and in home care services (HCS), who are the frailest of the older population. We aimed to investigate the effect of the first wave of the COVID-19 pandemic in March-May 2020 on experiences of anxiety and loneliness among older people living in RCF or receiving HCS and the impact of the progression of the pandemic on these experiences.

METHODS

A retrospective cross-sectional design using data from the national user satisfaction survey (March - May 2020) by the Swedish National Board of Health and Welfare. Survey responses were retrieved from 27,872 older people in RCF (mean age 87 years) and 82,834 older people receiving HCS (mean age 84 years). Proportional-odds (cumulative logit) model was used to estimate the degree of association between dependent and independent variables.

RESULTS

Loneliness and anxiety were more prevalent among the older persons living in RCF (loneliness: 69%, anxiety: 63%) than those receiving HCS (53% and 47%, respectively). Proportional odds models revealed that among the RCF and HCS respondents, the cumulative odds ratio of experiencing higher degree of anxiety increased by 1.06% and 1.04%, respectively, and loneliness by 1.13% and 1.16%, respectively, for 1% increase in the COVID-19 infection rate. Poor self-rated health was the most influential factor for anxiety in both RCF and HCS. Living alone (with HCS) was the most influential factor affecting loneliness. Experiences of disrespect from staff were more strongly associated with anxiety and loneliness in RCF than in HCS.

CONCLUSION

Older people in RCF or receiving HCS experienced increasing levels of anxiety and loneliness as the first wave of the pandemic progressed. Older people' mental and social wellbeing should be recognized to a greater extent, such as by providing opportunities for social activities. Better preparedness for future similar events is needed, where restrictions on social interaction are balanced against the public health directives.

COVID-19 related anxiety and its associated factors: a cross-sectional study on older adults in Bangladesh

BACKGROUND

The COVID-19 pandemic has resulted in serious mental health conditions, particularly among older adults. This research explored the prevalence of COVID-19-related anxiety and its associated factors among older adults residing in Bangladesh.

METHODS

This cross-sectional study was conducted among 1,045 older Bangladeshi adults aged ≥ 60 years through telephone interviews in September 2021. A semi-structured interview schedule was used to collect data on participants' characteristics and COVID-19-related anxiety. The anxiety level was measured using the Bengali version of the five-point Coronavirus Anxiety Scale (CAS). A linear regression model explored the factors associated with COVID-19-related anxiety.

RESULTS

Overall, the prevalence of COVID-19-related anxiety was 23.2%. The regression analysis revealed that the average COVID-19-related anxiety score was significantly higher among females (β: 0.43, 95% CI: 0.05 to 0.81), and among those who faced difficulty getting medicine (β: 0.57, 95% CI: 0.16 to 0.97), felt isolated (β: 0.60, 95% CI: 0.24 to 0.95), and felt requiring additional care during the pandemic (β: 0.53, 95% CI: 0.16 to 0.91). Alternatively, the average COVID-19-related anxiety score was significantly lower among those who were widowed (β: -0.46, 95% CI: -0.87 to -0.04) and living distant from the health centre (β: -0.48, 95% CI: -0.79 to -0.17).

CONCLUSION

The findings of the present study suggest providing immediate psychosocial support package to the older adults, particularly females and those who are vulnerable to receive health and social care support during the COVID-19 pandemic in Bangladesh.

Valence norms for 3,600 English words collected during the COVID-19 pandemic: Effects of age and the pandemic

The topic of affective development over the lifespan is at the forefront of psychological science. One of the intriguing findings in this area is superior emotion regulation and increased positivity in older rather than younger adults. This paper aims to contribute to the empirical base of studies on the role of affect in cognition. We report a new dataset of valence (positivity) ratings to 3,600 English words collected from North American and British English-speaking younger (below 65 years of age) and older adults (65 years of age and older) during the COVID-19 pandemic. This dataset represents a broad range of valence and a rich selection of semantic categories. Our analyses of the new data pitted against comparable pre-pandemic (2013) data from younger counterparts reveal differences in the overall distribution of valence related both to age and the psychological fallout of the pandemic. Thus, we found at the group level that older participants produced higher valence ratings overall than their younger counterparts before and especially during the pandemic. Moreover, valence ratings saw a super-linear increase after the age of 65. Together, these findings provide new evidence for emotion regulation throughout adulthood, including a novel demonstration of greater emotional resilience in older adults to the stressors of the pandemic.

The experience of aging before one's time during the coronavirus pandemic among war veterans in Israel

Subjective age, the personal sense of how old one feels, is an important concomitant of posttraumatic outcomes in the second half of life. The present study aims to disentangle the interrelationships between posttraumatic stress disorder symptoms (PTSS) and subjective age, during the COVID-19 pandemic, among a sample of Israeli older adults who are veterans of the 1973 Yom Kippur War. Participants were interviewed in 2015 (T1; N = 259; mean age = 65.23, SD = 5.32) and in 2020, during the COVID-19 outbreak in Israel (T2). We assessed subjective age, PTSS, fear of COVID-19, self-rated health, and COVID-19 related accelerated subjective aging. A cross-lagged path analysis showed that while higher PTSS at T1 were associated with an increase in subjective age from T1 to T2, subjective age at T1 was not associated with PTSS at T2. PTSS at T1, but not subjective age, were associated with higher COVID-19 related accelerated subjective aging at T2. Older adults with continued PTSS due to past traumas, might be susceptible to the stressors of COVID-19 expressed in the personal subjective experience of having aged quickly in a short period of time. Our findings also suggest that in the context of stress and trauma, subjective age is more appropriately conceived as an outcome variable rather than a predictor of PTSS.

