A Comparison of Mental Health in a Sample of Older Women Before and During the COVID-19 Pandemic

The COVID-19 pandemic has substantially impacted lives globally. Due to age-related risks, the older adult population has uniquely experienced negative changes caused by the pandemic. Research has also shown that the pandemic has disproportionately affected women. Therefore, it is important to understand how the mental health of older women has been impacted during this global crisis. This study aims to examine the differences in mental health indices in a sample of older women before versus during the COVID-19 pandemic. To date, participants include 201 women (aged 60-94) who completed an online survey of self-report measures assessing depression, anxiety, alcohol use, binge eating, positive affect, and emotional quality of life (QOL). We conducted one-way ANOVAs to compare each mental health construct in two samples of older women collected pre- and peri-pandemic. Results indicated that the peri-pandemic group reported significantly higher anxiety (F = 5.25, p = .02), with a trend for more role limitations due to emotional problems (F = 2.79, p = .09), than the pre-pandemic group. No significant differences emerged for levels of depression, alcohol consumption, binge eating, positive affect, or emotional wellbeing between groups. These findings point to the psychological resilience of older adults in the face of extreme adverse events, including this global crisis. Older women, while impacted differently during the COVID-19 pandemic, reported minimal exacerbations of mental health problems compared to older women pre-pandemic. Efforts to identify moderators that may either attenuate or promote further psychological resilience among older adults is warranted.

Early Documentation of Life-Sustaining Treatment Orders Prior to Diagnosis of COVID-19 in Nursing Home Residents

Coronavirus disease 2019 (COVID-19) has had a devastating impact on older adult nursing home residents (NHR). NHRs comprise greater than one-third of COVID-19 U.S. deaths, emphasizing the importance of engaging in end-of-life discussions. At South Texas Veterans Health Care System (STVHCS), we implemented early documentation of patient’s Life-Sustaining Treatment (LST) or end-of-life goals-of-care preferences prior COVID-19 infection. We now aim to examine the association between early LST documentation (prior to COVID-19 diagnosis) and hospital admissions for COVID-19 by conducting a retrospective cohort study of Veteran NHRs at STVHCS from March 2020-January 2021. Inclusion criteria were NHRs with COVID-19 diagnosis, LST documentation, and clear timing of whether the LST documentation occurred before or after COVID-19 diagnosis. Logistic regression was used to determine the likelihood of hospitalization by whether LST was documented before or after COVID-19 diagnosis. 208 NHRs were diagnosed with COVID-19 and 160 (76.9%) had LST documentation. Of these, 148 were included in the analysis: 84 (56.8%) had a completed LST note prior to diagnosis and 64 (43.2%) after diagnosis. The hospitalization rate was 46% for those with LST prior to diagnosis compared to 78% in those with LST after diagnosis (OR = 0.24, 95% CI: 0.12-0.50, P<0.001), showing that early LST documentation was associated with 76% lower likelihood of hospitalization. Early interventions for LST documentation can reduce hospitalization in high-risk populations. These findings may have implications for reducing unnecessary hospitalizations, diminishing healthcare costs, and resolving ethical dilemmas related to potential resource allocation during a pandemic.

Social Isolation in Older Women during the COVID-19 Pandemic: The impact on Quality of Life and Mental health

To mitigate the spread of COVID-19, countries worldwide enacted quarantines, particularly for older adults, as mortality from COVID-19 is inequitably distributed among this group. Notably, social isolation in older adults is associated with a heightened risk of cardiovascular, autoimmune, and mental health problems (e.g., depression, anxiety). Furthermore, the mental health of women in particular has been greatly impacted by the pandemic. Although previous research indicates that social isolation among older adults is a “serious public health concern”, less is known about the extent to which the COVID-19 pandemic has exacerbated this issue. The primary objective is to investigate the effects of social isolation on mental health indices and health-related quality of life (HRQOL) in older women in the context of the COVID-19 pandemic. Participants include 77 postmenopausal women (aged 60+) who completed self-report measures online during the COVID-19 pandemic. Controlling for education and annual household income in all analyses, we used linear regression models to investigate the effects of social isolation on depression, anxiety, alcohol use, binge eating, and the 8 domains of the SF-36. Results indicate that, when controlling for education and income, social isolation significantly predicted depression, binge eating, and poorer HRQOL in all 8 domains of the SF-36 (all p’s < .01) Social isolation did not predict anxiety and alcohol consumption when controlling for these sociodemographic variables. Enrollment is ongoing;this poster will report updated results. Results indicate the continued need for creative avenues to improve social connectedness during the COVID-19 pandemic.

Assessing acceptability and patient experience of a behavioral lifestyle intervention using fitbit technology in older adults to manage type 2 diabetes amid COVID-19 pandemic: A focus group study.

Type 2 diabetes (T2D) contributes to reduced quality of life in older adults, especially in those with comorbidities such as being overweight or obese. Personal fitness technology (Fitbit ®) has the potential to improve the management of T2D. Using a semi-structured interview guide, focus groups were conducted to explore participants' acceptability and experiences following a behavioral lifestyle intervention that integrated Fitbit in overweight/obese older adults with T2D amid the COVID-19 pandemic which began during the time of this study. Focus group transcripts were transcribed and analyzed using thematic analysis. Eighteen (18) of the 20 participants completed the program and focus group interviews. Overall, we observed high acceptability of the program, and participants reported favorable experiences such as increased knowledge of health behaviors, improved diabetes management, and improved quality of life following the behavioral lifestyle intervention, even under stressful life circumstances from COVID-19.