PHYSICAL SYMPTOM TRAJECTORIES OF OLDER ADULTS DURING THE COVID-19 PANDEMIC

Older adults experience increased risk for morbidity and mortality during the COVID-19 pandemic (CDC, 2021). Social distancing and lockdown to prevent contagion may affected physical and mental health. We examined the fifteen physical symptom trajectories of older adults during the early months of the COVID-19 pandemic. We also examined age, gender, and marital status differences in each physical symptom trajectory. The sample consisted of 247 older adults (Mage = 71.1, SD = 7.3, 88.7% White, 73% women, 73.4% married), who participated in eight weekly longitudinal online surveys from April 28 to June 23, 2020. Random-effects logistic regression analysis controlling for age, gender, marital status, and depressive symptoms showed that the nine physical symptoms (headache, constipation/diarrhea, muscle soreness, shortness of breath, tightness of chest, backache, heart pounding, congestion, and sore throat) significantly decreased in the first few weeks, but then six symptoms (constipation/diarrhea, shortness of breath, tightness of chest, heart pounding, congestion, and sore throat) increased in later weeks of the study period. Middle-aged participants reported higher number of headache, tightness of chest, heart pounding, and nausea/upset stomach than older participants. Women experienced more constipation/diarrhea, trembling/shaking, and sore throat than men. Those who were not married responded with higher number of shortness of breath, backache and poor appetite compared to married participants. Higher depressive symptoms were significantly related to each physical symptom. The results suggest that healthcare providers should evaluate physical symptoms focusing on the patients who are at greater risk of poor health during the pandemic.

LONG-TERM POSITIVE AND NEGATIVE CONSEQUENCES OF THE COVID-19 PANDEMIC AMONG OLDER ADULTS

Despite their greater physiological vulnerability, community-residing older adults have shown surprising psychological resilience, at least at the beginning of the COVID-19 pandemic. However, a handful of reports suggest that older adults' well-being has decreased after a few months, although others have suggested a recovery after a year (Schlomann et al., 2021). The purpose of this study was to examine change in change from baseline (April-May, 2020) to a 13- month follow-up (June, 2021). We analyzed data from 162 older adults with complete data at both time points. Mean age at baseline was 72, SD = 7.6, range = 51-96;71% were female, 13% were minorities;74% were married, 71% retired, and most (85%) had at least a BA. Linear modelling showed that there were only marginal increases in the number of problems across time (B = .25, p = .08), but their severity did not increase. There were no significant changes in depression, anxiety, loneliness or physical symptoms over this time period. The modest increase in problems may have been offset by an end to being in lockdown and an increase in social contacts which doubled over this time period, B = 1.65, p <.001). More troubling was that self-reported resilience decreased, B = -.92, p < .01), as did the ability to perceive positives in this situation, B = -2.46, p < .01), and self-reported cognitive problems increased, B=.67, p < .01). Thus, the results showed decidedly mixed effects, suggesting individual differences in long-term adaptation to COVID.

ARE OLDER ADULTS ABLE TO DRAW UPON PRIOR EXPERIENCES WHEN COPING WITH THE NOVEL COVID-19 STRESSOR?

Despite higher physiological vulnerability to stress, older adults may accumulate resources through prior experiences that can promote resilience (Aldwin & Igarashi, 2016). During the COVID-19 pandemic, older adults drew on prior experiences and resources to cope (McKinlay et al., 2021;Herron et al., 2021), although these events were typically not specified. Some found vulnerability due to prior trauma (Galica et al., 2021). We examined whether older adults drew upon specific experiences or more general resilience resources in coping with this novel stressor. Data were collected using an online survey from April 28-May 4, 2020 from 235 older adults in Oregon (Mage = 71.35, SD = 7.39;74% female;92% White). We examined open-ended responses from a question that asked whether prior experiences influenced how they were dealing with the COVID-19 situation. Nearly 2/3 provided valid responses (n=144). After inductive open coding, preliminary consolidation resulted in three broad categories: past experiences (74%), resources (19%), and both (8%). The most common prior experiences were illness (n = 20) and work (n = 19). Some (n=10) reported specific coping strategies learned during prior stressful experiences. Resources include personal characteristics (e.g., being "introverted” or "resilient”), financial ("financially secure”) and social resources ("loving spouse”). Five reported experiences that made COVID-19 more difficult ("PTSD/anxiety prior to COVID-19 makes this even worse”). Although 1/3 of the sample could not draw upon a prior experience in coping with this novel stressor, many older participants could utilize their lived experience when coping with problems during the COVID-19 pandemic.