Gender and Psychosocial Differences in Psychological Resilience among a Community of Older Adults during the COVID-19 Pandemic

The study aimed at exploring gender and additional sociodemographic differences in psychological resilience, as well as the association between resilience and psychological distress in older adults, during the first lockdown in Italy, due to the COVID-19 pandemic. Participants attended an online survey during the first lockdown in May 2020. Psychological distress was assessed through the Depression Anxiety Stress Scale-21, the Resilience Scale (RS) was administered to evaluate psychological resilience, and sociodemographic variables were also collected. The study involved 108 community older adults (mean age 70.02 ± 3.5 years). Comparisons revealed that women reported significantly lower total scores of RS (p = 0.027), as well as lower levels of resilience-related domains, namely Meaningfulness (p = 0.049), Self-Reliance (p = 0.011), Perseverance (p = 0.035), and Existential Aloneness (p = 0.014), compared to men. Significantly higher RS scores were found in older adults being involved in a relationship, compared to those not involved in relationships (p = 0.026), and in older adults with children (p = 0.015), compared to those without offspring, suggesting the importance for older adults of not dealing alone with such a dramatic and stressful event, such as the pandemic. Negative correlations were found between psychological resilience and stress, depression, and anxiety. Linear regressions revealed that lower RS total scores, as well as lower scores in the majority of the RS scales, were associated with greater levels of stress, greater levels of anxiety, and greater levels of depressive symptoms. This study suggested that older women might appear more vulnerable in facing the pandemic, compared to men; having not lived alone through the lockdown period might also be considered as a factor of resilience for older adults.

The Impact of COVID-19 Restrictions on Perceived Health and Well-Being of Active Australian Older Adults

The aim of this study was to determine the impact of COVID-19 restrictions on older adults' perceived health and well-being according to different types of participation in sport and physical activity by gender and region. A survey was implemented during the first COVID-19 lockdown in Australia (June 2020) and information collected on demographics, sport and physical activity patterns pre-COVID-19, and health and well-being outcomes during lockdown and compared to 1 year earlier. During COVID-19 lockdown, older adults who participated in both club sport and informal activities had significantly better general health, physical health, and resilience than those who participated solely in a single setting. Those participating in both team and individual activities reported better general well-being. Older adults who were active in a range of settings and modes had improved health and well-being. Social support is especially important for older adults to become and remain active.

Mental Health Consequences of COVID-19 Pandemic Period in the European Population: An Institutional Challenge

The worldwide spread of SARS-CoV-2 has been responsible for an infectious pandemic, with repercussions on socio-economic aspects and on the physical and mental health of the general population. The present systematic review aimed to evaluate the data belonging to the European framework, analyzing the population by age group. Original articles and reviews on the state of mental health of the general European population have been researched starting from 2021. Initially, a total of 1764 studies were found, among which a total of 75 were selected. Youth were the age group most affected by pandemic consequences on mental health, with emotional and behavioral alterations observed from a third to more than a half of children and adolescents examined. Among both adolescents and adults, the female gender had a higher prevalence of psychopathological symptoms. The main risk factors were poor social support, economic difficulties, and, in particular, unemployment or job changes. Additional individual risk factors were the perception of loneliness, the presence of pre-pandemic mental illness/distress, and some personality traits, such as neuroticism, impulsiveness, and the use of maladaptive coping strategies. Unexpectedly, the elderly maintained good resilience towards change, even if a stress factor was represented by the feeling of loneliness and poor social contact. As regards suicidal behaviors, among adolescents, there was an increase in attempts of 25%, with a greater risk for the female gender. This risk increased also among adults, in association with symptoms of anxiety and depression, and poor socio-environmental conditions. In conclusion, some population groups were found to be at greater risk of psychological burden during pandemic waves, thus representing priority targets for socio-health interventions.

The Impact of SARS-CoV-2 (COVID-19) on the Acuity of Mental Health-Related Diagnosis at Admission for Young Adults in New York City and Washington, DC: Observational Study

BACKGROUND

The COVID-19 pandemic has required restrictive measures to mitigate transmission of the virus. Evidence has demonstrated increased generalized anxiety and depression among young adults due to the COVID-19 pandemic. However, minimal research has examined the longitudinal effect of COVID-19 over the course of time and its impact on anxiety and depression. Additionally, age and gender have been found to play a significant role on individuals' mental health, with young adults and women particularly at risk.

OBJECTIVE

The aim of this study was to examine the impact of the COVID-19 pandemic on anxiety and depression upon admissions to treatment.

METHODS

This was an observational study that was completed longitudinally in which the grouping variable split the time interval into five equal groups for assessments over each period of time. A total of 112 young adults (aged 18-25 years) were recruited for the study. Participants completed assessments online through a Qualtrics link.

