Increase in depression and anxiety symptoms and stable levels of compassion among older adults from before to during the COVID-19 pandemic

Abstract

Introduction The coronavirus pandemic and resulting restrictions of social activity have the potential to differentially affect older adults. People over 65 years old are at increased vulnerability to COVID-19 compared to younger adults, which may increase anxiety and efforts to socially isolate. In addition, older adults may be uniquely affected by smaller social networks or less access to technological substitutes for social interactions. While a recent study on mental well-being among older adults with pre-existing major depressive disorder found no changes in depression and anxiety associated with the early months of the coronavirus pandemic, it is unclear whether the same will be seen among community-dwelling older adults over an extended course of the pandemic. It is also important to understand whether and how some older adults are able to maintain wellness under social restrictions. We enrolled participants who took part in a pre-pandemic clinical trial (MEDEX) comparing the ability of Mindfulness-Based Stress Reduction (MBSR), aerobic exercise, the combination, or health education to reduce cognitive decline. Participants in MEDEX were assessed for levels of depression, anxiety, and compassion prior to the start of the pandemic. In a new study called StayWELL, we conducted follow-up assessments starting in June 2020, using online and mobile surveys, and examined the difference and relationship of pre- and during-pandemic measures of mental health symptoms and compassion. Methods Participant inclusion criteria: 1) older than 65 years, 2) participated in the MEDEX study, and 3) possess a mobile device with touch screen and internet access. Design: Fully virtual ecological momentary assessment (EMA) study: Using a web-based survey, we measured compassion with the Santa Clara Brief Compassion Scale and mental health symptoms using PROMIS depression and anxiety scores. StayWELL participants complete four two-week intensive sampling bursts throughout the pandemic. Data from the first burst – June 2020 – was analyzed in this study. General linear models are used to investigate the relationship of pre- and during-pandemic measures of depression, anxiety and compassion. Results Seventy-six participants are actively enrolled in our study (mean age=70 years, SD=4.3). Seventy-eight percent are women, and the mean (SD) education is 16.6 (2.0) years. The racial distribution is 84% White, 8% Black/African American, 4% Asian, and 3% More than One Race; five percent of participants identify as Hispanic. Preliminary analysis to examine change in mental health and compassion from pre-pandemic (MEDEX data) to during-pandemic (StayWELL baseline) indicate that depressive and anxiety symptoms were significantly higher three months into the pandemic compared to pre-pandemic measures, while compassion for others remained unchanged and high in this sample. Scores at the two timepoints were correlated, particularly for compassion (see Figure 1). Conclusions In this sample of older adults, anxiety and depressive symptom levels increased from before to during the pandemic. Our preliminary results support the role of compassion as a stable, individual trait marker. This ongoing longitudinal project will allow us to understand trajectories of change in mental health and well-being across the pandemic, how this relates to the degree of social isolation, and how positive psychological traits such as compassion may buffer changes in well-being brought on by the stress of living through a global health and economic crisis. Additional data is collected to further characterize mental health and wellbeing throughout the course of the pandemic using smart-phone based assessments of empathy, social isolation, loneliness, resilience, and mindfulness at similar timepoints with EMA and GPS location tracking and mobile keystroke activity (BiAffect app) on a daily basis. Funding Early Postdoc Mobility Fellowship of the Swiss National Science Foundation (SNSF) to FK. The coronavirus pandemic and resulting restrictions of social activity have the potential to differentially affect older adults. People over 65 years old are at increased vulnerability to COVID-19 compared to younger adults, which may increase anxiety and efforts to socially isolate. In addition, older adults may be uniquely affected by smaller social networks or less access to technological substitutes for social interactions. While a recent study on mental well-being among older adults with pre-existing major depressive disorder found no changes in depression and anxiety associated with the early months of the coronavirus pandemic, it is unclear whether the same will be seen among community-dwelling older adults over an extended course of the pandemic. It is also important to understand whether and how some older adults are able to maintain wellness under social restrictions. We enrolled participants who took part in a pre-pandemic clinical trial (MEDEX) comparing the ability of Mindfulness-Based Stress Reduction (MBSR), aerobic exercise, the combination, or health education to reduce cognitive decline. Participants in MEDEX were assessed for levels of depression, anxiety, and compassion prior to the start of the pandemic. In a new study called StayWELL, we conducted follow-up assessments starting in June 2020, using online and mobile surveys, and examined the difference and relationship of pre- and during-pandemic measures of mental health symptoms and compassion. Participant inclusion criteria: 1) older than 65 years, 2) participated in the MEDEX study, and 3) possess a mobile device with touch screen and internet access. Design: Fully virtual ecological momentary assessment (EMA) study: Using a web-based survey, we measured compassion with the Santa Clara Brief Compassion Scale and mental health symptoms using PROMIS depression and anxiety scores. StayWELL participants complete four two-week intensive sampling bursts throughout the pandemic. Data from the first burst – June 2020 – was analyzed in this study. General linear models are used to investigate the relationship of pre- and during-pandemic measures of depression, anxiety and compassion. Seventy-six participants are actively enrolled in our study (mean age=70 years, SD=4.3). Seventy-eight percent are women, and the mean (SD) education is 16.6 (2.0) years. The racial distribution is 84% White, 8% Black/African American, 4% Asian, and 3% More than One Race; five percent of participants identify as Hispanic. Preliminary analysis to examine change in mental health and compassion from pre-pandemic (MEDEX data) to during-pandemic (StayWELL baseline) indicate that depressive and anxiety symptoms were significantly higher three months into the pandemic compared to pre-pandemic measures, while compassion for others remained unchanged and high in this sample. Scores at the two timepoints were correlated, particularly for compassion (see Figure 1). In this sample of older adults, anxiety and depressive symptom levels increased from before to during the pandemic. Our preliminary results support the role of compassion as a stable, individual trait marker. This ongoing longitudinal project will allow us to understand trajectories of change in mental health and well-being across the pandemic, how this relates to the degree of social isolation, and how positive psychological traits such as compassion may buffer changes in well-being brought on by the stress of living through a global health and economic crisis. Additional data is collected to further characterize mental health and wellbeing throughout the course of the pandemic using smart-phone based assessments of empathy, social isolation, loneliness, resilience, and mindfulness at similar timepoints with EMA and GPS location tracking and mobile keystroke activity (BiAffect app) on a daily basis.