Impact of Sex on COVID-19 Media Exposure, Anxiety, Perceived Risk, and Severity in Middle-Aged and Older Adults

Socio-economic inequalities in the breadth of internet use before and during the COVID-19 pandemic among older adults in England

Understanding digital exclusion in older adults during the COVID-19 pandemic could help tailor responses to future outbreaks. This cohort study used data from older adults aged 60+ years in England who participated in wave nine (2018/2019) of the main English Longitudinal Study of Ageing (ELSA) survey, and/or wave one of the ELSA COVID-19 sub-study (June/July 2020). Using latent class analysis and latent transition analysis, we aimed to identify distinct subgroups of older adults characterised by different patterns of internet use pre- and intra-pandemic, explore the extent to which individuals remained in the same subgroup or transitioned to a different subgroup during the COVID-19 pandemic, and examine longitudinal associations of socio-economic factors (education, occupational class, and wealth) with latent class membership. Preliminary tests showed that the types of internet activities differed between men and women; therefore, subsequent analyses were stratified by biological sex. Three clusters (low, medium, and high) were identified in male participants at both timepoints. Among female participants, three clusters were distinguished pre-pandemic and two (low versus high) during the pandemic. The latent classes were characterised by participants' breadth of internet use. Higher education, occupational class, and wealth were associated with greater odds of membership in the medium and/or high classes, versus the low class, in men and women. A high degree of stability in latent class membership was observed over time. However, men experienced a stark decrease in online health information-seeking. Our results highlight that inequality regarding the range of functional and social opportunities provided by the internet prevailed during the pandemic. Policymakers should ensure that digital access and upskilling initiatives are equitable for all.

Mid-to-Late-Life Anxiety and Sleep during Initial Phase of COVID-19: Age- and Sex-Specific Insights to Inform Future Pandemic Healthcare

This study examined associations between COVID-19-related anxiety and sleep in middle-aged and older adults and tested whether these varied by age or sex. In June/July 2020, middle-aged/older adults aged 50+ (n = 277, 45% women, Mage = 64.68 ± 7.83) in the United States completed measures of sleep and COVID-19-related anxiety. Multiple regressions examined whether anxiety was independently associated with or interacted with age or sex in its associations with sleep health, controlling for age, education, medical conditions, sleep/pain medication use, and COVID-19 status. Greater COVID-19 anxiety was associated with worse sleep quality and daytime dysfunction. COVID-19-related anxiety interacted with age (not sex) in associations with total sleep time and sleep efficiency. Greater anxiety was associated with shorter total sleep time and lower sleep efficiency in oldest-older adults (~73 years old) and youngest-older adults (~65 years old) but not middle-aged adults (~57 years old). In mid to late life, older adults may be most vulnerable to the impact of COVID-19-related anxiety on sleep health. Social and behavioral (e.g., knowledge on age-related vulnerability to COVID-19 risk/morbidity/mortality, uncertainty, and changes to daily routines) and physiological factors (sleep disruption and age-related autonomic dysfunction) may underlie these associations. Interventions that mitigate negative pandemic-related psychological and sleep outcomes may be particularly relevant for older adults.

A Precautionary Tale: Individual Decision Making in the Time of COVID-19

Precaution taking is an important part of managing COVID-19 and has been since the start of the pandemic. Guided by the Health Belief Model, two studies conducted during the beginning of the COVID-19 pandemic aimed to identify possible individual difference predictors of precautionary actions. Study 1 was an online, cross-sectional study using 763 adults aged 20-79 years old. Study 2, a 30-day daily diary study, examined daily precautions in 261 persons over the age of 55 years old. Study 1 and Study 2 indicated that COVID-19 knowledge predicted precautionary behaviors. Multilevel models from Study 2 indicated that daily increases in in-person interactions and leaving home were associated with decreases in precautions, but increases in disruption to routine were associated with increases in precautions. In both studies, including concurrent and lagged models in Study 2, significant interactions between information seeking and perceived risk suggested higher information seeking was related to higher precautions for those who consider themselves low risk. Findings highlight the burden of daily precautions and potentially modifiable factors of engagement in precautions.

