Luo Yan
The University of Alabama, Tuscaloosa, AL, United States.
JMIR Aging. 2021 Oct 5;4(4):e29953. doi: 10.2196/29953.
During the COVID-19 pandemic, the depression level among US adults has significantly increased. Age disparity in depression during the pandemic has been reported in recent studies. Delay or avoidance of medical care is one of the collateral damages associated with the COVID-19 pandemic, and it can lead to increased morbidity and mortality.
This study aimed to assess the prevalence of depression and delayed care among US middle-aged adults and older adults during the pandemic, as well as investigate the association of delayed care with depression among those 2 age groups.
This cross-sectional study used data from the 2020 Health and Retirement Study (HRS) COVID-19 Project (Early, Version 1.0). Univariate analyses, bivariate analyses, and binary logistic regression were applied. US adults older than 46 years were included. Depression was measured by the Composite International Diagnostic Interview-Short Form (CIDI-SF). Delayed care was measured by the following 4 items: delayed surgery, delayed seeing a doctor, delayed dental care, and other delayed care.
A total of 3246 participants were identified. More than half of the participants were older than 65 years (n=1890, 58.2%), and 274 (8.8%) participants had depression during the pandemic. Delayed dental care was positively associated with depression among both middle-aged adults (OR 2.05, 95% CI 1.04-4.03; P=.04) and older adults (OR 3.08, 95% CI 1.07-8.87; P=.04). Delayed surgery was positively associated with depression among older adults (OR 3.69, 95% CI 1.06-12.90; P=.04). Self-reported pain was positively related to depression among both age groups. Middle-aged adults who reported higher education levels (some college or above) or worse self-reported health had a higher likelihood of having depression. While perceived more loneliness was positively associated with depression among older adults, financial difficulty was positively associated with depression among middle-aged adults.
This study found that depression was prevalent among middle-aged and older adults during the pandemic. The study highlighted the collateral damage of the COVID-19 pandemic by identifying the association of delayed surgery and dental care with depression during the pandemic. Although surgery and dental care cannot be delivered by telehealth, telehealth services can still be provided to address patients' concerns on delayed surgery and dental care. Moreover, the implementation of telemental health services is needed to address mental health symptoms among US middle-aged and older adults during the pandemic. Future research that uses more comprehensive measurements for delayed care is needed to decipher the path through which delayed care is associated with depression.
在新冠疫情期间，美国成年人的抑郁水平显著上升。近期研究报告了疫情期间抑郁的年龄差异。延迟或避免医疗护理是与新冠疫情相关的附带损害之一，它可能导致发病率和死亡率上升。
本研究旨在评估疫情期间美国中年和老年成年人中抑郁和延迟护理的患病率，并调查这两个年龄组中延迟护理与抑郁之间的关联。
这项横断面研究使用了2020年健康与退休研究（HRS）新冠项目（早期版本1.0）的数据。应用了单变量分析、双变量分析和二元逻辑回归。纳入年龄超过46岁的美国成年人。抑郁通过综合国际诊断访谈简表（CIDI-SF）进行测量。延迟护理通过以下4项进行测量：延迟手术、延迟看医生、延迟牙科护理和其他延迟护理。
共确定了3246名参与者。超过一半的参与者年龄超过65岁（n = 1890，58.2%），274名（8.8%）参与者在疫情期间患有抑郁症。延迟牙科护理在中年成年人（OR 2.05，95% CI 1.04 - 4.03；P = 0.04）和老年成年人（OR 3.08，95% CI 1.07 - 8.87；P = 0.04）中均与抑郁呈正相关。延迟手术在老年成年人中与抑郁呈正相关（OR 3.69，95% CI 1.06 - 12.90；P = 0.04）。自我报告的疼痛在两个年龄组中均与抑郁呈正相关。报告受教育程度较高（大专及以上）或自我报告健康状况较差的中年成年人患抑郁症的可能性更高。虽然感知到更多孤独在老年成年人中与抑郁呈正相关，但经济困难在中年成年人中与抑郁呈正相关。
本研究发现疫情期间抑郁在中年和老年成年人中普遍存在。该研究通过确定疫情期间延迟手术和牙科护理与抑郁之间的关联，突出了新冠疫情的附带损害。虽然手术和牙科护理不能通过远程医疗提供，但仍可提供远程医疗服务来解决患者对延迟手术和牙科护理的担忧。此外，需要实施远程心理健康服务来解决疫情期间美国中年和老年成年人的心理健康症状。未来需要进行更多关于延迟护理综合测量的研究，以解读延迟护理与抑郁相关的途径。
