Negative ageism and compassionate ageism in news coverage of older people under COVID-19: how did the pandemic progression and public health responses associate with different news themes?

Previous studies have found negative ageing narratives in the media during the COVID-19 pandemic. However, few have focused on compassionate ageism and how the news responded to the progression of the COVID-19 pandemic. We investigated (a) media themes of negative and compassionate ageism and (b) their relationships with COVID-19 parameters and the public health response. The sample included 1,197 articles relevant to COVID-19 and older people in Hong Kong published between January and December 2020. We used thematic analysis to identify themes from the news articles and structural equation modelling to explore these themes' relationship with the number of older people infected, effective reproduction number, number of COVID-19 deaths and public health response parallel in time. Pandemic-related variables were lagged for a day - the time needed to be reflected in the news. Two negative ageism themes portrayed older people as vulnerable to COVID-19 but counterproductive in combating the pandemic. Two compassionate ageism themes depicted older people as a homogenous group of passive assistance recipients. The theme blaming older people was associated with the number of confirmed infections (beta = 0.418, p = 0.002) but vulnerability of older people was not associated with pandemic-related variables. The theme helping older people was negatively associated with the percentage of older people in confirmed infections (beta = -0.155, p = 0.019). The theme resources available was negatively associated with confirmed infections (beta = -0.342, p < 0.001) but positively associated with the Containment and Health Index (beta = 0.217, p = 0.005). Findings suggested that negative and compassionate ageism were translated into narratives about older people in the media as the pandemic evolved but did not address the actual risk they faced. Media professionals should be aware of the potential negative and compassionate ageism prompted by the news agenda and promote adequate health behaviours and responses.

Depressive Symptoms and Its Correlates in Undergraduates during the COVID-19 Pandemic.

INTRODUCTION: This study aims to investigate depressive symptoms and its association with resilience, pessimistic bias of COVID-19, lifestyle changes, and family conflicts among undergraduates in a Hong Kong university. METHODS: 1020 undergraduates in The University of Hong Kong completed the online survey between May and August 2020. Severity of depressive symptoms was assessed using the Patient Health Questionnaire-9. Resilience was assessed using the Connor-Davidson Resilience Scale. Pessimistic bias was assessed using two questions on the perceived risks of contracting COVID-19 and of dying from COVID-19. Changes in lifestyles and the presence of family conflicts were measured. Multivariable and mediation analyses were performed to examine association of depressive symptoms with other variables. RESULTS: 61.7% of the respondents reported having mild to severe depressive symptoms. 18.5% of the variance in depressive symptoms was explained by resilience, pessimistic bias, changes in the frequency of sleep, studying at home, and family conflict. Pessimistic bias partially mediated the association between resilience and depressive symptoms. CONCLUSION: The proportion of undergraduates with mild to severe depressive symptoms during the pandemic was high. Measures to reduce family conflict, maintain healthy daily habits, adjust pessimistic bias, and enhance resilience may help to improve the mental well-being of undergraduates during the pandemic.

