A longitudinal analysis of the impact of the COVID-19 pandemic on the mental health of middle-aged and older adults from the Canadian Longitudinal Study on Aging.

The coronavirus disease 2019 (COVID-19) pandemic presents an unprecedented challenge to public health, with over 233 million confirmed cases and over 4.6 million deaths globally as of September 20211. Although many studies have reported worse mental health outcomes during the early weeks of the pandemic, some sources suggest a gradual decrease in anxiety and depressive symptoms during the lockdown2. It remains to be explained whether mental health continued to deteriorate during the initial lockdown or whether there were signs of stabilization or improvement in the mental health of community-dwelling middle-aged and older adults. Our results showed that adults had twice the odds of depressive symptoms during the pandemic compared with the prepandemic period, with subgroups characterized by lower socioeconomic status and poor health-related factors experiencing a greater impact. Over 43% of adults showed a pattern of moderate or clinically high levels of depressive symptoms at baseline that increased over time. Loneliness and COVID-19 stressors were predictors of worsening depressive symptom trajectories. The disparities and patterns in the depressive symptom trajectories suggest that the negative mental health impacts of the pandemic persist and may worsen over time. Interventions that address the pandemic stressors and alleviate their impact on the mental health of adults are needed.

Predictors of reported alcohol intake during the first and second waves of the COVID-19 pandemic in Canada among middle-aged and older adults: results from the Canadian Longitudinal Study on Aging (CLSA).

OBJECTIVE: To examine proportions and predictors of change in alcohol intake and binge drinking during the first 2 waves of the COVID-19 pandemic among middle-aged and older participants in the Canadian Longitudinal Study on Aging (CLSA) COVID-19 Questionnaire Study. METHODS: A total of 28,559 (67.2% of the potential sample) CLSA participants consented to the study with 24,114 completing the exit survey (fall 2020). Descriptive statistics and logistic regressions to examine predictors of change (increase or decrease) in alcohol intake and binge drinking were performed. RESULTS: Among alcohol users, 26.3% reported a change in alcohol consumption during the first 10 months of the pandemic. Similar percentages increased (13.0%) or decreased (13.3%) consumption. In our mutually adjusted logistic regression model, odds of change in alcohol intake were greater for younger age, higher income, current cannabis smoker, positive screen for depression, anxiety, and loneliness. The magnitude of all associations for decreased intake was less than that of increased intake, and the directions were opposite for male sex and age. Predictors of current binge drinking (27.9% of alcohol users) included male sex, younger age, higher education and income, cannabis use, depression, and anxiety. CONCLUSION: Factors predictive of potentially worrisome alcohol use (i.e. increased intake, binge drinking) included younger age, sex, greater education and income, living alone, cannabis use, and worse mental health. Some of these factors were also associated with decreased intake, but the magnitudes of associations were smaller. This information may help direct screening efforts and interventions towards individuals at risk for problematic alcohol intake during the pandemic.

RéSUMé: OBJECTIF: Examiner les proportions et les prédicteurs des changements dans la consommation d'alcool et l'hyperalcoolisation rapide au cours des deux premières vagues de la pandémie de COVID-19 chez les personnes âgées et d'âge moyen ayant participé à l'étude par questionnaire sur la COVID-19 de l'Étude longitudinale canadienne sur le vieillissement (ELCV). MéTHODE: Un total de 28 559 participants de l'ELCV (67,2 % de l'échantillon potentiel) ont consenti à l'étude sur la COVID-19, et 24 114 ont répondu à l'enquête à la sortie (automne 2020). Nous avons procédé par statistique descriptive et par régression logistique pour examiner les prédicteurs des changements (augmentation ou diminution) dans la consommation d'alcool et l'hyperalcoolisation rapide. RéSULTATS: Chez les consommateurs d'alcool, 26,3 % ont déclaré un changement de leur consommation d'alcool au cours des 10 premiers mois de la pandémie. Un pourcentage semblable de consommateurs d'alcool avaient accru (13 %) ou diminué (13,3 %) leur consommation. Dans notre modèle de régression logistique mutuellement ajusté, la probabilité de changement dans la consommation d'alcool était plus élevée chez les répondants plus jeunes, les répondants au revenu élevé, les fumeurs de cannabis actuels et les répondants ayant fait état de dépression, d'anxiété ou de solitude. Les associations avec la diminution de la consommation étaient moins significatives qu'avec l'augmentation de la consommation, et elles allaient dans le sens opposé pour ce qui est du sexe masculin et de l'âge. Les prédicteurs de l'hyperalcoolisation rapide actuelle (27,9 % des consommateurs d'alcool) étaient le sexe masculin, l'âge plus jeune, l'instruction et le revenu élevés, la consommation de cannabis, la dépression et l'anxiété. CONCLUSION: Les facteurs pouvant prédire une consommation d'alcool potentiellement inquiétante (c.-à-d. consommation accrue, hyperalcoolisation rapide) étaient l'âge plus jeune, le sexe, l'instruction et le revenu élevés, le fait de vivre seul, la consommation de cannabis et la moins bonne santé mentale. Certains de ces facteurs étaient aussi associés à une consommation réduite, mais ces associations étaient moins significatives. Ces informations pourraient orienter les efforts de dépistage et les interventions auprès des personnes à risque de consommation problématique d'alcool durant la pandémie.

