Cheng Greta Jianjia, Wagner Abram L, O'Shea Brendan Q, Joseph Carly A, Finlay Jessica M, Kobayashi Lindsay C
Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA.
Social Environment and Health Program, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA.
Innov Aging. 2022 Jul 30;6(5):igac047. doi: 10.1093/geroni/igac047. eCollection 2022.
This study aimed to examine the associations between multimorbidity at the COVID-19 pandemic onset and subsequent longitudinal trajectories of depressive symptoms, anxiety symptoms, and loneliness in middle-aged and older adults over a 12-month follow-up.
Data were from monthly online questionnaires in the COVID-19 Coping Study of U.S. adults aged ≥55 from April/May 2020 through April/May 2021 ( = 4,024). Multimorbidity was defined as having ≥2 versus <2 chronic conditions at baseline. Mental health outcomes were assessed monthly as depressive symptoms (8-item Center for Epidemiologic Studies Depression scale), anxiety symptoms (5-item Beck Anxiety Inventory), and loneliness (3-item UCLA Loneliness Scale). We used multivariable-adjusted population- and attrition-weighted mixed-effects linear models to examine the longitudinal associations between multimorbidity and mental health symptoms.
Multimorbidity at the pandemic onset was associated with elevated depressive ( = 0.37; 95% CI: 0.16-0.59) and anxiety ( = 0.39; 95% CI: 0.15-0.62) symptoms at baseline. Changes in symptoms for all three mental health outcomes were nonlinear over time, with worsening symptoms over the first 6 months of the pandemic (April/May to September/October 2020), followed by improvement in symptoms over the subsequent 6 months (September/October 2020 to April/May 2021). Middle-aged and older adults with multimorbidity experienced faster rates of change in anxiety symptoms and loneliness than those without multimorbidity, with persistently elevated mental health symptomatology throughout the follow-up.
Results highlight the unique and persistent mental health risks experienced by middle-aged and older adults with multimorbidity during the COVID-19 pandemic. The observed improvements in symptoms underscore the mental resilience of these individuals, indicating their adaptation to the ongoing pandemic.
本研究旨在探讨新冠疫情暴发时的多种疾病共患情况与中老年成年人在12个月随访期间抑郁症状、焦虑症状和孤独感的后续纵向轨迹之间的关联。
数据来自2020年4月/5月至2021年4月/5月对年龄≥55岁的美国成年人进行的新冠应对研究中的月度在线问卷调查（n = 4,024）。多种疾病共患定义为在基线时患有≥2种与<2种慢性病。每月评估心理健康结果，包括抑郁症状（8项流行病学研究中心抑郁量表）、焦虑症状（5项贝克焦虑量表）和孤独感（3项加州大学洛杉矶分校孤独量表）。我们使用多变量调整的总体和损耗加权混合效应线性模型来研究多种疾病共患与心理健康症状之间的纵向关联。
疫情暴发时的多种疾病共患与基线时抑郁症状（β = 0.37；95%置信区间：0.16 - 0.59）和焦虑症状（β = 0.39；95%置信区间：0.15 - 0.62）升高有关。所有三种心理健康结果的症状变化随时间呈非线性，在疫情的前6个月（2020年4月/5月至9月/1日）症状恶化，随后在接下来的6个月（2020年9月/1日至2021年4月/5月）症状改善。与无多种疾病共患的人相比，患有多种疾病共患的中老年成年人焦虑症状和孤独感的变化速度更快，在整个随访期间心理健康症状持续升高。
结果凸显了新冠疫情期间患有多种疾病共患的中老年成年人所面临的独特且持续的心理健康风险。观察到的症状改善强调了这些个体的心理恢复力，表明他们对持续的疫情的适应。
