Abstract

Background: Despite the emphasis placed on the psychological impact of the COVID-19 pandemic, evidence from representative studies of older adults including pre-COVID-19 data and repeated assessments during the pandemic is scarce. We examined changes in mental health before and during the initial and later phases of the pandemic and tested whether patterns varied with sociodemographic characteristics. Methods: The sample included 5146 older adults from the English Longitudinal Study of Ageing (53% women, average age 66·74 years) who provided data before the pandemic (2018-19) and at two occasions in 2020 (June-July and November-December). We tested changes in depression, quality of life, loneliness, and anxiety before and during the pandemic using fixed-effects regression models. Findings: The prevalence of clinically significant depressive symptoms increased from 12·5% pre-pandemic to 22·6% in June-July 2020, with a further rise to 28·5% in November-December. This was accompanied by increased loneliness and deterioration in quality of life. The prevalence of anxiety rose from 9·4% to 10·9% between June-July and November-December 2022. Women and non-partnered people experienced worse changes in mental health. Participants with less wealth had lowest levels of mental health before and during the pandemic. Higher socioeconomic groups had better mental health overall, but responded to the pandemic with more negative changes. Patterns of changes were similar across age groups. Interpretation: Mental health and wellbeing continued to worsen as lockdown continued, and socioeconomic inequalities persisted. Women and non-partnered people experienced greater deterioration in all mental health outcomes.Funding Information: ESRC/UKRI; National Institute on Aging; UK Government Departments.Declaration of Interests: All authors declare no conflict of interests.Ethics Approval Statement: All respondents provided informed consent. Ethical approval for the regular ELSA study was obtained from the National Research Ethics Service. The ELSA COVID-19 Substudy has been approved by the University College London Research Ethics Committee.

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