RESULTS

Psychometric properties of the admission assessments were uniformly highly statistically significant. There was a significant difference in generalized anxiety between the group-1 and group-3 time intervals. No significant difference was found across the time intervals for depression. Differences in predicting the impact of the psychometrics scores were found with respect to gender. Only the ability to participate and the quality-of-life subfactor of the Functional Assessment of Chronic Illness Therapy (FACIT) assessment were significant.

CONCLUSIONS

This study sought to understand the impact that COVID-19 has had on young adults seeking mental health services during the pandemic. Gender emerged as a clear significant factor contributing to increased anxiety in young adults seeking mental health services during the pandemic. These findings have critical importance to ensuring the potential treatment success rate of clients, while providing an overarching understanding of the impact of the pandemic and establishing clinical recommendations for the treatment of individuals who are seeking out treatment.

Age differences in mental health from May through August 2020 among U.S. adults: trajectories and the role of pandemic, lifestyle, and social factors

Objectives: Using nationally representative data among U.S. adults, we assess age differences in changes in mental health both from 2018 to May 2020 and during the pandemic. We also examine factors explaining age differences in mental health.Methods: We analyzed 2018 General Social Survey data (N = 2,348; age 18-89) and three waves of COVID Response Tracking Study data (N = 2,279; age 20-94) spanning May-August 2020. Outcomes included happiness, loneliness, stress, positive affect, and negative affect.Results: U.S. adults reported greater loneliness and less happiness in May 2020 versus 2018. Only loneliness and negative affect changed significantly from May to August 2020, showing declines. Mental health trajectories did not differ significantly by age. Overall, older adults reported lower loneliness, stress, and negative affect than younger adults during 2020. Older age was associated with two factors linked with better mental health: less likelihood of COVID-19 exposure and greater satisfaction with social activities and relationships. However, none of the factors examined herein explained age differences in mental health.Conclusion: Although mental health trajectories during the pandemic were similar across ages, older adults tended to report better mental health than younger adults. Future research should identify factors that explain age differences in mental health that persisted into 2020.

Does COVID-19 psychological fatigue exist? Results of three online cross-sectional studies conducted in Spain from April 2020 to March 2021

Background

A previously published meta-analysis found that about one-third of the general population experienced some mental health problem during the early phase of the COVID-19 pandemic, potentially leading to a late mental health crisis. We aimed to describe the acute, short-term, and long-term effects of the COVID-19 pandemic on mental health.

Methods

A one-year online survey (S) was conducted in Spain (April 2020 - March 2021). We recruited 18 180 subjects using a virtual respondent-driven snowball sampling method (S1 April 2020, n = 6108; S2 October-November 2020, n = 6418; S3 March 2021, n = 5654). Participants completed the Spanish Depression, Anxiety, and Stress Scale (DASS-21).

Results

Overall, our results suggest a progressive increase in the prevalence of anxiety and stress throughout the pandemic waves and relative stability of depression. Women had a greater probability of having depression, anxiety, or stress than men in each survey (P < 0.001). The youngest group (aged 18-24) reported a higher probability (P < 0.05) of having depression, anxiety, or stress than the older groups in S1 and S2. Middle-aged people (25-59) had a greater probability of being a case in the DASS-21 scales than the oldest group (60+), except for depression in men (P = 0.179). In S3, the trend changed: the youngest group showed a decrease in depression and stress while the oldest group showed a dramatic increase (anxiety: men = 664.5%, women = 273.52%; stress: men = 786%, women = 431.37%).

Conclusions

It is plausible to conclude that COVID-19 psychological fatigue exists, especially in middle-aged and older adults. Strategies to assist people who have fewer coping skills should be implemented in the near future.

Home confinement and mental health problems during the Covid-19 pandemic among the population aged 50 and older: A gender perspective

Home confinement during the Covid-19 pandemic is usually associated with worsening mental health. In the case of older adults, although they have been identified as a vulnerable group in terms of mental health, the results of studies on the relationship between home confinement and mental health are not consistent and few studies have adopted a gender perspective. Using data from the SHARE Corona Survey (2020), we aimed to analyse the role of gender on the relationship between home confinement and increased depression in individuals aged 50 and over living in Europe and Israel. Our study shows that, although women reported increased depression/sadness during the Covid-19 pandemic more often than men, it was the latter who experienced the greatest increase.

Life during COVID-19 lockdown in Italy: the influence of cognitive state on psychosocial, behavioral and lifestyle profiles of older adults

OBJECTIVE

Few studies have examined lockdown effects on the way of living and well-being of older adults stratified by cognitive state. Since cognitive deficits are common in this population, we investigated how cognition influenced their understanding of the pandemic, socio-behavioral responses and lifestyle adaptations during lockdown, and how these factors affected their mood or memory.

METHOD

Telephone-based survey involving 204 older adults ≥65 y/o (median: 82) with previous assessments of cognitive state: 164 normal-old (NOLD), 24 mild-neurocognitive disorder (mild-NCD), 18 mild-moderate dementia. A structured questionnaire was developed to assess psychological and socio-behavioral variables. Logistic regression was used to ascertain their effects on mood and memory.