OPTIMAL AGING AND SATISFACTION WITH SOCIAL SUPPORT DURING THE COVID-19 PANDEMIC

Social support is important for optimal aging, especially during the COVID-19 pandemic when older adults are at risk of social isolation and its attendant health problems. Providing support may be especially protective of health outcomes. We examined whether actual received, provided, and satisfaction with support were related to optimal aging early in the pandemic (April-May, 2020). Survey participants (N=238) were on average 71.2 years old (SD=7.3), 73% female, 92.6% White, and highly educated (48% with post-graduate degrees). Optimal aging (Aldwin & Igarashi, 2016) was indicated by a latent variable of health outcomes, including depressive symptoms, cognitive lapses, and physical symptoms. Nearly all older adults (90+%) reported receiving or providing actual support from or to at least one family member or friend. We investigated the associations between age, summed social support, satisfaction with support, and health outcomes, controlling for chronic illnesses. Two SEM models were estimated for received support and provided support, respectively. After trimming non-significant paths, both models had acceptable fits (CFI > .90, RMSEA < .08, SRMR < .08). Age and chronic illnesses had negative associations with health outcomes, but neither received nor provided social support was significant. However, satisfaction with both received and provided support were significant and independently associated with optimal aging in both models. Thus, isolation levels in this sample were surprisingly low, as indicated by high levels of social support received and provided. However, only the quality of (or satisfaction with) support was important for optimal aging during this unique and shared stressful experience.

TRAJECTORIES OF ANXIETY SYMPTOMS DURING THE COVID-19 PANDEMIC AMONG OLDER ADULTS

Older adults face particular challenges during the COVID-19 pandemic, including increased risk for morbidity and mortality (CDC, 2021). Social distancing and lockdown to prevent contagion may create social isolation and loneliness, adversely affecting mental and physical health. We examined anxiety symptom trajectories of older adults and identified risk and protective factors during the early months of the COVID-19 pandemic. We also examined how anxiety symptoms were associated with both between- and within-person variations in loneliness, social contacts, and physical problems. We sampled 247 older adults (Mage = 71.1, SD = 7.3, range = 51 - 95), who participated in eight weekly longitudinal online surveys from April 28 to June 23, 2020. Multilevel modeling analysis controlling for age, gender, marital status, and education showed that anxiety symptoms significantly decreased in the first few weeks, but then increased around week 6 of the study period. At the between-person level, individuals with higher levels of both loneliness and physical problems were at risk for experiencing higher levels of anxiety, but social contacts were not significant. Middle-aged participants reported higher anxiety symptoms than older participants. Women experienced higher anxiety symptoms than men. As a protective factor, individuals who were high in resilience had significantly lower anxiety symptoms over time, compared to those with low in resilience. In the within-person level, anxiety symptoms were positively coupled with both loneliness and physical symptoms over time. We conclude that lonely individuals and those in poor health were at greater risk of poor mental health during the pandemic.

COVID-19 ERA EFFECTS ON OLDER ADULTS' COGNITIVE COMPLAINTS, DEPRESSIVE SYMPTOMS, AND STRESSFUL EVENTS

Older adults have adjusted better to the COVID-19 pandemic in terms of their psychological well-being than younger adults. We investigated individual differences in vulnerability within older adulthood as pandemic severity changed, providing a more refined prediction of older adults' adjustment to COVID-19. Participants from this longitudinal study were included if they had at least one semiannual assessment before and one during the COVID-19 era (N = 111, 65% women, age range = 62-96 at onset of COVID-19 era in the US). There were 1,098 pre-COVID-19 assessments (M=9.9, 1/5/2018-1/22/2020) and 265 post-COVID-19 (M=2.4, 1/23/2020-10/31/2021). At each assessment, participants reported on six cognitive complaints (MOS), five depressive symptoms (Geriatric Depression Scale), and six domains of undesirability-weighted stressful life events (Louisville Older Persons Event Scale). Daily national, state, and regional COVID-19 case and death rates were obtained from the Centers for Disease Control and summed for the week preceding each assessment. In multilevel ZIP models, the COVID-19 era significantly increased depressive symptoms (0.68 to 1.18, p < .0001) and stressful events (30.9 to 48.5, p < .0001), but did not significantly affect severity of cognitive complaints. Older age was associated with greater impact of COVID-19 on depressive symptoms and stressful events;women reported more stressful events when pandemic severity was high, but men reported more stressful events when pandemic severity was low. Although older adults in general have adjusted better to the pandemic than younger adults, the old-old had greater vulnerability to this unavoidable event than the young-old.