COVID-19-Related Changes in Assistance Networks for U.S. Older Adults with and without Dementia.

OBJECTIVES: Pre-pandemic research suggests assistance networks for older adults grow over time and are larger for those living with dementia. We examined how assistance networks of older adults changed in response to the onset of the COVID-19 pandemic and whether these changes differed for those with and without dementia. METHODS: We used three rounds of the National Health and Aging Trends Study. We estimated multinomial logistic regression models to test whether changes in assistance networks during COVID-19 (2019-2020) - defined as expansion, contraction, and adaptation - differed from changes prior to COVID-19 (2018-2019). We also estimated OLS regression models to test differences in numbers of helpers assisting with one (specialist) vs. multiple (generalist) domains before and during COVID-19. For both sets of outcomes, we investigated whether pandemic-related changes differed for those with and without dementia. RESULTS: Over all activity domains, a greater proportion of assistance networks adapted during COVID-19 compared to the pre-COVID-19 period (RRR = 1.19, p < .05). Contractions in networks occurred for those without dementia. Transportation assistance contracted for those with and without dementia, and mobility/self-care assistance contracted for those with dementia. The average number of generalist helpers decreased during COVID-19 (ß = -0.09, p < .001). DISCUSSION: Early in the pandemic, assistance networks of older adults adapted by substituting helpers, by contracting to reduce exposures with more intimate tasks for recipients with dementia, and by reducing transportation assistance. Future research should explore the impact of such changes on the well-being of older adults their assistance networks.

Social Contact Prior to COVID-19 and Longitudinal Mental Health Trajectories During COVID-19 Among Adults Ages ≥55

Social support protects mental health during a crisis. We examined whether prior contact with social organizations and friends/neighbors was associated with better trajectories of loneliness, depression and self-rated memory during the COVID-19 pandemic. We conducted latent class analysis and regression analysis on longitudinal data from the COVID-19 Coping Study of US adults aged ≥55 from April-October 2020 (n=3105). Overall, prior contact with friends(B=-.075,p<.001), neighbors(B=-.048,p=.007), and social organizations(B=-.073,p<.001) predicted better mental health amid COVID-19. Three classes were identified: Class1 had the best outcomes, whereas Class3 had the worst outcomes and were most likely to live alone(B=.149,p<.001). For Class1, prior contact with social organizations(B=-.052,p=.044) predicted decreasing loneliness. For Class2, prior contact with friends(B=-.075,p<.001) predicted decreasing loneliness and better memory(B=-.130,p=.011). Conversely, prior contact with neighbors(B=-.165,p=.010) predicted worsening loneliness among Class3. Our findings pose new questions on the role of neighborhood networks to mitigate poor mental health outcomes among older adults during a crisis.

Prior Social Contact and Mental Health Trajectories during COVID-19: Neighborhood Friendship Protects Vulnerable Older Adults.

Social networking protects mental health during a crisis. Prior contact with social organizations, friends, and non-friend neighbors may be associated with better trajectories of loneliness, depression and subjective memory during COVID-19. Regression analysis was conducted using longitudinal data from a representative sample of n = 3105 US adults aged ≥55 in April-October 2020. Latent profile analysis was also conducted. Prior contact with friends (B = -0.075, p < 0.001), neighbors (B = -0.048, p = 0.007), and social organizations (B = -0.073, p < 0.001) predicted for better mental health during COVID-19. Three profiles were identified: Profile 1 had the best outcomes, with prior contact with social organizations (B = -0.052, p = 0.044) predicting decreasing loneliness. For Profile 2, prior 'meeting' contact with friends predicted decreasing loneliness (B = -0.075, p < 0.001) and better subjective memory (B = -0.130, p = 0.011). Conversely, prior contact with neighbors (B = -0.165, p = 0.010) predicted worsening loneliness among Profile 3. The COVID-19 pandemic has had a differential impact on the mental health trajectories of aging adults with social ties of different strengths. Stronger neighborhood networks are important to mitigate poor mental health outcomes among vulnerable older adults during a crisis. Older adults who are living alone and had relied on non-friend neighbors for social connectedness require additional community supports. Policy interventions are required to mitigate the mental health impact of future pandemics.