ABSTRACT
Precipitated by chronic psychological stress, immune system dysregulation, and a hyperinflammatory state, the sequelae of postacute COVID-19 (long COVID) include depression and new-onset diabetes. We hypothesize that exercise counters the neuropsychiatric and endocrine sequelae of long COVID by inducing the release of circulating factors that mediate the anti-inflammatory response, support brain homeostasis, and increase insulin sensitivity.
Subject(s)
COVID-19 , Brain , COVID-19/complications , Disease Progression , Exercise , Humans , Post-Acute COVID-19 SyndromeSubject(s)
Ageism , Coronavirus Infections , Health Services for the Aged/standards , Pandemics , Patient Care , Pneumonia, Viral , Resilience, Psychological , Ageism/prevention & control , Ageism/psychology , Betacoronavirus , COVID-19 , Clinical Decision-Making/ethics , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Coronavirus Infections/psychology , Humans , Intergenerational Relations , Pandemics/prevention & control , Patient Care/ethics , Patient Care/methods , Patient Care/psychology , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Pneumonia, Viral/psychology , Risk Factors , SARS-CoV-2 , United StatesSubject(s)
Aged/psychology , COVID-19/psychology , Mental Health , Resilience, Psychological , Humans , PandemicsSubject(s)
Aging , Cognition Disorders/therapy , Coronavirus Infections , Geriatric Psychiatry , Health Services for the Aged , Pandemics , Pneumonia, Viral , Telemedicine/organization & administration , Aged , Aging/physiology , Aging/psychology , Betacoronavirus , COVID-19 , Communicable Disease Control/methods , Continuity of Patient Care/trends , Coronavirus Infections/epidemiology , Coronavirus Infections/psychology , Geriatric Psychiatry/methods , Geriatric Psychiatry/standards , Geriatric Psychiatry/trends , Health Services for the Aged/supply & distribution , Health Services for the Aged/trends , Humans , Internet Access , Mental Health/trends , Pneumonia, Viral/epidemiology , Pneumonia, Viral/psychology , Quality of Health Care , SARS-CoV-2 , Vulnerable PopulationsSubject(s)
Coronavirus Infections/epidemiology , Delivery of Health Care , Education, Medical, Graduate , Geriatric Psychiatry , Neurocognitive Disorders/psychology , Pneumonia, Viral/epidemiology , Telemedicine , Adaptation, Psychological , Betacoronavirus , COVID-19 , Communication , Delirium/psychology , Dementia/psychology , Electroconvulsive Therapy , Health Services Accessibility , Humans , Internet Access , Nursing Homes , Pandemics , Patient Satisfaction , Personnel Staffing and Scheduling , Qualitative Research , Resilience, Psychological , SARS-CoV-2 , Social Isolation , Transcranial Magnetic Stimulation , United States/epidemiology , WorkflowABSTRACT
OBJECTIVE: To determine the effect of the COVID-19 pandemic on the mental health of older adults with pre-existing major depressive disorder (MDD). PARTICIPANTS: Participants were 73 community-living older adults with pre-existing MDD (mean age 69 [SD 6]) in Los Angeles, New York, Pittsburgh, and St Louis. DESIGN AND MEASUREMENTS: During the first 2 months of the pandemic, the authors interviewed participants with a semistructured qualitative interview evaluating access to care, mental health, quality of life, and coping. The authors also assessed depression, anxiety, and suicidality with validated scales and compared scores before and during the pandemic. RESULTS: Five themes from the interviews highlight the experience of older adults with MDD: 1) They are more concerned about the risk of contracting the virus than the risks of isolation. 2) They exhibit resilience to the stress and isolation of physical distancing. 3) Most are not isolated socially, with virtual contact with friends and family. 4) Their quality of life is lower, and they worry their mental health will suffer with continued physical distancing. 5) They are outraged by an inadequate governmental response to the pandemic. Depression, anxiety, and suicidal ideation symptom scores did not differ from scores before the pandemic. CONCLUSION: Most older adults with pre-existing MDD show resilience in the first 2 months of the COVID-19 pandemic but have concerns about the future. Policies and interventions to provide access to medical services and opportunities for social interaction are needed to help to maintain mental health and quality of life as the pandemic continues.