RESULTS

With increasing cognitive deficits, understanding of the pandemic and the ability to follow lockdown policies, adapt to lifestyle changes, and maintain remote interactions decreased. Participants with dementia were more depressed; NOLDs remained physically and mentally active but were more bored and anxious. Sleeping and health problems independently increased the likelihood of depression (OR: 2.29; CI: 1.06-4.93; p = 0.034 and OR: 2.45; CI: 1.16-5.16; p = 0.018, respectively); Regular exercise was protective (OR: 0.30; CI: 0.12-0.72; p = 0.007). Worsening subjective memory complaints were associated with dementia (p = 0.006) and depression (p = 0.004); New-onset sleeping problems raised their odds (OR: 10.26; CI: 1.13-93.41; p = 0.039). Finally, >40% with health problems avoided healthcare mainly due to fear of contagion.

DISCUSSION

NOLD and mild-NCD groups showed similar mood-behavioral profiles suggesting better tolerance of lockdown. Those with dementia were unable to adapt and suffered from depression and cognitive complaints. To counteract lockdown effects, physical and mental activities and digital literacy should be encouraged.

COVID in Context: The Lived Experience of Richmond’s Low-Income Older Adults

Taking a phenomenological approach, this qualitative study describes the lived experiences of low-income older adults during the COVID-19 pandemic. A socio-ecological model was used to organize the five identified themes describing the lived experience: socio-economic context, Black Lives Matter and the politics of race, COVID and polarized views of COVID, interpersonal context (social connections), and individual context (feelings, beliefs, and behaviors). Study findings illustrate the intersectionality of contextual influences on the experience of low-income older adults. Study participants demonstrated remarkable resilience and coping strategies developed in response to the challenges they experienced throughout their lifetime which benefited them when faced with the pandemic, social unrest, and political events that took place in 2020. This study highlights the importance of understanding the larger context of COVID-19 which has significant implications for policy makers and public health leaders.

Social Disconnection and Psychological Distress in Canadian Men During the COVID-19 Pandemic

The COVID-19 pandemic has significantly challenged many men’s mental health. Efforts to control the spread of the virus have led to increasing social disconnection, fueling concerns about its long-term effects on men’s mental health, and more specifically their experience of psychological distress. Social disconnection, psychological distress, and the relationship between them have yet to be formally explored in a Canadian male sample during the COVID-19 pandemic. The present study examined whether reduced social connection among men was associated with increased anxiety and depressive symptoms (psychological distress) and whether this association was moderated by living alone. The sample consisted of 434 help-seeking Canadian men who completed standardized measures. Analyses controlled for the potentially confounding effects of age and fear of COVID-19. Findings revealed that less social connection was associated with increased psychological distress. This association was not moderated by living alone, nor was living alone directly associated with psychological distress. Younger age and fear of COVID-19 were each independently associated with psychological distress. Socially disconnected men were more likely to experience anxiety and depressive symptoms, suggesting the need for interventions focussed on men’s social connectedness, social support, and belongingness to help reduce some COVID-19-induced mental health risks.

The emotional side of post-traumatic stress reaction during COVID-19 pandemic: an Italian survey

Background

Social restrictions due to COVID-19 might have had a significant impact on mental health. The aim of this study was to assess the prevalence of four emotional domains (nervousness, anger, numbness, physiological arousal) in a sample of citizens during the first pandemic wave in 2020, and their association with sociodemographic characteristics, housing conditions and lifestyle modifications.

Methods

A cross-sectional study based on a self-administered online questionnaire was set up to investigate emotions. Respondents were recruited through a non-probabilistic snowball sampling approach. The SPAN questionnaire was used to measure emotions in the interviewed population. The association between emotions and independent variables (gender, age, marital status, educational level, working condition, housing condition, COVID-19 positivity, sleep disturbance, increase in alcohol consumption and decrease in physical activity) was assessed through the multivariate Poisson regression.

Results

A total of 6,675 subjects were included in the analysis. Almost half of respondents (48.9%) experienced nervousness, 41.3% anger, 15.6% numbness and 18.8% physiological arousal. Females were more likely to face nervousness, anger and physiological arousal. For all the outcomes a decreasing trend was observed from younger to older. Singles were more likely to experience numbness compared to married people. Increase in alcohol consumption was associated with nervousness, anger and numbness. Decrease in physical activity was associated with nervousness, anger and physiological arousal. Restless sleep was the variable most associated with all emotional domains.

Conclusions

The first COVID-19 pandemic wave had a significant emotional impact on this sample, especially among younger people, singles and females. Even without reaching clinical relevance, these emotions could represent a form of psychological distress, which requires the implementation of preventive strategies, in particular regarding lifestyle care.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-12749-1.

A Systematic Review and Meta-Analysis of Symptoms of Anxiety, Depression, and Insomnia in Spain in the COVID-19 Crisis

BACKGROUND

General population, frontline healthcare workers (HCWs), and adult students in Spain are at risk of anxiety, depression, and insomnia symptoms during the COVID-19 crisis. A meta-analysis of the individual studies on these symptoms would provide systematic evidence to aid policymakers and researchers in focusing on prevalence, risk, and best interventions.

