Abstract P255: Risk Factors for Incident Depressive Symptoms During the COVID-19 Pandemic Among Multi-Ethnic Older Adults: The Multi-Ethnic Study of Atherosclerosis (MESA)

Abstract

Objectives: The COVID-19 pandemic has been associated with an increase in the prevalence of depression symptoms among young adults in the US. We examined the impact of the pandemic on the prevalence and incidence of depression symptoms, and related sociodemographic and cardiovascular risk factors, among older adults in a US general population-based sample. Methods: The Multi-Ethnic Study of Atherosclerosis (MESA) is a longitudinal cohort study that recruited participants who were 45-84 years old and without cardiovascular disease in 2000-02. Depression symptoms were assessed using the Center for Epidemiologic Studies depression scale (CES-D-10), during the pandemic (2021-2022) and pre- pandemic (2010-2011). We examined depressive symptoms in individuals with scores in both time periods. Incident depressive symptoms were defined as a CES-D-10 score ≥10 among participants with a CES-D-10 score <10 on pre-pandemic assessment. Risk factors for increases in CES-D-10 score and incident depressive symptoms, were examined by linear and logistic regression, respectively, adjusting for socio-demographic factors, health behaviors, and clinical characteristics. Results: Pre-pandemic and pandemic era CES-D-10 measures were available in 1602 MESA participants with mean age 75 years including 895 (55 %) women, who self-reported race/ethnicity as Non-Hispanic White (42%), Chinese (15%), Black (22%), or Hispanic (21%). The prevalence of depressive symptoms was 13.6% during the pre-pandemic period and 15.8% during the pandemic, and there were 180 incident cases of depressive symptoms (13%). After adjustment, significant increases in CES-D-10 scores were observed in women (+1.2, P<.001) and participants with lower education (less than high school versus college, +1.1, P=.03). Incident depressive symptoms were associated with female sex (aOR=2.16, p<0.001) and current smoking (aOR=2.04, p=0.03). Incident depressive symptoms were modestly yet not significantly associated with moderate to severe COVID-19 infection (aOR=1.88, p=.06). We did not find hypertension or diabetes to be significantly associated with worsening or incident depression symptoms. Conclusions: The prevalence of depressive symptoms increased modestly during the COVID-19 pandemic, compared to assessments one decade earlier, in a sample of multi-ethnic older adults. Greater risk of incident or worsening depressive symptoms was observed in women and current smokers. Additional research is needed on how pandemic-era depressive symptoms could affect future cardiovascular health.