GROUP-BASED TRAJECTORIES AND PREDICTORS OF PSYCHOLOGICAL DISTRESS DURING COVID-19: A LONGITUDINAL STUDY OF OLDER ADULTS IN QUEBEC

ABSTRACT

In response to the COVID-19 pandemic, governments around the world imposed confinement and physical distancing directives for all citizens. Although essential to reduce the spread of the SARS-CoV-2 virus, these measures may have collateral consequences for older adults, such as increased psychological distress. Research suggests, as a population, older adults have been experiencing less psychological distress than younger adults during COVID-19. However, most of these studies examine mean levels of psychological distress and do not capture the heterogeneity of outcomes, like subgroups who may experience increased psychological distress. The goal of this longitudinal study was to use group-based trajectory modelling (GBTM) to identify meaningful subgroups that follow different trajectories of psychological distress among 645 older adults with a mean age of 78.69 (SD = 5.67). Participants were recruited from two research cohorts and newspaper ads. Telephone-based assessments were conducted across four time periods T1-Spring 2020-first confinement, T2-Summer 2020-first deconfinement, T3-Fall 2020-second confinement, and T4-Winter/Spring 2021-continued confinement. Participants completed the Kessler 6-item Psychological Distress Scale (K6) to assess psychological distress at each time point and provided information on socioeconomic, medical, and psychosocial factors. Results indicated that the average psychological distress level was stable across the first three time points but slightly increased at the fourth assessment (Fig. 1). Using GBTM, three groups emerged to best characterize the different trajectories of psychological distress resilient (50.5%), fluctuating (34.9%), and elevated (14.6%) distress groups (Fig. 1). Those in the fluctuating and elevated groups were more likely to have chronic mental health problems, mobility issues, insomnia symptoms, loneliness, COVID-19 related acute stress and general health anxiety than those in the resilient group. Those who lived in poverty, who could not use technology, and who took psychotropic medication had uniquely increased odds of being in the elevated group. These findings identify subgroups of older adults at greater risk of psychological distress with potential intervention targets to alleviate distress during and after the pandemic.