Regular Research Article
Experiences of American Older Adults with Pre-existing Depression During the Beginnings of the COVID-19 Pandemic: A Multicity, Mixed-Methods Study

https://doi.org/10.1016/j.jagp.2020.06.013Get rights and content

Highlights

  • What is the primary question addressed by this study?

    What is the effect of the COVID-19 pandemic on the mental health of older adults with pre-existing major depressive disorder?

  • What is the main finding of this study?

    Seventy-three older adults with pre-existing depression who participated in this study show no increase in depression, anxiety, or suicidality, as measured by the PHQ-9 and PROMIS anxiety scale before and after the pandemic. Findings from qualitative interviews conducted at the same time as the scales indicate that participants were upset by the governmental response and were more concerned about the risks of contracting the virus than the risks of isolation, but were experiencing decreased quality of life and anticipated that their mental health would suffer with continued physical distancing.

  • What is the meaning of the finding? Older adults with MDD showed resilience during the initial phase of the pandemic, but that will need additional resources, such as ways to maintain social connection, as the pandemic continues.

ABSTRACT

Objective

To determine the effect of the COVID-19 pandemic on the mental health of older adults with pre-existing major depressive disorder (MDD).

Participants

Participants were 73 community-living older adults with pre-existing MDD (mean age 69 [SD 6]) in Los Angeles, New York, Pittsburgh, and St Louis.

Design and Measurements

During the first 2 months of the pandemic, the authors interviewed participants with a semistructured qualitative interview evaluating access to care, mental health, quality of life, and coping. The authors also assessed depression, anxiety, and suicidality with validated scales and compared scores before and during the pandemic.

Results

Five themes from the interviews highlight the experience of older adults with MDD: 1) They are more concerned about the risk of contracting the virus than the risks of isolation. 2) They exhibit resilience to the stress and isolation of physical distancing. 3) Most are not isolated socially, with virtual contact with friends and family. 4) Their quality of life is lower, and they worry their mental health will suffer with continued physical distancing. 5) They are outraged by an inadequate governmental response to the pandemic. Depression, anxiety, and suicidal ideation symptom scores did not differ from scores before the pandemic.

Conclusion

Most older adults with pre-existing MDD show resilience in the first 2 months of the COVID-19 pandemic but have concerns about the future. Policies and interventions to provide access to medical services and opportunities for social interaction are needed to help to maintain mental health and quality of life as the pandemic continues.

Key Words

Covid-19 Pandemic
depression
resilience
anxiety

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