Living Alone and Depressive Symptoms Among Older Adults in the COVID-19 Pandemic: Role of Non-Face-to-Face Social Interactions.

Abstract

ObjectiveThis study examined the association of living alone with changes in depressive symptom status and the moderating effect of non-face-to-face social interactions among older adults during the coronavirus disease (COVID-19) pandemic.DesignA longitudinal studySetting and ParticipantsThis study recruited individuals aged ≥ 65 years without long-term care in one semi-urban city in Japan, who completed mailed questionnaires in March (baseline) and October 2020 (follow-up).MethodsBased on depressive symptoms assessed by the Two-Question Screening at baseline and follow-up, participants were classified as: “non-case,” “onset,” “remission,” and “persistence.” Non-face-to-face social interactions during the pandemic, including phone calls or emails with separated families or friends, were dichotomized as “less than weekly interactions” and “weekly interactions.” A multinomial logistic regression analysis was conducted to examine the association of living arrangement (living alone or together) with changes in depressive symptoms status.ResultsData of 1,001 participants were analyzed (mean age = 79.9 years). Of them, 13.8% lived alone. Overall, 40.6% participants were grouped as “non-case,” 11.7% as “onset,” 11.0% as “remission,” and 27.1% as “persistence.” Living alone was significantly associated with depressive symptom onset (odds ratio = 1.92, 95% confidence interval = 1.03–3.56, p = 0.039), and a negative interaction (protective effect) was found between living alone and weekly non-face-to-face social interactions for depressive symptom onset.Conclusion and ImplicationsDuring the pandemic, older adults living alone had a higher depressive symptom risk, but non-face-to-face social interactions may have buffered this risk. Our findings suggest the importance of supporting older adults living alone in times of social restrictions such as the pandemic, and furthermore, maintaining social connections, including non-face-to-face relationships, is necessary to protect their mental health.