Depressive symptoms among older adults pre- and post- COVID-19 pandemic

Briggs, Robert; McDowell, Cillian P.; De Looze, Céline; Kenny, Rose Anne; Ward, Mark

Objectives It is a concern that public health measures to prevent older people contracting COVID-19 could lead to a rise in mental health problems such as depression. The aim of this study therefore is to examinetrends of depressive symptomsbefore and during the COVID-19 pandemic in a large cohort of older people. Design Observational study with 6-year follow-up. Setting& Participants Over 3,000 community-dwelling adults aged ≥60 yearsparticipating in The Irish Longitudinal Study on Ageing (TILDA). Methods Mixed-effects multilevel models were used to describe trends in depressive symptoms across 3 waves of TILDA; Waves 4 (2016), 5 (2018) and a final wave conductedJuly-November 2020. Depressive symptoms were measured using 8-item CES-D, a score ≥9 indicating clinically significant symptoms. Results The prevalence of clinically significant depressive symptoms at Waves 4 and 5 was 7.2% (6.5–7.9) and 7.2% (6.5–8.0) respectively. This more than doubled to 19.8% (18.5–21.2) during the COVID-19 pandemic. There was no change in CES-D scores between Waves 4 and 5 (β=0.09 (-0.04 – 0.23) but a large increase in symptoms was observed during the pandemic (β=2.20 (2.07–2.33)). Age ≥70 years was independently associated with depressive symptoms (β=0.45 (0.18–0.72)) during the pandemic but notfrom Wave 4 to 5 (β=0.09 (-0.18–0.36)). Living with others was associated with lower burden of symptoms during the pandemic (β=-0.40 (-0.71 - -0.09)) but not between Waves 4 and 5 (β=-0.40 (-0.71 - -0.09)). Conclusions& Implications This study demonstrates significant increases in the burden of depressive symptoms amongst older people during the COVID-19 pandemic, particularly those aged ≥70 years and/or living alone. Even a small increase in the incidence of late life depression can have major implications for healthcare systems and societies in general. Improving access to age-attuned mental health care should therefore be a priority.