IMPACT OF COVID-19 PANDEMIC ON MENTAL HEALTH IN OLDER ADULTS: COMPARISON BETWEEN 2020 AND 2022

The COVID-19 pandemic had a major impact on older adults' mental health, but less is known about its longer-term effect. We examined changes in depressive and anxiety symptoms among older adults between the onset and two years into the pandemic. Data were drawn from two cross-sectional telephone surveys conducted with older adults aged ≥ 60 years in Hong Kong in 2020 and 2022. Respondents were screened for depression and anxiety using Patient Health Questionnaire-2 (PHQ-2) and General Anxiety Disorders-2 (GAD-2) and, if screened positive (i.e. scoring ≥ 3 in PHQ-2 or GAD-2), evaluated with PHQ-9 and GAD-7 for symptom severity. After case-control matching baseline age, gender, living districts, and pre-existing mental health conditions based on the respondent ratio between the two surveys (i.e. 2:1 ratio), 4095 and 2099 respondents from the 2020 and 2022 surveys were included in the analysis. Respondents' average baseline age was 75 years old, 77% were female, and 13% had a pre-existing mental health condition. There were significant increases in the proportion of older adults screened positive for depression (8.3% to 13.5%) and anxiety (6.9% to 11.4%) and a significant increase in depressive symptom severity (4.63 to 7.72) between 2020 and 2022 (p < .001). Logistic regression suggested that, over two years, older adults with pre-existing mental health conditions were 1.59 times more likely to screen positive for depression than those without such conditions. Linear regression suggested that males were associated with increased depressive (B=-2.42, p=.004) and anxiety (B=-2.49, p=.021) symptom severity than females over the years.

ASSOCIATIONS BETWEEN COVID-19 RELATED STRESS, COVID-19 EXPERIENCES, AND MENTAL HEALTH RISKS IN OLDER PEOPLE

There is increasing recognition of the need to understand the mechanism of psychological impact brought by COVID-19. The present research used the Delphi technique to develop a COVID-19-Related Stress Scale for older people in Hong Kong (CSS-old) (study one) and examined its associations with COVID-19 experiences and mental health risks (study two). In study one, 17 helping professionals and 20 service users co-developed an 8-item CSS-old through four rounds of Delphi. In study two, a cross-sectional telephone survey was conducted between April and June 2022 among 4,921 older people (age≥60) recruited through community centres. Respondents were assessed using Patient Health Questionnaire-2 (PHQ-2), Generalized Anxiety Disorder 2-item (GAD-2), and CSS-old;their experiences with COVID-19 (infection, close friend/family infection) and demographical information were collected. A three-factor solution of CSS-old was identified after dropping one item (X2(df) = 83.53(11), CFI=0.996, TLI=0.993, RMSEA=0.037): (1) disruption to routines;(2) fear of infecting families/friends;and (3) concern for the community's health. Structural equation modelling analyses revealed that being female (B=0.45), having close friend/family infected (B=1.10) and having a pre-existing mental health condition (B=1.87) were positively associated with COVID-19-related stress. Infection of COVID-19 (BPHQ=0.22;BGAD=0.24) and a pre-existing mental health condition (BPHQ=0.71;BGAD=0.59) had direct associations with depressive and anxiety symptoms;COVID-19-related stress mediated the relationship between close friend/family infection with depressive (B=0.20) and anxiety symptoms (B=0.21, all p < 0.05). These results suggest that older people's COVID-19-related stress is beyond infection of the disease, and different experiences with COVID-19 may increase depression and anxiety risks through different pathways.

DIFFERENTIAL ROLES OF COVID-19-RELATED STRESSORS IN MENTAL HEALTH PROBLEMS: A NETWORK APPROACH

COVID-19-related stress is heterogeneous and associated with increased mental health conditions in older adults. This study is to investigate relationships between different stressors and how different stressors may increase risks for mental health conditions through a network approach. A telephone survey was conducted among 4,921 older adults (age≥60) from April to June 2022 during the biggest community outbreak of COVID-19 in Hong Kong. The validated 8-item COVID-19-Related Stress Scale (CSS-old) (Cronbach's α: 0.91) was used to investigate the different stressor for older people in Hong Hong. Respondents were screened for depression using the Patient Health Questionnaire-2 (PHQ-2), anxiety using the Generalized Anxiety Disorder 2-item (GAD-2), and stressors with the CSS-old, 4708 responded to all questions. A regularized partial correlation network via graphical LASSO procedure was computed to analyze the relationship between 8 stressors;a directed acyclic graph (DAG) via a Bayesian hill-climbing algorithm was generated from CSS-old and comorbidity network with PHQ-2 and GAD-2 items. Network analyses identified CSS-old item 6 (families or friends infected), item 3 (daily life interrupted), item 5 (fear of infection affecting the family), and item 8 (worry for community's health) as the core stressors. DAG analysis found a key triggering role for item 1 (suspension of community services), and the activation of the mental health problems occurred through item 1, which bridged the COVID-19-related stress and mental health problems. These findings suggested that providing support for families with COVID-19 patients and alternative services during community service suspension may reduce mental health problems risks.

