Mood and activity changes during the COVID-19 pandemic in rural and urban Veterans and their cohabitants.

OBJECTIVES: We aimed to examine the impact of COVID-19 pandemic-related stay-at-home orders on weekly reports of mood and activity before and during COVID-19 in a sample of older Veterans and their cohabitants. METHODS: Urban and rural Veterans and their cohabitants living in the Pacific Northwest ≥62 years old were enrolled as part of the Collaborative Aging Research Using Technology initiative (n = 100, age = 71.2 ± 6.5, 41% women). Participants reported frequency of social activities (e.g., travel away), physical illness, and mood (blue mood and loneliness) via weekly online health forms. RESULTS: A total of 2,441 weekly online health forms (OHFs) were collected from 100 participants. During the COVID-19 pandemic, blue mood (OR = 4.4, p < .0001) and loneliness (OR = 7.2, p < .0001) were significantly higher than before the pandemic, and travel away from home was significantly lower (OR = 0.5, p < .0001). Prevalence of blue mood and loneliness were not associated with rurality. CONCLUSIONS: The current study established that blue mood and loneliness were significantly more prevalent in older Veterans following COVID-19 stay-at-home orders regardless of rurality. CLINICAL IMPLICATIONS: The COVID-19 pandemic associated health precautions, while necessary to curb acute health risks, have created a unique situation that places vulnerable populations at increased risk of low mood.

Type and frequency of social contacts associated with low mood before and during the COVID-19 pandemic in older adults: I-CONECT project.

BACKGROUND: Social isolation is a risk factor for dementia, but the underlying mechanism is not well understood. It is possible that lack of social contacts negatively affects emotional well-being, which leads to cognitive decline. To shed light on this potential mediation mechanism, we examined changes in type and frequency of social contacts and their effects on mood using data collected before and during the COVID-19 pandemic among socially isolated older adults aged 75 and older. METHOD: The data come from an ongoing randomized controlled trial, the Internet-Based Conversational Engagement Clinical Trial (I-CONECT, ClinicalTirals.gov: NCT02871921). One hundred forty-six participants (age=81.0±4.5, 71.9% women) who were in the trial both before and during the pandemic and whose data were available as of November of 2020 were included in the current analysis. Weekly health questionnaires administered on all participants regardless of treatment assignments were collected before and during the COVID-19 pandemic. Low mood ("Blueness") was self-reported as feeling downhearted or blue for three or more days in the past week (YES/NO). Social contacts were self-reported by amount of time they had interacted, with whom (family; friends; others), and via which modalities (in-person; phone/video call; text/email). RESULT: A total of 4,774 weeks of survey data were analyzed (3,047 before COVID 19). The weekly average time spent in-person, on phone/video call, and via text/email were 282, 113, and 44 minutes, respectively. During the COVID-19 pandemic, participants on average spent 82 minutes less in total social contact per week (in-person: reduced 123 minutes, video/call: increased 28 minutes, text/email: increased 13 minutes per week). Generalized estimating equation model revealed that in-person family contact was associated with less blueness regardless of the pandemic (OR=0.91, p=0.04). There was a COVID*text/email time with friends interaction (OR=0.68, p=0.03), suggesting that during the COVID-19 pandemic, an increase of 1 hour of texting/emailing with friends per week was associated with 32% decrease in experiencing blueness three or more days per week. CONCLUSION: In-person family time is beneficial for mental health. While in-person contacts become less frequent during the COVID-19 pandemic, increased text/email time with friends becomes an alternative to maintain mental health for socially isolated older adults.

Can changes in social contact (frequency and mode) mitigate low mood before and during the COVID-19 pandemic? The I-CONECT project.

BACKGROUND/OBJECTIVES: The coronavirus disease 2019 (COVID-19) global outbreak allowed a natural experiment to observe how older adults changed social patterns and how it affected their emotional well-being. We studied the frequency and modes of social contact and their effects on older adults' mood before and during the COVID-19 pandemic. DESIGN: Phone-based surveys were administered weekly before and during the COVID-19 pandemic. SETTING: Participants were recruited from Portland, Oregon, and Detroit, Michigan. PARTICIPANTS: Older adults ≥75 years old (n = 155, age = 81.0 ± 4.5, 72.3% women) were included in a randomized controlled trial, the Internet-Based Conversational Engagement Clinical Trial (I-CONECT). MEASUREMENTS: Low mood was self-reported as feeling downhearted or blue for three or more days in the past week. Social contact was self-reported by the amount of time spent in interactions, with whom (family, friends, others), and via which modes (in-person, phone/video call, text/email/letter). RESULTS: A total of 5525 weeks of data were derived from 155 participants. Before the COVID-19 pandemic, average social interaction time spent in-person, on phone/video call, and via text/email/letter was 406, 141, and 68 min/week, respectively. During the COVID-19 pandemic, time spent in-person was reduced by 135 min/week, while time spent via phone/video call and writing increased by 33 and 26 mins/week, respectively. In-person family contact was associated with less low mood regardless of the pandemic (odds ratio = 0.92, p < 0.05). There was a COVID-19 × text/email/letter with friends interaction (odds ratio = 0.77, p = 0.03), suggesting that during the COVID-19 pandemic, an increase of 1 h of writing with friends per week was associated with a 23% decrease in the likelihood of experiencing low mood. CONCLUSION: The lost in-person time relating to COVID-19 restrictions tended to be partially compensated for with increased calls and writing time, although overall social interaction time decreased. During the COVID-19 pandemic, at least two types of social interactions (writing to friends and in-person family time) showed promise for mitigating low mood for older adults with limited social resources.

Older Adults' Daily Activity and Mood Changes Detected During the COVID-19 Pandemic Using Remote Unobtrusive Monitoring Technologies.

BACKGROUND AND OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic has limited older adults' access to in-person medical care, including screenings for cognitive and functional decline. Remote, technology-based tools have shown recent promise in assessing changes in older adults' daily activities and mood, which may serve as indicators of underlying health-related changes (e.g., cognitive decline). This study examined changes in older adults' driving, computer use, mood, and travel events prior to and following the COVID-19 emergency declaration using unobtrusive monitoring technologies and remote online surveys. As an exploratory aim, the impact of mild cognitive impairment (MCI) on these changes was assessed. RESEARCH DESIGN AND METHODS: Participants were 59 older adults (41 cognitively intact and 18 MCI) enrolled in a longitudinal aging study. Participants had their driving and computer use behaviors recorded over a 5-month period (75 days pre- and 76 days post-COVID emergency declaration) using unobtrusive technologies. Measures of mood, overnight guests, and frequency of overnight travel were also collected weekly via remote online survey. RESULTS: After adjusting for age, gender, and education, participants showed a significant decrease in daily driving distance, number of driving trips, highway driving, and nighttime driving, post-COVID-19 as compared to pre-COVID-19 (p < .001) based on generalized estimating equation models. Further, participants spent more time on the computer per day post-COVID-19 (p = .03). Participants endorsed increases in blue mood (p < .01) and loneliness (p < .001) and decreases in travel away from home and overnight visitors (p < .001) from pre- to post-COVID-19. Cognitive status did not impact these relationships. DISCUSSION AND IMPLICATIONS: From pre- to post-COVID-19 emergency declaration, participants drove and traveled less, used their computer more, had fewer overnight visitors, and reported greater psychological distress. These results highlight the behavioral and psychological effects of stay-at-home orders on older adults who are cognitively intact and those with MCI.