The Impact of the COVID-19 Pandemic on the Mental Health of Older Primary Care Patients and Their Family Members

Relationship between health-related quality of life, depression, and anxiety in older primary care patients and their family members

OBJECTIVES

Patient-family member dyads experience transitions through illness as an interdependent team. This study measures the association of depression, anxiety, and health-related quality of life (HRQOL) of older adult primary care patient-family member dyads.

METHODS

Baseline data from 1,808 patient-family member dyads enrolled in a trial testing early detection of Alzheimer's disease and related dementias in primary care. Actor-Partner Independence Model was used to analyze dyadic relationships between patients' and family members' depression (PHQ-9), anxiety (GAD-7), and HRQOL (SF-36 Physical Component Summary score and Mental Component Summary score).

RESULTS

Family member mean (SD) age is 64.2 (13) years; 32.2% male; 84.6% White; and 64.8% being the patient's spouse/partner. Patient mean (SD) age is 73.7 (5.7) years; 47% male; and 85.1% White. For HRQOL, there were significant actor effects for patient and family member depression alone and depression and anxiety together on their own HRQOL (p < 0.001). There were significant partner effects where family member depression combined with anxiety was associated with the patient's physical component summary score of the SF-36 (p = 0.010), and where the family member's anxiety alone was associated with the patient's mental component summary score of the SF-36 (p = 0.031).

CONCLUSION

Results from this study reveal that many dyads experience covarying health status (e.g. depression, anxiety) even prior to entering a caregiving situation.

COVID-19 Narratives from Those with Chronic Illness

Older, chronically ill adults already at risk for social isolation experienced exacerbated isolation due these COVID-19 interventions. This study aimed to describe the narratives of older adults with chronic illness during COVID-19, connect them to the broader literature and use them as exemplars for a holistic analysis of policies for respiratory pandemics. Using narratives related to COVID-19 experiences from a larger research study on spiritual coping with chronic heart failure, the study rendered the themes of isolation, uncertainty, and making the best of it which were connected to additional literature validating the experiences of the participants. The narratives and their themes were then used as a launching point for a holistic analysis of the pandemic response and its effects on well-being for older adults. Clinicians and policymakers should carefully consider not just the physical health burden of a respiratory pandemic on older, chronically, ill adults, but also the holistic health burdens of policies. With these broader health domain considerations in mind ethical and practical recommendations future responses to viral respiratory pandemics are offered.

Is a plant-based diet effective to maintain a good psycho-affective status in old age? Results of a survey of a long-lived population from Sardinia

BACKGROUND

Depression is common among the elderly, resulting in poor quality of life and elevated healthcare expenditure. Among other factors, dietary habits could also affect this condition, although the specific food patterns involved remain to be established. The present study aimed to assess the role of plant- versus animal-dominant foods consumption on the affective state of nonagenarians from a Sardinian population, Italy, well known for its longevity (Blue Zone).

METHODS

Data, including demographic, education, anthropometric parameters, monthly income, and comorbidity were recorded and analyzed. Symptomatic depression was assessed using the Geriatric Depression Scale (GDS) during a comprehensive home geriatric assessment; nutritional status was evaluated by a validated food frequency questionnaire.

RESULTS

A total of 200 elderly subjects living in the Sardinian Blue Zone (mean age 93.9 ± 3.9 years) participated in the study; symptomatic depression was present in 51% of the whole cohort and was more common among women. Multivariable logistic regression showed a significantly greater risk of depression in people consuming plantbased foods (OR = 1.42, 95% CI 1.04-1.93), whereas moderate animal-derived foods consumption was associated with a better affective state (OR = 0.79, 95% CI 0.62-0.98).

CONCLUSIONS

These findings indicate that a more balanced diet, including animal-derived foods, instead of an exclusive plant-dominant diet, may be more appropriate in the elderly, and abstention from animal-based food intake should not be recommended in advanced age to prevent depression.