'I feel like this will never end': mental health during the COVID-19 pandemic among older adults with chronic conditions.

OBJECTIVES: The COVID-19 pandemic may have a negative impact on mental health, especially among older adults with chronic conditions who are more vulnerable to severe illness. In this qualitative study, we evaluated how the pandemic has impacted the ways that adults aged 50 and older with chronic conditions managed their mental health. METHODS: A total of 492 adults (M = 64.95 years, SD = 8.91, range = 50-94) who lived in Michigan (82.1%) and 33 other U.S. states completed one anonymous online survey between 14 May 14 and 9 July 2020. Open-ended responses were coded to ascertain relevant concepts and were reduced to develop major themes. RESULTS: We determined four main themes. The COVID-19 pandemic impacted how participants took care of their mental health through: (1) pandemic-related barriers to social interaction; (2) pandemic-related routine changes; (3) pandemic-related stress; and (4) pandemic-related changes to mental health service use. CONCLUSION: This study indicates that older adults with chronic conditions experienced various challenges to managing their mental health in the early months of the COVID-19 pandemic, but also showed considerable resilience. The findings identify potential targets of personalized interventions to preserve their well-being during this pandemic and in future public health crises.

Social Contact, Emotional Support, and Anxiety during the COVID-19 Pandemic among Older Adults with Chronic Conditions.

OBJECTIVES: The COVID-19 pandemic may contribute to heightened anxiety among older adults with chronic conditions, which might be attenuated by social resources. This study examined how social contact and emotional support were linked to anxiety symptoms among adults aged 50 and older with chronic conditions, and whether these links varied by age. METHODS: Participants included 705 adults (M = 64.61 years, SD = 8.85, range = 50- 94) from Michigan (82.4%) and 33 other U.S. states who reported at least one chronic condition and completed an anonymous online survey between May 14 and July 9, 2020. RESULTS: Multiple regression models revealed among younger people, those reporting more frequent social contact had significantly lower anxiety symptoms. Emotional support was not significantly associated with anxiety symptoms. CONCLUSIONS: More frequent social contact was linked to lower anxiety symptoms for younger but not older individuals. Emotional support was not significantly associated with anxiety symptoms. CLINICAL IMPLICATIONS: Interventions to manage anxiety during the pandemic among older adults with chronic conditions may benefit from strategies to safely increase social contact, especially for middle-aged adults.

Caregiver status and illness self-efficacy during the COVID-19 pandemic among older adults with chronic conditions.

OBJECTIVES: Older adults providing unpaid care to a relative or friend during the COVID-19 pandemic may have diminished self-efficacy in managing their own chronic illness, especially in the context of more complex self-management. We evaluated whether adults aged 50 and older with caregiving roles are more likely to report reduced illness self-efficacy since the pandemic, and whether this link is exacerbated by a higher number of conditions. METHODS: Participants (105 caregivers and 590 noncaregivers) residing in Michigan (82.6%) and 33 other U.S. states completed one online survey between May 14 and July 9, 2020. RESULTS: Controlling for sociodemographic and health characteristics, stressors related to COVID-19, and behavioral and psychosocial changes since the pandemic, caregivers were more likely than noncaregivers to report reduced illness self-efficacy when they had a higher number of chronic conditions. CONCLUSION: These findings highlight the importance of maintaining caregivers' self-care during the COVID-19 pandemic and in future public health crises.

Factors Associated With Sleep Disturbances Related to the COVID-19 Pandemic Among Older Adults With Chronic Conditions.

OBJECTIVES: The COVID-19 pandemic may contribute to sleep problems among older adults with chronic conditions. We examined factors linked to pandemic-related sleep disturbances in a US sample of adults aged 50 and older with chronic conditions. DESIGN: Cross-sectional anonymous online survey between May 14 and July 9, 2020. SETTING: Michigan (82.3% of participants) and 33 other US states. PARTICIPANTS: Total of 705 adults (M = 64.57 years, SD = 8.82, range = 50-94) who reported at least one chronic condition. MEASUREMENTS: Sociodemographic and health characteristics, physical activity, media use, pandemic-related stress, social resources, and pandemic-related sleep disturbances. RESULTS: In the fully adjusted regression models, people who reported more worry about COVID-19 infection, more financial strain, and greater loneliness reported significantly greater pandemic-related sleep disturbances. CONCLUSIONS: These findings identify factors that may heighten risk of sleep problems since the COVID-19 pandemic in an especially vulnerable subgroup of older adults.

Loneliness During the COVID-19 Pandemic Among Older Adults With Chronic Conditions.

The COVID-19 pandemic may intensify loneliness among older adults with chronic conditions who are at high risk of severe illness, but little is known about factors associated with loneliness during the pandemic. We considered factors linked to loneliness among 701 adults aged 50 years and older with chronic conditions from Michigan (82.5%) and 33 other U.S. states. Participants completed an anonymous online survey between May 14 and July 9, 2020. About two thirds (66.4%) reported moderate to severe loneliness. The fully adjusted regression model revealed that being a person of color, having a spouse or cohabiting partner, and more emotional support were associated with lower levels of loneliness. Higher anxiety symptoms, more worry about COVID-19 infection, and more financial strain because of the pandemic were linked to greater loneliness. These findings inform strategies to support a vulnerable subgroup of older adults during this pandemic and in future public health crises.

Age Differences in Stress, Life Changes, and Social Ties During the COVID-19 Pandemic: Implications for Psychological Well-Being.

BACKGROUND AND OBJECTIVES: Experiences of the coronavirus disease 2019 (COVID-19) pandemic and its implications for psychological well-being may vary widely across the adult life span. The present study examined age differences in pandemic-related stress and social ties, and links with psychological well-being. RESEARCH DESIGN AND METHODS: Participants included 645 adults (43% women) aged 18-97 (M = 50.8; SD = 17.7) from the May 2020 nationally representative Survey of Consumers. Participants reported the extent to which they felt stress related to the pandemic in the last month, the extent to which their lives had changed due to the pandemic, as well as social isolation, negative relationship quality, positive relationship quality, and frequency of depression, anxiety, and rumination in the past week. RESULTS: Results showed that older people reported less pandemic-related stress, less life change, less social isolation, and lower negative relationship quality than younger people. Greater pandemic-related stress, life change, social isolation, and negative relationship quality were associated with poorer psychological well-being. Poorer social ties (i.e., greater social isolation and negative quality) exacerbated the effects of the COVID-19 pandemic (stress, life change) on psychological well-being. DISCUSSION AND IMPLICATIONS: Researchers have indicated that older adults may be more vulnerable to COVID-19 pandemic-related stress and social isolation, but this study indicates that young adults may be relatively more vulnerable. Because isolation and negative relationship quality appear to exacerbate the deleterious effects of the COVID-19 pandemic on psychological well-being, reducing social isolation and negative relations are potential targets for intervention.