Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany.
Institute for Community Medicine, University Medicine Greifswald (UMG), Greifswald, Germany.
Front Public Health. 2023 May 22;11:1141433. doi: 10.3389/fpubh.2023.1141433. eCollection 2023.
With the outbreak of COVID-19, government measures including social distancing and restrictions of social contacts were imposed to slow the spread of the virus. Since older adults are at increased risk of severe disease, they were particularly affected by these restrictions. These may negatively affect mental health by loneliness and social isolation, which constitute risk factors for depressiveness. We aimed to analyse the impact of perceived restriction due to government measures on depressive symptoms and investigated stress as mediator in an at-risk-population in Germany.
Data were collected in April 2020 from the population of the -study, including individuals with a Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) score ≥9, using the depression subscale of the Brief Symptom Inventory (BSI-18) and the Perceived Stress Scale (PSS-4). Feeling restricted due to COVID-19 government measures was surveyed with a standardized questionnaire. Stepwise multivariate regressions using zero-inflated negative binomial models were applied to analyse depressive symptoms, followed by a general structural equation model to assess stress as mediator. Analysis were controlled for sociodemographic factors as well as social support.
We analysed data from 810 older adults (mean age = 69.9, SD = 5). Feeling restricted due to COVID-19 government measures was linked to increased depressiveness ( = 0.19; < 0.001). The association was no longer significant when adding stress and covariates ( = 0.04; = 0.43), while stress was linked to increased depressive symptoms ( = 0.22; < 0.001). A final model confirms the assumption that the feeling of restriction is mediated by stress (total effect: = 0.26; < 0.001).
We found evidence that feeling restricted due to COVID-19 government measures is associated with higher levels of depressive symptoms in older adults at increased risk for dementia. The association is mediated by perceived stress. Furthermore, social support was significantly associated with less depressive symptoms. Thus, it is of high relevance to consider possible adverse effects of government measures related to COVID-19 on mental health of older people.
随着 COVID-19 的爆发，政府采取了包括社交距离和限制社交接触在内的措施，以减缓病毒的传播。由于老年人患重病的风险增加，他们特别受到这些限制的影响。这些限制可能会通过孤独和社会隔离对心理健康产生负面影响，而孤独和社会隔离是抑郁的危险因素。我们旨在分析由于政府措施而导致的感知限制对抑郁症状的影响，并在德国的一个高危人群中研究压力作为中介因素。
2020 年 4 月，使用 Brief Symptom Inventory（BSI-18）抑郁量表和 Perceived Stress Scale（PSS-4），从心血管危险因素、衰老和痴呆发病率（CAIDE）评分≥9 的人群中收集研究人群的数据。使用标准化问卷调查因 COVID-19 政府措施而感到受限的情况。采用零膨胀负二项回归模型进行逐步多元回归，以分析抑郁症状，然后采用一般结构方程模型评估压力作为中介因素。分析中控制了社会人口因素以及社会支持。
我们分析了 810 名老年人的数据（平均年龄 69.9，标准差 5）。因 COVID-19 政府措施而感到受限与抑郁增加有关（β=0.19； < 0.001）。当加入压力和协变量时，这种关联不再显著（β=0.04； = 0.43），而压力与抑郁症状增加有关（β=0.22； < 0.001）。最终模型证实了这样的假设，即限制感是由压力介导的（总效应：β=0.26； < 0.001）。
我们有证据表明，由于 COVID-19 政府措施而感到受限与痴呆高危老年人的抑郁水平升高有关。这种关联是由感知压力介导的。此外，社会支持与较少的抑郁症状显著相关。因此，考虑 COVID-19 相关政府措施对老年人心理健康的可能不利影响具有重要意义。