Factors Associated With Willingness to Receive a COVID-19 Vaccine Among 23,819 Adults Aged 50 Years or Older: An Analysis of the Canadian Longitudinal Study on Aging.

Identifying persons who are least willing to receive a coronavirus disease 2019 (COVID-19) vaccine is critical for increasing uptake via targeted outreach. We conducted a survey of 23,819 Canadian Longitudinal Study on Aging participants from September 29 to December 29, 2020, to assess factors associated with COVID-19 vaccination willingness and reasons for willingness or lack thereof. Among adults aged 50-96 years, 84.1% (95% confidence interval (CI): 83.7, 84.6) were very or somewhat willing to receive a COVID-19 vaccine; 15.9% (95% CI: 15.4, 16.3) were uncertain or very or somewhat unwilling. Based on logistic regression, those who were younger, female, had lower education and income, were non-White, and lived in a rural area were less willing to receive a COVID-19 vaccine. After controlling for these factors, recent receipt of influenza vaccine (adjusted odds ratio = 14.3, 95% CI: 12.5, 16.2) or planning to receive influenza vaccine (adjusted odds ratio = 10.5, 95% CI: 9.5, 11.6), as compared with no receipt or planning, was most strongly associated with COVID-19 vaccination willingness. Willingness was also associated with believing one had never been infected with severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) and experiencing negative pandemic consequences. Safety concerns were most common among those unwilling. Our comprehensive assessment of COVID-19 vaccination willingness among older adults in Canada, a prioritized group for vaccination due to their risk of severe COVID-19 outcomes, provides a road map for conducting outreach to increase uptake, which is urgently needed.

Impact of COVID-19 on mobility and participation of older adults living in Hamilton, Ontario, Canada: a multimethod cohort design protocol.

INTRODUCTION: The novel COVID-19 required many countries to impose public health measures that likely impacted the participation and mobility of community-dwelling older adults. This protocol details a multimethod cohort design undertaken to describe short-term and medium-term changes to the mobility and participation of older Canadians living in the community rather than retirement facilities during the COVID-19 pandemic. METHODS AND ANALYSIS: A longitudinal telephone (or online)-administered survey is being conducted with a random sample of older adults living within 20 km of McMaster University, Hamilton, Ontario, Canada, identified from census dissemination areas. Baseline data collection of community-dwelling older adults aged 65 years and over began in May 2020 with follow-ups at 3, 6, 9 and 12 months. The Late-Life Function and Disability Instrument and global rating of change anchors are the primary outcomes of interest. A subsample of respondents will participate in open-ended, semistructured interviews conducted over the telephone or through video-conference, to explore participants' lived experiences with respect to their mobility and participation during the pandemic. Descriptive statistics and quantitative approaches will be used to determine changes in mobility and social and personal participation, and associated personal and environmental factors. For the interviews, qualitative data will be analysed using descriptive phenomenology. ETHICS AND DISSEMINATION: Approval was obtained from the Hamilton Integrated Research Ethics Board of McMaster University (2020-10814-GRA). This study may inform the design of programmes that can support community-dwelling older adults during and after the COVID-19 pandemic. Findings will be disseminated through peer-reviewed publications and conferences focused on ageing.