Media consumption and psychological distress among older adults in the United States

The consumption of news media covering national and global events, particularly those that invoke fear or worry, such as pandemics or terrorist attacks, may affect older adults' mental wellbeing. Using the COVID-19 pandemic as a case study, this research analyzes nationally representative data from older adults in the US to address the following research questions: (1) What is the relationship between COVID-19-based media consumption and psychological distress? (2) Does any relationship between media consumption and psychological distress vary by gender, race/ethnicity, education, and marital status? Results indicate that (1) older adults who closely followed the news about the pandemic scored higher on psychological distress than those following less closely and (2) this relationship was more pronounced among Hispanic older adults. These findings are contextualized in the broader stress process model with a focus on a macro-level stressor and differential exposure and vulnerability resulting in variability in the relationship between the stressor and psychological distress.

Sex differences in associations between alcohol use and sleep in mid-to-late life

OBJECTIVES

To examine associations between alcohol use and sleep in middled-aged/older adults and to test sex as a moderator of this relationship.

METHODS

Participants were 183 adults (46% female) ages 50 and above who consumed alcohol in the past year. Linear regressions tested sex as a moderator of associations between alcohol use and sleep parameters. Alcohol use was measured using the Alcohol Use Disorders Identification Test (AUDIT). Overall sleep health and sleep quality were assessed using the Pittsburgh Sleep Quality Index (PSQI), and pre-sleep arousal was assessed using the Pre-Sleep Arousal Scale.

RESULTS

Overall, 11% of participants screened positive for hazardous drinking (AUDIT scores of 7+/8+ for women/men), and 59% reported poor overall sleep health (scores >5 on the PSQI). Alcohol use was not associated with overall sleep health (B = -0.25, p = .08) or pre-sleep arousal (B = 0.15, p = .64). However, contrary to hypotheses, more hazardous drinking was associated with better subjective sleep quality, only among women (B = -0.08, p = .009). Alcohol use was not associated with sleep quality among men (B = 0.01, p = .58). Associations remained significant when controlling for age, symptoms of anxiety and depression, body mass index, use of sleep medication, number of medical conditions, and chronic pain.

CONCLUSIONS

Among middle-aged and older adults, alcohol use is more strongly associated with sleep patterns among women than men, when assessed concurrently (i.e., at the same time point). Findings support the need for further consideration of sex differences in associations between alcohol use and sleep.

The interplay between cognitive and affective risks in predicting COVID-19 precautions: a longitudinal representative study of Americans

OBJECTIVE

Cognitive risk figures prominently in models predicting health behaviors, but affective risk is also important. We examined the interplay between cognitive risk (personal likelihood of COVID-19 infection or death) and affective risk (worry about COVID-19) in predicting COVID-19 precautionary behaviors. We also examined how outbreak severity bias (overestimation of the severity of COVID-19 in one's community) predicted these outcomes.

DESIGN

In a representative sample of U.S. adults (N = 738; M_age = 46.8; 52% women; 78% white), participants who had not had COVID-19 took two online surveys two weeks apart in April 2020.

MAIN OUTCOME MEASURES

We assessed cognitive risk, affective risk, and outbreak severity bias at baseline and at follow-up two precaution variables: prevention behaviors (e.g. social distancing) and behavioral willingness (e.g. vaccinations).

RESULTS

Overall, affective risk better predicted precautions than cognitive risk. Moreover, overestimating the severity of the outbreak predicted more affective risk (but not cognitive risk) and in turn more precautions. Additional analyses showed that when affective risk was lower (as opposed to higher) greater cognitive risk and outbreak severity bias both predicted more precautions.

CONCLUSION

These findings illustrate the importance of affective risk and outbreak severity bias in understanding COVID-19 precautionary behavior.