OBJECTIVE

This paper aims to be the first meta-analysis and systematic review to calculate the prevalence of anxiety, depression, and insomnia symptoms in Spain's adult population (general population, frontline healthcare workers (HCWs), and adult students) during the Covid-19 epidemic.

METHOD

Random-effect meta-analysis was used to estimate the prevalence of anxiety, depression, and insomnia.

RESULTS

The meta-analysis includes 28 studies with 38 individual samples in Spain. The pooled prevalence of anxiety symptoms in 22 studies comprising a sample population of 82,024 was 20% (95% CI: 15-25%), that of depression symptoms in 22 articles with a total sample comprising 82,890 individuals was 22% (95% CI: 18-28%), and that of insomnia symptoms in three articles with a sample population of 745 was 57% (95% CI: 48-66%.

CONCLUSIONS

The accumulative evidence reveals that adults in Spain suffered higher prevalence rates of mental symptoms during the COVID-19 crisis, with a significantly higher rate relative to other countries such as China. Our synthesis also reveals a relative lack of studies on frontline and general HCWs in Spain.

Emotional distress among older adults during the COVID-19 outbreak: understanding the longitudinal psychological impact of the COVID-19 pandemic

BACKGROUND

Older adults have proven their ability to overcome adversities throughout their life. This study aims to assess the impact of the COVID-19 pandemic on older adults' psychological distress (anxiety and depression) over time.

METHODS

A community-dwelling Spaniard population (N = 192) completed a survey and reported on their sociodemographic characteristics, appraisal and personal resources. Older adults took part in a longitudinal online survey collected in April 2020 (during the lockdown restrictions) and at two subsequent time points 3 and 9 months after baseline (without lockdown restrictions and during the third wave of the pandemic respectively).

RESULTS

Older adults did not evidence higher emotional distress than during the initial lockdown. Furthermore, depression remained stable and anxiety significantly decreased. Results also suggest that some sociodemographic characteristics, appraisals and personal resources are relevant. Older participants showed less anxiety than younger ones. Furthermore, being a male, resilience, and acceptance were related with the decrease of anxiety. Otherwise, fear of the COVID-19 outbreak and depression were related with the increase of anxiety.

CONCLUSION

Older adults may adapt to the adverse pandemic impact by using more adaptive resources that reduce their distress. Efforts to ameliorate older adults' anxiety by focusing on older adults' personal resources should be considered.

Mental Health and Social Connectedness Across the Adult Lifespan in the Context of the COVID-19 Pandemic

The coronavirus disease (COVID-19) pandemic has had profound consequences on collective mental health and well-being, and yet, older adults appear better off than younger adults. The current study examined mental health impacts of the pandemic across adult age groups in a large sample (n = 5,320) of Canadians using multiple hierarchical regression analyses. Results suggest older adults are experiencing better mental health and more social connectedness relative to younger adults. Loneliness predicted negative mental health outcomes across all age groups, while the negative association between social support and mental health was only significant at average and high levels of loneliness in the 65–69 age group. Results point towards differential mental health impacts of the pandemic across adult age groups and indicate that loneliness and social support may be key intervention targets during the COVID-19 pandemic. Future research should further examine mechanisms of resiliency among older Canadian adults during the pandemic.

Mental health and factors related to life satisfaction in nursing home and community-dwelling older adults during COVID-19 pandemic in Turkey

BACKGROUND

The geriatric population is supposed to be at high risk for psychological distress as well as adverse outcomes and mortality during the COVID-19 pandemic. This study aimed to investigate the levels of depression, anxiety, death anxiety and life satisfaction levels and factors related to life satisfaction in individuals aged 65 years and older during the pandemic and to compare these variables between nursing home (NH) and community-dwelling older adults.

METHOD

This study has a cross-sectional and descriptive design, and a total of 133 nursing NH and community-dwelling older adults were enrolled in the study. Turkish death anxiety scale (TDAS), life satisfaction scale (SLS) and depression anxiety stress scale-21 (DASS-21) were used for the assessment.

RESULTS

The majority of the older adults had no or mild depression, anxiety and stress symptoms in spite of the prolonged confinements, and were slightly satisfied with their lives. However, depression, anxiety, stress and TDAS levels were higher in participants aged 80 years and older. Residents of NHs had higher TDAS, depression and anxiety levels and lower SLS levels than community-dwelling older adults. Participants who were meeting their children and/or grandchildren less than 2 h a week, were found to have significantly lower SLS and higher depression scores. The increase in depression and TDAS scores predicted a decrease in SLS scores in older adults.

CONCLUSIONS

As NH resident older adults have higher psychological distress and decreased life satisfaction due to the social isolation caused by the prolonged confinements, NH staff should be regularly informed on both preventive measures and mental health consequences of the pandemic, and should be trained for basic therapeutic interventions. Older adults should be supported to use telecommunication technologies to contact their families and friends, and participate in safe and accessible person-centred activity programs.

