Department of Epidemiology and Public Health, University College London, London, United Kingdom.
Department of Behavioural Science and Health, University College London, London, United Kingdom.
JAMA Psychiatry. 2022 Feb 1;79(2):151-159. doi: 10.1001/jamapsychiatry.2021.3749.
Despite the emphasis placed on the psychological impact of the COVID-19 pandemic, evidence from representative studies of older adults including pre-COVID-19 data and repeated assessments during the pandemic is scarce.
To examine changes in mental health and well-being before and during the initial and later phases of the COVID-19 pandemic and test whether patterns varied with sociodemographic characteristics in a representative sample of older adults living in England.
DESIGN, SETTING, AND PARTICIPANTS: This longitudinal cohort study analyzed data from 5146 older adults participating in the English Longitudinal Study of Ageing who provided data before the COVID-19 pandemic (2018 and 2019) and at 2 occasions in 2020 (June or July as well as November or December).
The COVID-19 pandemic and sociodemographic characteristics, including sex, age, partnership status, and socioeconomic position.
Changes in depression (8-item Centre for Epidemiological Studies Depression scale), anxiety (7-item Generalized Anxiety Disorder scale), quality of life (12-item Control, Autonomy, Self-realization, and Pleasure scale), and loneliness (3-item Revised University of California, Los Angeles, loneliness scale) were tested before and during the COVID-19 pandemic using fixed-effects regression models.
Of 5146 included participants, 2723 (52.9%) were women, 4773 (92.8%) were White, and the mean (SD) age was 67.7 (10.6) years. The prevalence of clinically significant depressive symptoms increased from 12.5% (95% CI, 11.5-13.4) before the COVID-19 pandemic to 22.6% (95% CI, 21.6-23.6) in June and July 2020, with a further rise to 28.5% (95% CI, 27.6-29.5) in November and December 2020. This was accompanied by increased loneliness and deterioration in quality of life. The prevalence of anxiety rose from 9.4% (95% CI, 8.8-9.9) to 10.9% (95% CI, 10.3-11.5) from June and July 2020 to November and December 2020. Women and nonpartnered people experienced worse changes in mental health. Participants with less wealth had the lowest levels of mental health before and during the COVID-19 pandemic. Higher socioeconomic groups had better mental health overall but responded to the COVID-19 pandemic with more negative changes.
In this longitudinal cohort study of older adults living in England, mental health and well-being continued to worsen as the COVID-19 pandemic progressed, and socioeconomic inequalities persisted. Women and nonpartnered people experienced greater deterioration in mental health.
尽管强调了 COVID-19 大流行对心理的影响，但很少有针对包括大流行前老年人的代表性研究和大流行期间反复评估的证据。
在 COVID-19 大流行的初始和后期阶段之前和期间，检查心理健康和幸福感的变化，并测试在代表英格兰老年人的样本中，模式是否随社会人口特征而变化。
设计、地点和参与者：这项纵向队列研究分析了参加英国老龄化纵向研究的 5146 名老年人的数据，这些老年人在 COVID-19 大流行之前（2018 年和 2019 年）和 2020 年的 2 个时间点（6 月或 7 月以及 11 月或 12 月）提供了数据。
COVID-19 大流行和社会人口特征，包括性别、年龄、伴侣状况和社会经济地位。
使用固定效应回归模型在 COVID-19 大流行之前和期间测试抑郁（8 项流行病学研究中心抑郁量表）、焦虑（7 项广泛性焦虑障碍量表）、生活质量（12 项控制、自治、自我实现和快乐量表）和孤独感（3 项修订版加利福尼亚大学洛杉矶分校孤独量表）的变化。
在包括的 5146 名参与者中，有 2723 名（52.9%）为女性，4773 名（92.8%）为白人，平均（SD）年龄为 67.7（10.6）岁。从 COVID-19 大流行前的 12.5%（95%CI，11.5-13.4）到 2020 年 6 月和 7 月的 22.6%（95%CI，21.6-23.6），有临床意义的抑郁症状的患病率增加，到 2020 年 11 月和 12 月进一步上升至 28.5%（95%CI，27.6-29.5）。这伴随着孤独感的增加和生活质量的恶化。焦虑的患病率从 6 月和 7 月的 9.4%（95%CI，8.8-9.9）上升到 10.9%（95%CI，10.3-11.5）和 11.5）。2020 年 11 月和 12 月。女性和非伴侣人群的心理健康变化更差。财富较少的参与者在 COVID-19 大流行之前和期间心理健康水平最低。较高的社会经济群体总体上有更好的心理健康，但对 COVID-19 大流行的反应更为负面。
在这项针对居住在英格兰的老年人的纵向队列研究中，随着 COVID-19 大流行的继续，心理健康和幸福感继续恶化，社会经济不平等持续存在。女性和非伴侣人群的心理健康恶化更为严重。