Anxiety among older adults during the COVID-19 pandemic

A growing body of research examines the COVID-19 pandemic's effects on well-being. Only few studies focus on older adults or explore the predictors of COVID-19-related anxiety. Intolerance of uncertainty (IU) and some behaviors (e.g., avoidance, procrastination) are linked to anxiety among older adults and could both be relevant to consider in a pandemic context. This study measured the occurrence and anxiety levels among older adults and verified the possible role of IU and behaviors in predicting anxiety symptoms, impairment and distress related to COVID-19 health standards. It also examined the indirect effect of IU on symptoms, impairment and distress through behaviors. Participants aged 60 and over (N = 356) were recruited and administered questionnaires. Anxiety levels and symptom impairment were high and appeared to have increased since the beginning of the pandemic. IU and behavioral manifestations of anxiety were associated with higher anxiety symptoms, impairment and distress related to COVID-19 health standards. The indirect effects of IU on the tendency to worry and COVID-19-related anxiety through behavioral manifestations of anxiety were confirmed. This study provides knowledge on the relationship between COVID-19 and anxiety in older adults and identifies predictors relevant to this population.

Effects of COVID-19-related psychological distress and anxiety on quality of sleep and life in healthcare workers in Iran and three European countries

Introduction

The COVID-19 pandemic has considerably affected human beings most of whom are healthcare workers (HCWs) combating the disease in the front line.

Methods

This cross-sectional study aims to explore the effects of stress and anxiety caused by COVID-19 on the quality of sleep and life in HCWs, including physicians, nurses, and other healthcare staff. In this global study, we asked 1,210 HCWs (620 and 590 volunteers from Iran and European countries, including Germany, the Netherlands, and Italy, respectively), who age 21-70, to participate in the test. Several measures of COVID-related stress, anxiety, sleep, and life quality, including the 12-item General Health Questionnaire (GHQ-12), Fear of COVID-19 scale (FCV-19S), Beck Anxiety Inventory (BAI), the Pittsburgh Sleep Quality Index (PSQI), and World Health Organization Quality of Life-BREF (WHOQOL-BREF) are recorded.

Results

Volunteers reported high rates of stress and anxiety and poor sleep quality as well as lower quality of life. The correlation analysis between the measures is reported. According to the results, regardless of the location, HCWs, predominantly female nurses, developed anxiety and stress symptoms which consequently resulted in lower sleep and life quality. Both for Iranian and the European HCWs, significant differences existed between nurses and the other two groups, with the p-values equal to 0.0357 and 0.0429 for GHQ-12, 0.0368, and 0.714 for BAI measure. Even though nurses reported the most stress, anxiety, fear of COVID-19, lower quality of life and sleep in both countries, and also an increase in other measures as well, there existed no statistically significant difference in FCV-19S, PSQI, and WHOQOL-BREF.

Discussion

This study helps to expand our knowledge the effects of pandemics on HCWs and also for healthcare management to predict HCW's mental health conditions in similar situations.

Perceived risk of infection and death from COVID-19 among community members of low- and middle-income countries: A cross-sectional study

Background: Risk perceptions of coronavirus disease 2019 (COVID-19) are considered important as they impact community health behaviors. The aim of this study was to determine the perceived risk of infection and death due to COVID-19 and to assess the factors associated with such risk perceptions among community members in low- and middle-income countries (LMICs) in Africa, Asia, and South America.

Methods: An online cross-sectional study was conducted in 10 LMICs in Africa, Asia, and South America from February to May 2021. A questionnaire was utilized to assess the perceived risk of infection and death from COVID-19 and its plausible determinants. A logistic regression model was used to identify the factors associated with such risk perceptions.

Results: A total of 1,646 responses were included in the analysis of the perceived risk of becoming infected and dying from COVID-19. Our data suggested that 36.4% of participants had a high perceived risk of COVID-19 infection, while only 22.4% had a perceived risk of dying from COVID-19. Being a woman, working in healthcare-related sectors, contracting pulmonary disease, knowing people in the immediate social environment who are or have been infected with COVID-19, as well as seeing or reading about individuals infected with COVID-19 on social media or TV were all associated with a higher perceived risk of becoming infected with COVID-19. In addition, being a woman, elderly, having heart disease and pulmonary disease, knowing people in the immediate social environment who are or have been infected with COVID-19, and seeing or reading about individuals infected with COVID-19 on social media or TV had a higher perceived risk of dying from COVID-19.

Conclusions: The perceived risk of infection and death due to COVID-19 are relatively low among respondents; this suggests the need to conduct health campaigns to disseminate knowledge and information on the ongoing pandemic.