Predictors of Anxiety, Stress, and Concern of COVID-19 Infection in Older Adults During the First and the Second Waves of the COVID-19 Pandemic in Slovakia

OBJECTIVES

This cross-sectional online study examined the role of socio-demographic and psychological characteristics in predicting anxiety, stress, and concern of coronavirus (COVID-19) infection in older adults during the first and second waves of the COVID-19 pandemic in Slovakia.

METHODS

Six hundred and seven older adults (Sample 1) and 156 older adults (Sample 2) participated in the study during the first and second waves of the COVID-19 pandemic, respectively. The older adults completed a battery of validated instruments for anxiety, stress, concern of COVID-19 infection (outcome variables), satisfaction with health, perceived danger of COVID-19, loneliness, intolerance of uncertainty (IU), optimism, powerlessness, and coping self-efficacy (predictor variables). The data were analyzed using multiple linear regression.

RESULTS

The older adults in both samples experienced moderate levels of anxiety, stress, and concern of COVID-19 infection. The greatest amount of variability in anxiety and stress was explained by powerlessness, IU, optimism, and coping self-efficacy. Concern of COVID-19 infection was best predicted by the perceived danger of COVID-19.

CONCLUSION

The findings contribute to the existing knowledge about the mental health of older adults during the COVID-19 pandemic and highlight the role of the psychological predictors of anxiety, stress, and concern of COVID-19 infection during both waves.

Comparison of the Mental Health Impact of COVID-19 on Vulnerable and Non-Vulnerable Groups: A Systematic Review and Meta-Analysis of Observational Studies

Vulnerable populations may be more vulnerable to mental health problems posed by the coronavirus disease 2019 (COVID-19) pandemic. A systematic review was performed to compare the mental health impact of COVID-19 between vulnerable and non-vulnerable groups. Five electronic databases were searched for observational studies reporting the psychological outcomes of both vulnerable populations and healthy controls during the COVID-19 era. The primary outcomes are the severity of depression and anxiety, and secondary outcomes include other aspects of mental health such as stress or sleep disturbance. Meta-analysis was performed for the severity of mental health symptoms, and the results were presented as standardized mean difference and 95% confidence intervals. A total of 25 studies were included. According to the findings, the elderly generally experienced significantly lower levels of psychological symptoms including depression, anxiety, and perceived stress. Pregnant women, patients with chronic diseases, and patients with pre-existing severe mental disorders showed mixed results according to each mental health outcome. The results indicate that vulnerable groups have been affected differently in the COVID-19 era. Though the insufficient number and heterogeneity of included studies leave the results inconclusive, our findings may contribute to identifying priorities of mental health needs among various vulnerable populations and allocating health resources with efficiency.

Development and Validation of the Robust - Pandemic Coping Scale (R-PCS)

The psychological consequences of epidemics/pandemics, such as the COVID-19 pandemic, include an increase in psychopathological symptoms, such as depression, anxiety, and stress, and negative emotions, such as fear. However, relatively little attention has been paid to how people cope with the pandemic. Coping is a multi-component process, helping to diminish the traumatic impact of stressful events in a variety of ways. We studied how university students coped with the first wave of the COVID-19 pandemic, by developing the Robust - Pandemic Coping Scale (R-PCS), a new scale for measuring coping strategies related to epidemics/pandemics. The scale is based on a classification of coping strategies referred to the needs of competence, relatedness, and autonomy. To create a robust scale, such that the item values would be independent of the sample used for developing it, we employed Rasch modeling. We used a sample of 2,987 Italian university students who participated in an online survey including the R-PCS and the Power to Live with Disasters Questionnaire (PLDQ), during March 2020. First, we applied a dual approach combining exploratory and confirmatory factor analyses, which supported the goodness of a 4-factor model (i.e., Despair, Adjustment, Proactivity, and Aversion) for the R-PCS, invariant across gender and age of respondents (younger or as old as 23 years, older than 23 years). We then transformed the raw scores of the R-PCS into interval logit scale scores applying the Rasch model. Second, our findings supported the discriminant validity and the criterion validity of the R-PCS, examining the correlations with the PLDQ. They also confirmed its predictive validity: the R-PCS scores were related to 2-month-later enjoyment and anger, indicating that Adjustment and Proactivity were adaptive while Despair and Aversion were maladaptive. Third, our study revealed gender and age differences: the scores were higher for Despair, Adjustment, and Proactivity for females; for Aversion for males; and for Proactivity for students older than 23 years. The study suffers from limitations related to social desirability, gender imbalance, and self-selection effects in the recruitment.

