Predictors of persistent depressive and anxiety symptoms among older adults during the COVID-19 pandemic in Canada.

ABSTRACT

BACKGROUND: The COVID-19 pandemic has increased the risk of psychological distress for older adults during a period of reduced access to mental health support. We identified predictors of persistent depressive and anxiety symptoms among older adults throughout the initial 9 months of the pandemic. METHODS: This was a longitudinal study using web-based surveys sent to a convenience sample of Canadians aged ≥55 years. A baseline survey was sent in May 2020, with eight surveys sent monthly between June 2020 and January 2021. Data were separated into three study periods, corresponding to coronavirus case rates. Respondents who met predetermined thresholds for elevated depressive or anxiety symptoms using standardized mental health scales during all three periods were defined as having persistent symptoms. Multivariable Poisson regression was used to compare the risk of persistent symptoms across respondent characteristics selected a priori. RESULTS: There were 835 respondents who answered questions about depressive symptoms and 865 who answered questions about anxiety symptoms across all three study periods. Among those with complete follow-up data, 19.2% (n = 159/827) reported persistent depressive symptoms and 16.4% (n = 140/856) reported persistent anxiety symptoms. Respondents with persistent depressive symptoms were more likely to be women (adjusted relative risk [aRR] 1.71; 95% CI 1.19-2.46), and report multimorbidity (aRR 1.45; 95% CI 1.07-1.97), pre-existing depression (aRR 2.00; 95% CI 1.45-2.77) and pre-existing anxiety (aRR 1.50; 95% CI 1.10-2.06). The same respondent characteristics were correlates of persistently elevated anxiety symptoms. CONCLUSIONS: Older women, older adults with pre-existing depression and anxiety, and those with multimorbidity were more likely to report persistent mental health symptoms during the first 9 months of the COVID-19 pandemic. These individuals were known to have elevated risk prior to the pandemic, and expanded interventions targeted to these groups are necessary to adequately address their mental health needs.