The impact of Virtual Individual Cognitive Stimulation Therapy (V-iCST) on cognition, quality of life, mood, and communication in dementia: a feasibility randomized controlled trial

Background: The COVID-19 pandemic has led to the suspension of community-based dementia services worldwide, where evidence-based interventions for dementia, like Cognitive Stimulation Therapy (CST), were delivered. Treatment access is paramount during the pandemic and beyond for people with dementia to maintain functioning and well-being. This study aimed to evaluate the feasibility and acceptability of a virtual, 14-session program of Individual Cognitive Stimulation Therapy (V-iCST) in the UK. Method(s): A single-blind feasibility randomized controlled trial (RCT) was conducted in the UK. Thirty-four people with mild to moderate dementia were recruited from dementia organizations and networks. Seventeen were randomly assigned to receive V-iCST (14, 45-min sessions) and 17 to treatment as usual (TAU) over seven weeks. Feasibility and acceptability data, for example, recruitment, attrition, attendance, adverse effects, and fidelity, were collected. Outcome measures on cognitive function, quality of life (QoL), mood, and communication were collected pre and post-test. Analysis of covariance was used to compare changes in V-iCST and TAU. Result(s): We have successfully completed recruitment. Results on feasibility, acceptability, and preliminary efficacy will be available at the conference. Conclusion(s): We hypothesize that V-iCST is feasible and acceptable and will have positive effects on cognitive, QoL, mood, and communication. Findings will be available at the conference. Copyright © 2022 the Alzheimer's Association.

Measuring subjective stress among young people in Hong Kong: validation and predictive utility of the single-item subjective level of stress (SLS-1) in epidemiological and longitudinal community samples

AimsBrief measurements of the subjective experience of stress with good predictive capability are important in a range of community mental health and research settings. The potential for large-scale implementation of such a measure for screening may facilitate early risk detection and intervention opportunities. Few such measures however have been developed and validated in epidemiological and longitudinal community samples. We designed a new single-item measure of the subjective level of stress (SLS-1) and tested its validity and ability to predict long-term mental health outcomes of up to 12 months through two separate studies.MethodsWe first examined the content and face validity of the SLS-1 with a panel consisting of mental health experts and laypersons. Two studies were conducted to examine its validity and predictive utility. In study 1, we tested the convergent and divergent validity as well as incremental validity of the SLS-1 in a large epidemiological sample of young people in Hong Kong (n = 1445). In study 2, in a consecutively recruited longitudinal community sample of young people (n = 258), we first performed the same procedures as in study 1 to ensure replicability of the findings. We then examined in this longitudinal sample the utility of the SLS-1 in predicting long-term depressive, anxiety and stress outcomes assessed at 3 months and 6 months (n = 182) and at 12 months (n = 84).ResultsThe SLS-1 demonstrated good content and face validity. Findings from the two studies showed that SLS-1 was moderately to strongly correlated with a range of mental health outcomes, including depressive, anxiety, stress and distress symptoms. We also demonstrated its ability to explain the variance explained in symptoms beyond other known personal and psychological factors. Using the longitudinal sample in study 2, we further showed the significant predictive capability of the SLS-1 for long-term symptom outcomes for up to 12 months even when accounting for demographic characteristics.ConclusionsThe findings altogether support the validity and predictive utility of the SLS-1 as a brief measure of stress with strong indications of both concurrent and long-term mental health outcomes. Given the value of brief measures of mental health risks at a population level, the SLS-1 may have potential for use as an early screening tool to inform early preventative intervention work.