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了解韧性:COVID-19 大流行期间社区居住的老年人心理健康和幸福感的基于生活方式的行为预测因素。

Understanding resilience: Lifestyle-based behavioral predictors of mental health and well-being in community-dwelling older adults during the COVID-19 pandemic.

机构信息

Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Ste. 1360, Seattle, WA, 98101, USA.

Department of Medicine, University of Washington, Seattle, WA, USA.

出版信息

BMC Geriatr. 2024 Aug 12;24(1):676. doi: 10.1186/s12877-024-05251-3.

Abstract

BACKGROUND

Changes in sleep, physical activity and mental health were observed in older adults during early stages of the COVID-19 pandemic. Here we describe effects of the COVID-19 pandemic on older adult mental health, wellbeing, and lifestyle behaviors and explore predictors of better mid-pandemic mental health and wellbeing.

METHODS

Participants in the Adult Changes in Thought study completed measures of lifestyle behaviors (e.g., sleep, physical activity) and mental health and wellbeing both pre-pandemic during regular study visits and mid-pandemic via a one-time survey. We used paired t-tests to compare differences in these measures pre- vs. mid-pandemic. Using multivariate linear regression, we further explored demographic, health, and lifestyle predictors of pandemic depressive symptoms, social support, and fatigue. We additionally qualitatively coded free text data from the mid-pandemic survey for related comments.

RESULTS

Participants (N = 896) reported significant changes in mental health and lifestyle behaviors at pre-pandemic vs. mid-pandemic measurements (p < 0.0001). Qualitative findings supported these behavioral and wellbeing changes. Being male, never smoking, and lower pre-pandemic computer time and sleep disturbance were significantly associated with lower pandemic depressive symptoms. Being partnered, female, never smoking, and lower pre-pandemic sleep disturbance were associated with higher pandemic social support. Pre-pandemic employment, more walking, less computer time, and less sleep disturbance were associated with less pandemic fatigue. Participant comments supported these quantitative findings, highlighting gender differences in pandemic mental health, changes in computer usage and physical activity during the pandemic, the value of spousal social support, and links between sleep disturbance and mental health and wellbeing. Qualitative findings also revealed additional factors, such as stresses from personal and family health situations and the country's concurrent political environment, that impacted mental health and wellbeing.

CONCLUSIONS

Several demographic, health, and lifestyle behaviors appeared to buffer the effects of the COVID-19 pandemic and may be key sources of resilience. Interventions and public health measures targeting men and unpartnered individuals could promote social support resilience, and intervening on modifiable behaviors like sleep quality, physical activity and sedentary activities like computer time may promote resilience to fatigue and depressive symptoms during future community stressor events. Further research into these relationships is warranted.

摘要

背景

在 COVID-19 大流行的早期阶段,老年人的睡眠、身体活动和心理健康发生了变化。在这里,我们描述了 COVID-19 大流行对老年人心理健康、幸福感和生活方式行为的影响,并探讨了更好的大流行中期心理健康和幸福感的预测因素。

方法

成人思想变化研究的参与者在大流行前的常规研究访问期间以及通过一次性调查在大流行中期完成了生活方式行为(例如睡眠、身体活动)和心理健康和幸福感的测量。我们使用配对 t 检验比较了这些措施在大流行前和大流行中期的差异。使用多元线性回归,我们进一步探讨了人口统计学、健康和生活方式对大流行期间抑郁症状、社会支持和疲劳的预测因素。我们还对大流行中期调查的自由文本数据进行了定性编码,以获取相关评论。

结果

参与者(N=896)报告称,在大流行前和大流行中期的测量中,心理健康和生活方式行为发生了显著变化(p<0.0001)。定性研究结果支持了这些行为和幸福感的变化。男性、从不吸烟、大流行前较少使用电脑和睡眠障碍与较低的大流行期间抑郁症状显著相关。已婚、女性、从不吸烟、大流行前睡眠障碍较少与较高的大流行期间社会支持相关。大流行前的就业、更多的步行、较少的电脑时间和较少的睡眠障碍与较少的大流行期间疲劳相关。参与者的评论支持了这些定量研究结果,突出了大流行期间心理健康的性别差异、大流行期间电脑使用和身体活动的变化、配偶社会支持的价值以及睡眠障碍与心理健康和幸福感之间的联系。定性研究结果还揭示了其他因素,例如个人和家庭健康状况以及国家同期政治环境的压力,这些因素对心理健康和幸福感产生了影响。

结论

几个人口统计学、健康和生活方式行为似乎缓冲了 COVID-19 大流行的影响,可能是韧性的关键来源。针对男性和未婚个体的干预措施和公共卫生措施可以促进社会支持的韧性,干预可改变的行为,如睡眠质量、身体活动和久坐不动的行为,如电脑时间,可能会促进在未来的社区应激事件中对疲劳和抑郁症状的韧性。有必要进一步研究这些关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae9e/11318348/f7a247e315f1/12877_2024_5251_Fig1_HTML.jpg

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