Older Adults in the United States and COVID-19: A Qualitative Study of Perceptions, Finances, Coping, and Emotions

Introduction: Older adults have the poorest coronavirus (COVID-19) prognosis with the highest risk of death due to complications, making their COVID-19 experiences particularly important. Guided by the stress-appraisal-coping theoretical model, we sought to understand COVID-related perceptions and behaviors of older adults residing in the United States. Materials and Methods: We used convenience sampling to recruit persons with the following inclusion criteria: Aged ≥ 65 years, English fluency, and U.S. residency. Semi structured in-depth interviews were conducted remotely and audio recorded between April 25, 2020 and May 7, 2020. Interviews were professionally transcribed with a final study sample of 43. A low-inference qualitative descriptive design was used to provide a situated understanding of participants' life experiences using their naturalistic expressions. Results: The mean age of participants was 72.4 ± 6.7. Slightly over half were female (55.8%), 90.6% were White, and 18.6% lived alone. The largest percentages of participants resided in a rural area (27.9%) or small city (25.6%). We identified four themes, including (1) risk perception, (2) financial impact, (3) coping, and (4) emotions. Most participants were aware of their greater risk for poor COVID-19 outcomes but many did not believe in their increased risk. Financial circumstances because of the pandemic varied with largely no financial impacts, while others reported negative impacts and a few reported positive impacts. Coping was problem- and emotion-focused. Problem-focused coping included precautionary efforts and emotion-focused coping included creating daily structure, pursuing new and/or creative activities, connecting with others in new ways, and minimizing news media exposure. Overall, emotional health was negatively affected by the pandemic although some participants reported positive emotional experiences. Conclusions: Perceiving themselves as high risk for COVID-19 complications, older adults used precautionary measures to protect themselves from contracting the virus. The precautionary measures included social isolation, which can negatively affect mental health. Older adults will need to be resourceful and draw on existing resources to cope, such as engaging in creative activities and new strategies to connect with others. Our findings underscore the importance of the preservation of mental health during extended periods of isolation by taking advantage of low-to-no-cost existing resources.

Perceived fear of COVID-19 and its associated factors among Nepalese older adults in eastern Nepal: A cross-sectional study

BACKGROUND

Coronavirus disease 2019 (COVID-19) has affected all age groups worldwide, but older adults have been affected greatly with an increased risk of severe illness and mortality. Nepal is struggling with the COVID-19 pandemic. The normal life of older adults, one of the vulnerable populations to COVID-19 infection, has been primarily impacted. The current evidence shows that the COVID-19 virus strains are deadly, and non-compliance to standard protocols can have serious consequences, increasing fear among older adults. This study assessed the perceived fear of COVID-19 and associated factors among older adults in eastern Nepal.

METHODS

A cross-sectional study was conducted between July and September 2020 among 847 older adults (≥60 years) residing in three districts of eastern Nepal. Perceived fear of COVID-19 was measured using the seven-item Fear of COVID-19 Scale (FCV-19S). Multivariate logistic regression identified the factors associated with COVID-19 fear.

RESULTS

The mean score of the FCV-19S was 18.1 (SD = 5.2), and a sizeable proportion of older adults, ranging between 12%-34%, agreed with the seven items of the fear scale. Increasing age, Dalit ethnicity, remoteness to the health facility, and being concerned or overwhelmed with the COVID-19 were associated with greater fear of COVID-19. In contrast, preexisting health conditions were inversely associated with fear.

CONCLUSION

Greater fear of the COVID-19 among the older adults in eastern Nepal suggests that during unprecedented times such as the current pandemic, the psychological needs of older adults should be prioritized. Establishing and integrating community-level mental health support as a part of the COVID-19 preparedness and response plan might help to combat COVID-19 fear among them.

Prospective Memory and Positivity Bias in the COVID-19 Health Crisis: The Effects of Aging

This study aimed to determine whether the observed tendency to remember more positive than negative past events (positivity phenomena) also appears when recalling hypothetical events about the future. In this study, young, middle-aged, and older adults were presented with 28 statements about the future associated with the COVID-19 pandemic, half positive and half negative. In addition, half of these statements were endowed with personal implications while the other half had a more social connotations. Participants rated their agreement/disagreement with each statement and, after a distraction task, they recalled as many statements as possible. There was no difference in the agreement ratings between the three age groups, but the participants agreed with positive statements more than with negative ones and they identified more with statements of social content than of personal content. The younger and older individuals recalled more statements than the middle-aged people. More importantly, older participants recalled more positive than negative statements (positivity effect), and showed a greater tendency to turn negative statements into more positive or neutral ones (positivity bias). These findings showed that the positivity effect occurs in even such complex and situations as the present pandemic, especially in older adults. The results are discussed by reference to the notion of commission errors and false memories resulting from the activation of cognitive biases.

A review on the COVID-19-related psychological impact on older adults: vulnerable or not?

BACKGROUND

COVID-19 is a novel event of the twenty-first century. Therefore, contemporary research is required to determine the current pandemic's psychological impact on older populations. Soon after the COVID-19 outbreak, several narrative reviews and guidelines were released to support older adult's psychological wellbeing. However, a lack of data from original studies was reported until May 2020.

AIM

To identify studies published from May 2020 until January 2021 that quantitatively assessed the mental health impact of COVID-19 on older adults using validated psychometric tools.

METHOD

A comprehensive literature search of original research articles was conducted using specific terms. The screening procedure was conducted stepwise.

RESULTS

Among the 18 included studies, cross-sectional online surveys indicated that older adults were less psychologically distressed than younger ones. A longitudinal study revealed that COVID-19 did not have a major impact on loneliness and satisfaction with life. On the contrary, studies comparing pre- with peri-pandemic data revealed that older adults experienced more severe depressive/anxiety/stress symptoms and loneliness during the pandemic. Several studies reported though only subclinical symptoms, as well as low loneliness levels during the pandemic.

