Abstract
The COVID-19 pandemic is imposing a profound negative impact on the health and wellbeing of societies and individuals, worldwide. One concern is the effect of social isolation as a result of social distancing on the mental health of vulnerable populations, including older people. Within six weeks of lockdown, we initiated the CHARIOT COVID-19 Rapid Response Study, a bespoke survey of cognitively healthy older people living in London, to investigate the impact of COVID-19 and associated social isolation on mental and physical wellbeing. The sample was drawn from CHARIOT, a register of people over 50 who have consented to be contacted for aging related research. A total of 7,127 men and women (mean age=70.7 [SD=7.4]) participated in the baseline survey, May–July 2020. Participants were asked about changes to the 14 components of the Hospital Anxiety Depression scale (HADS) after lockdown was introduced in the UK, on 23rd March. A total of 12.8% of participants reported feeling worse on the depression components of HADS (7.8% men and 17.3% women) and 12.3% reported feeling worse on the anxiety components (7.8% men and 16.5% women). Fewer participants reported feeling improved (1.5% for depression and 4.9% for anxiety). Women, younger participants, those single/widowed/divorced, reporting poor sleep, feelings of loneliness and who reported living alone were more likely to indicate feeling worse on both the depression and/or anxiety components of the HADS. There was a significant negative association between subjective loneliness and worsened components of both depression (OR 17.24, 95% CI 13.20, 22.50) and anxiety (OR 10.85, 95% CI 8.39, 14.03). Results may inform targeted interventions and help guide policy recommendations in reducing the effects of social isolation related to the pandemic, and beyond, on the mental health of older people.
Highlights
With unprecedented population aging; the consequences of social isolation on the mental wellbeing of older people is emerging as a significant public health concern, exacerbated by the COVID-19 pandemic [1, 2]
12.8% of participants reported feeling worse on components of depression on the Hospital Anxiety Depression scale (HADS) and 12.3% reported feeling worse on components of anxiety
There was a substantially higher proportion of women scoring abnormal on the HADS depression and anxiety assessment, and who reported feeling worse in components of anxiety and depression post-lockdown, compared to men
Summary
With unprecedented population aging; the consequences of social isolation on the mental wellbeing of older people is emerging as a significant public health concern, exacerbated by the COVID-19 pandemic [1, 2]. The impact of severe acute respiratory syndrome (SARS) on mental health, within the general public has previously been reported [4], and recent systematic reviews are beginning to highlight the detrimental impact of COVID-19 on mental health among different populations [5,6,7] Factors exacerbating this risk are less known but vital in informing appropriate targeted intervention and preventative measures. Lockdown stipulated a ban on nonessential travel, closure of most shops, offices and public spaces, alongside self-isolation and quarantine for those with possible infection and shielding for those deemed extremely vulnerable due to health conditions. These measures have placed many individuals under conditions of complete isolation, especially those living alone. Social isolation, loneliness and depression have, in turn, been associated with cognitive decline [10, 11] and incident dementia [12, 13] among older people
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