Loneliness Among US Adults During the Early Phase of the COVID-19 Pandemic: Findings From the COVID-19 Coping Study

We aimed to estimate the prevalence of loneliness and identify the key sociodemographic, employment, living, and health-related risk factors for loneliness among middle-aged and older adults during the early COVID-19 pandemic in the US, when shelter-in-place and social distancing restrictions were in place for much of the country. Data were collected from online questionnaires in the COVID-19 Coping Study, a national study of 6,938 US adults aged 55-110 years, from April 2nd through May 31st, 2020. We estimated the population-weighted prevalence of loneliness (scores of ≥6/9 on the 3-item UCLA Loneliness Scale), overall and according to sociodemographic, employment, living, and health-related factors. We used population-weighted modified Poisson regression models to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) for the associations between these factors and loneliness, adjusted for age, sex, race, ethnicity, and education. Overall, 29.5% (95% CI: 27.9%, 31.3%) of US adults aged 55-110 were considered high in loneliness in April and May, 2020. In population-weighted, adjusted models, loneliness was most frequent among those with depression, those who were divorced or separated, those who lived alone, those diagnosed with multiple comorbid conditions, and individuals who were unemployed prior to the pandemic. In conclusion, we identified subpopulations of middle-aged and older US adults that were highly affected by loneliness during a period when COVID-19 shelter-in-place orders were in place across most of the country. These insights may inform the allocation of recourses to mitigate loneliness during times of restricted activity.

Loneliness Among US Adults Aged ≥55 Early in the COVID-19 Pandemic : Findings From the COVID-19 Coping Study.

OBJECTIVES: Loneliness is associated with increased risks of adverse health outcomes among middle-aged and older adults. We estimated the prevalence of loneliness and identified key sociodemographic, employment, living, and health-related risk factors for loneliness among adults aged ≥55 during the early phase of the COVID-19 pandemic in the United States, when much of the country was under shelter-in-place orders. METHODS: We collected data from online questionnaires in the COVID-19 Coping Study, a national study of 6938 US adults aged ≥55 from April 2 through May 31, 2020. We estimated the population-weighted prevalence of loneliness (scores ≥6 of 9 on the 3-item UCLA Loneliness Scale), overall and by sociodemographic, employment, living, and health-related factors. We used population-weighted modified Poisson regression models to estimate prevalence ratios (PRs) and 95% CIs for the associations between these factors and loneliness, adjusting for age, sex, race, ethnicity, and education level. RESULTS: Overall, we estimated that 29.5% (95% CI, 27.9%31.3%) of US adults aged ≥55 were considered high in loneliness in April and May 2020. In population-weighted adjusted models, loneliness was the most prevalent among those who reported depression, who were not married or in a relationship, who lived alone, and who were unemployed at the onset of the pandemic. CONCLUSIONS: We identified subpopulations of middle-aged and older adults who were vulnerable to loneliness during a period when COVID-19 shelter-in-place orders were in place across most of the country. These insights may inform the allocation of resources to mitigate an unintended health consequence during times of restricted activity.

Coping During the COVID-19 Pandemic: A Qualitative Study of Older Adults Across the United States.

Objective: Older adults may struggle with stresses and daily life challenges associated with the Coronavirus Disease 2019 (COVID-19) pandemic. Yet they may also utilize emotional and behavioral coping strategies. This qualitative paper aims to identify ways of coping with worries and stress during the pandemic from the perspectives of older adults in the United States. Methods: The COVID-19 Coping Study recruited 6,938 adults aged ≥55 through online multi-frame sampling from April 2-May 31, 2020 across all 50 US states, the District of Columbia, and Puerto Rico. The online questionnaire focused on the effects of COVID-19 on daily life, mental health, and well-being. This included an open-ended question regarding participants' coping strategies. We used qualitative content analysis to identify and code diverse coping strategies. Our general inductive approach enabled findings to emerge from the most frequent and dominant themes in the raw data. Results: A total of 5,180 adults [74% of the total sample; mean age 67.3 (SD 7.9); 63.8% female] responded to the question about using strategies to cope with living through the COVID-19 pandemic. Frequently-reported strategies included exercising and going outdoors, modifying routines, following public health guidelines, adjusting attitudes, and staying socially connected. Some coping strategies were health-limiting (e.g., overeating), while most strategies encouraged self-improvement, positive adjustment, and wellness. Conclusions: This study provides novel qualitative evidence on coping strategies of older adults early in the COVID-19 pandemic. Findings can inform community and clinical interventions to support older adults that harness positive coping strategies such as exercise, modified routines, and social strategies to improve physical and mental health, foster social support, and encourage meaningful daily activities during times of stress and trauma.

Cohort profile: the COVID-19 Coping Study, a longitudinal mixed-methods study of middle-aged and older adults' mental health and well-being during the COVID-19 pandemic in the USA.

PURPOSE: The COVID-19 pandemic, beginning in early 2020, has resulted in massive social, economic, political and public health upheaval around the world. We established a national longitudinal cohort study, the COVID-19 Coping Study, to investigate the effects of pandemic-related stressors and changes in life circumstances on mental health and well-being among middle-aged and older adults in the USA. PARTICIPANTS: From 2 April to 31 May 2020, 6938 adults aged ≥55 years were recruited from all 50 US states, the District of Columbia and Puerto Rico using online, multi-frame non-probability-based sampling. FINDINGS TO DATE: Mean age of the baseline sample was 67.3 years (SD: 7.9 years) and 64% were women. Two in three adults reported leaving home only for essential purposes in the past week (population-weighted proportion: 69%; 95% CI: 68% to 71%). Nearly one in five workers aged 55-64 years was placed on a leave of absence or furloughed since the start of the pandemic (17%; 95% CI: 14% to 20%), compared with one in three workers aged ≥75 years (31%; 95% CI: 21% to 44%). Nearly one-third of adults screened positive for each of depression (32%; 95% CI: 30% to 34%), anxiety (29%; 28% to 31%) and loneliness (29%; 95% CI: 27% to 31%), with decreasing prevalence of each with increasing age. FUTURE PLANS: Monthly and annual follow-ups of the COVID-19 Coping Study cohort will assess longitudinal changes to mental health, cognitive health and well-being in relation to social, behavioural, economic and other COVID-19-related changes to life circumstances. Quantitative and in-depth qualitative interview data will be collected through online questionnaires and telephone interviews. Cohort data will be archived for public use.