Evaluating the Effects of the COVID-19 Pandemic on Depression and Resilience in Older Adults

INTRODUCTION: Since March 2020, the COVID-19 pandemic has affected the physical and mental health of older adults. We know how social isolation and loneliness may adversely affect one's health, mood, and cognition, specifically in adults over 65. However, when faced with adversity, studies have shown older adults to be at least, if not more, resilient than their younger counterparts. This study aimed to understand the extent of psychosocial impact the pandemic had on older adults with and without depression currently enrolled in the Neurobiology of Late-Life Depression (NBOLD) Study. In conjunction with the Brief Carroll Depression and Brief Resilience Scales, we used a novel measure of pandemic-related experiences across several life domains in older adults, the Epidemic-Pandemic Impacts Inventory-Geriatrics Adaptation (EPII-G). Based on prior knowledge of how detrimental social isolation can be on mental health and how resilient older people can be, we hypothesized that depression scores would increase during the pandemic. We also suspected that resilience scores at least remain constant or possibly improve. According to the Centers for Disease Control and Prevention, adults 65 and older account for 14.3% of cases and 80% of COVID-19 related deaths in the United States. Between “stay at home” guidelines and visitation restrictions along the continuum of aging services, there is concern over the lasting effects of social isolation. Therefore there is a need to examine and map the ways by which one's physical and social environments impact loneliness. Although loneliness is considered to be a subjective feeling related to a person's experience, it is one of three main factors leading to depression and a factor in cause of suicide. Despite this, one characteristic has shown to be protective against these stressors. Resilient individuals exhibit internal qualities like self-reliance and optimism and have external support systems in place allowing them to adapt more readily in the face of change. There is still little research available regarding outcomes and factors from COVID-19 impacting older adults’ depression and resilience, which this study aims to address, while strengthening the validity of the EPII-G. METHODS: The study population included older adults previously diagnosed with Major Depressive Disorder (MDD) and non-depressed controls, enrolled in the N-BOLD study at University of Connecticut Health Center. Inclusion criteria for participants included: age of 60 or greater, ability to read and write English, and Mini-Mental State Examination score of 25 or greater. Depressed subjects met the criteria for MDD, either episodic or recurrent. Participants provided additional informed consent for the study. Baseline data was collected prior to the COVID-19 pandemic, with second interviews taking place mid-2020, and additional follow-up summer 2021. The study utilized the EPII-G, Brief Carroll Depression Scale (BC), and Brief Resilience Scale (BRS). The surveys were verbally administered by the research staff both in-person and via phone interviews. RESULTS: From mid-2020 to summer 2021, both depressed and emotional control groups saw an increase in total BC depression score. Older adults with a history of depression showed BC scores increase from 2.47 to 3.12, and older controls experienced increases from 0.5 to 1.11. Despite an increase in depression score, both cohorts also saw an increase in BRS resilience score, with the depressed group and control group showing increases in BRS from 18.18 to 19.75 and 20.93 to 23.33 respectively. We found a negative correlation between positive home life of person in the home on EPII-G and BC scores, with a correlation coefficient of -0.3645 and p-value of 0.0616. There was also a positive correlation with positive home life of person in the home and social activities for self and BRS scores, with correlation coefficients of 0.26304 and 0.29869 and p-values of 0.0845 and 0.0489 respectively. CONCLUSIONS: Individuals who didn't see disruption to their normal routine and had the means to communicate with loved ones had strong psycho-social supports in place, but were still vulnerable to the detrimental effects of isolation. Through their years of experience, older adults have had the time needed to develop protective factors such as self-reliance. They have also lived through poignant events such as war and economic depression, putting suffering into perspective. As many no longer work or attend school like their younger counterparts, they experienced less disruption to daily routine. This strong foundation has contributed to the resilience needed to overcome the stressors that surfaced during the pandemic. By continuing to follow these groups, we can evaluate changes in depressive symptoms, how long they persist, and if individuals return to baseline over time, as well as to continue to strengthen the EPII-G's validity. THIS RESEARCH WAS FUNDED BY: Research is supported by National Institute of Mental Health grant R01 MH108578. Chart: https://apps.aagponline.org/abstracts/uploads/2022/f1peuxbywkablos.pdf