Multimorbidity and Mental Health Trajectories Among Middle-Aged and Older U.S. Adults During the COVID-19 Pandemic: Longitudinal Findings From the COVID-19 Coping Study.

IF 4.9 3区医学 Q1 GERIATRICS & GERONTOLOGY Innovation in Aging Pub Date : 2022-07-30 eCollection Date: 2022-01-01 DOI:10.1093/geroni/igac047

Greta Jianjia Cheng, Abram L Wagner, Brendan Q O'Shea, Carly A Joseph, Jessica M Finlay, Lindsay C Kobayashi

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Abstract

Background and objectives: This study aimed to examine the associations between multimorbidity at the COVID-19 pandemic onset and subsequent longitudinal trajectories of depressive symptoms, anxiety symptoms, and loneliness in middle-aged and older adults over a 12-month follow-up.

Research design and methods: Data were from monthly online questionnaires in the COVID-19 Coping Study of U.S. adults aged ≥55 from April/May 2020 through April/May 2021 (N = 4,024). Multimorbidity was defined as having ≥2 versus <2 chronic conditions at baseline. Mental health outcomes were assessed monthly as depressive symptoms (8-item Center for Epidemiologic Studies Depression scale), anxiety symptoms (5-item Beck Anxiety Inventory), and loneliness (3-item UCLA Loneliness Scale). We used multivariable-adjusted population- and attrition-weighted mixed-effects linear models to examine the longitudinal associations between multimorbidity and mental health symptoms.

Results: Multimorbidity at the pandemic onset was associated with elevated depressive (b = 0.37; 95% CI: 0.16-0.59) and anxiety (b = 0.39; 95% CI: 0.15-0.62) symptoms at baseline. Changes in symptoms for all three mental health outcomes were nonlinear over time, with worsening symptoms over the first 6 months of the pandemic (April/May to September/October 2020), followed by improvement in symptoms over the subsequent 6 months (September/October 2020 to April/May 2021). Middle-aged and older adults with multimorbidity experienced faster rates of change in anxiety symptoms and loneliness than those without multimorbidity, with persistently elevated mental health symptomatology throughout the follow-up.

Discussion and implications: Results highlight the unique and persistent mental health risks experienced by middle-aged and older adults with multimorbidity during the COVID-19 pandemic. The observed improvements in symptoms underscore the mental resilience of these individuals, indicating their adaptation to the ongoing pandemic.

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COVID-19 大流行期间美国中老年人的多病症和心理健康轨迹：COVID-19 应对研究的纵向发现》。

背景和目的：本研究旨在探讨COVID-19大流行开始时的多病症与中老年人随后12个月随访期间的抑郁症状、焦虑症状和孤独感的纵向轨迹之间的关联：数据来自 2020 年 4 月/5 月至 2021 年 4 月/5 月期间对年龄≥55 岁的美国成年人进行的 COVID-19 应对研究的每月在线问卷调查（N = 4024）。多病症的定义是≥2种疾病与结果：大流行开始时的多病与基线时抑郁（b = 0.37；95% CI：0.16-0.59）和焦虑（b = 0.39；95% CI：0.15-0.62）症状的升高有关。随着时间的推移，所有三种心理健康结果的症状变化都是非线性的，在大流行的前 6 个月（2020 年 4 月/5 月至 9 月/10 月）症状恶化，随后 6 个月（2020 年 9 月/10 月至 2021 年 4 月/5 月）症状改善。与不患有多种疾病的中老年人相比，患有多种疾病的中老年人在焦虑症状和孤独感方面的变化速度更快，在整个随访过程中心理健康症状持续升高：研究结果凸显了患有多种疾病的中老年人在 COVID-19 大流行期间所经历的独特而持久的心理健康风险。观察到的症状改善强调了这些人的心理复原力，表明他们适应了正在发生的大流行。

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来源期刊

Innovation in Aging GERIATRICS & GERONTOLOGY-

CiteScore

4.10

自引率

0.00%

发文量

审稿时长

15 weeks

期刊介绍： Innovation in Aging, an interdisciplinary Open Access journal of the Gerontological Society of America (GSA), is dedicated to publishing innovative, conceptually robust, and methodologically rigorous research focused on aging and the life course. The journal aims to present studies with the potential to significantly enhance the health, functionality, and overall well-being of older adults by translating scientific insights into practical applications. Research published in the journal spans a variety of settings, including community, clinical, and laboratory contexts, with a clear emphasis on issues that are directly pertinent to aging and the dynamics of life over time. The content of the journal mirrors the diverse research interests of GSA members and encompasses a range of study types. These include the validation of new conceptual or theoretical models, assessments of factors impacting the health and well-being of older adults, evaluations of interventions and policies, the implementation of groundbreaking research methodologies, interdisciplinary research that adapts concepts and methods from other fields to aging studies, and the use of modeling and simulations to understand factors and processes influencing aging outcomes. The journal welcomes contributions from scholars across various disciplines, such as technology, engineering, architecture, economics, business, law, political science, public policy, education, public health, social and psychological sciences, biomedical and health sciences, and the humanities and arts, reflecting a holistic approach to advancing knowledge in gerontology.