The effect of COVID‐19 pandemic‐related financial challenges on mental health and well‐being among US older adults

BACKGROUND: Despite profound financial challenges during the COVID‐19 pandemic, there is a gap in estimating their effects on mental health and well‐being among older adults. METHODS: The National Health and Aging Trends Study is an ongoing nationally representative cohort study of US older adults. Outcomes included mental health related to COVID‐19 (scores averaged across eight items ranging from one to four), sleep quality during COVID‐19, loneliness during COVID‐19, having time to yourself during COVID‐19, and hopefulness during COVID‐19. Exposures included income decline during COVID‐19 and financial difficulty due to COVID‐19. Propensity score weighting produced covariate balance for demographic, socioeconomic, household, health, and well‐being characteristics that preceded the pandemic to estimate the average treatment effect. Sampling weights accounted for study design and non‐response. RESULTS: In weighted and adjusted analyses (n = 3257), both income decline during COVID‐19 and financial difficulty due to COVID‐19 were associated with poorer mental health related to COVID‐19 (b = −0.159, p < 0.001 and b = −0.381, p < 0.001, respectively), poorer quality sleep (OR = 0.63, 95% CI: 0.46, 0.86 and OR = 0.42, 95% CI: 0.30, 0.58, respectively), more loneliness (OR = 1.53, 95% CI: 1.16, 2.02 and OR = 2.72, 95% CI: 1.96, 3.77, respectively), and less time to yourself (OR = 0.54, 95% CI: 0.40, 0.72 and OR = 0.37, 95% CI: 0.27, 0.51, respectively) during COVID‐19. CONCLUSIONS: Pandemic‐related financial challenges are associated with worse mental health and well‐being regardless of pre‐pandemic characteristics, suggesting that they are distinct social determinants of health for older adults. Timely intervention is needed to support older adults experiencing pandemic‐related financial challenges.