CONCLUSIONS

Research studies suggested that older age may buffer against the COVID-19-related impact on mental health. Despite evidence against generalised perceptions of vulnerability, older adults' ability to adapt to adversity may be uneven, depending on cultural, social, economic and other individual factors. Taken together, the impact, moreover the long-term impact of COVID-19, is expected to vary across countries and older subpopulations, and remains to be evaluated by prospective, longitudinal studies.

The Evolution in Anxiety and Depression with the Progression of the Pandemic in Adult Populations from Eight Countries and Four Continents

Nearly a year after the classification of the COVID-19 outbreak as a global pandemic, it is clear that different factors have contributed to an increase in psychological disorders, including public health measures that infringe on personal freedoms, growing financial losses, and conflicting messages. This study examined the evolution of psychosocial impacts with the progression of the pandemic in adult populations from different countries and continents, and identified, among a wide range of individual and country-level factors, which ones are contributing to this evolving psychological response. An online survey was conducted in May/June 2020 and in November 2020, among a sample of 17,833 adults (Phase 1: 8806; Phase 2: 9027) from eight countries/regions (Canada, the United States, England, Switzerland, Belgium, Hong Kong, the Philippines, New Zealand). Probable generalized anxiety disorder (GAD) and major depressive episode (MDE) were assessed. The independent role of potential factors was examined using multilevel logistic regression. Probable GAD or MDE was indicated by 30.1% and 32.5% of the respondents during phases 1 and 2, respectively (a 7.9% increase over time), with an important variation according to countries/regions (range from 22.3% in Switzerland to 38.8% in the Philippines). This proportion exceeded 50% among young adults (18-24 years old) in all countries except for Switzerland. Beyond young age, several factors negatively influenced mental health in times of pandemic; important factors were found, including weak sense of coherence (adjusted odds ratio aOR = 3.89), false beliefs (aOR = 2.33), and self-isolation/quarantine (aOR = 2.01). The world has entered a new era dominated by psychological suffering and rising demand for mental health interventions, along a continuum from health promotion to specialized healthcare. More than ever, we need to innovate and build interventions aimed at strengthening key protective factors, such as sense of coherence, in the fight against the adversity caused by the concurrent pandemic and infodemic.

Psychological distress during COVID-19 pandemic in low-income and middle-income countries: a cross-sectional study of older persons in Thailand

OBJECTIVE

The COVID-19 situation in Thailand was controlled with various social measures. Much of the information covered in the media and in studies focused on the public health and economic aspects of the pandemic. This study aimed to explore the psychological well-being of older people, which is important especially in an ageing society categorised as low income or middle income due to the limits of economic and healthcare resources.

SETTING

The impact of COVID-19 on older persons in Thailand, an online survey, taken across nine provinces within the five regions of the country.

PARTICIPANTS

Information was collected from 1230 adults aged at least 60 years old.If an older person was illiterate, unable to access the internet or had a disability preventing them from responding to the survey, an intermediary residing in the community conducted the survey interview.

PRIMARY AND SECONDARY OUTCOME MEASURES

The analysis focused on the worries of older adults and the factors associated with psychological distress experienced during the pandemic using logistic regression analysis.

RESULTS

The majority of people aged at least 60 years old experienced psychological distress during COVID-19. Employment loss (OR 1.08, 95% CI 0.78 to 1.38), inadequate income (OR 1.77, 95% CI 1.28 to 2.44) and debt incursion (OR 2.74, 95% CI 1.57 to 4.80) were detrimental to psychological well-being. The negative changes in the perception of their health status (OR 1.92, 95% CI 1.23 to 2.99) and decreased life satisfaction (OR 1.49, 95% CI 0.45 to 1.87) also weighed on older Thais. The protective factors for psychological well-being were residing in rural areas (OR 0.46, 95% CI 0.35 to 0.61) and being married (OR 0.75, 95% CI 0.55 to 1.01).

CONCLUSION

Observing the concerns of the older population is important for introducing policies that can alleviate their precarious financial and health statuses.

Managing COVID-19 related distress in primary care: principles of assessment and management

COVID-19 will cause normal feelings of worry and stress and many of those who experience higher levels of distress will experience resolution of their symptoms as society returns to pre-COVID-19 functioning. Only a minority are likely to develop a psychiatric disorder. Certain individuals may be vulnerable to experiencing persisting symptoms, such as those with pre-existing comorbidity. Management approaches could centre around using collaborative approaches to provide and build on already existing socioeconomic support structures, the avoidance of over-medicalisation, watchful waiting and finally treating those who do meet the criteria for psychiatric diagnosis. Primary care clinicians are likely be the first healthcare point of contact for most COVID-19 related distress and it is important that they are able to provide evidence based and evidence informed responses, which includes social, psychological and pharmacological approaches. This expert opinion paper serves to summarise some approaches, based primarily on indirect extrapolation of evidence concerning the general management of psychological distress, in the absence of COVID-19 specific evidence, to assist primary care clinicians in their assessment and management of COVID-19 related distress.