The impact of COVID-19 on the well-being and cognition of older adults living in the United States and Latin America

Resilience Amidst Adversity: Experiences of Black Older Adults During the COVID-19 Pandemic

BACKGROUND AND OBJECTIVES

The paucity of research and policy on the impact of coronavirus disease 2019 (COVID-19) on the experiences of Black older adults in Canada and around the world has intensified the enduring impacts of racism on their health and well-being. To bridge this gap, our study explored the mental health of Black older adults in Montreal during the early period of the pandemic.

RESEARCH DESIGN AND METHODS

Using an Afro-emancipatory mixed-method research design, we collected and analyzed data from 3 sources: a survey, focus group interview with service providers from Black community organizations, and individual interviews with Black older adults.

RESULTS

Our findings reveal that Black older adults struggled with mental health challenges, including loss, grief, and intergenerational tensions, and encountered systemic barriers in accessing services. Despite these adversities, participants demonstrated remarkable resilience, drawing upon their faith and community networks for support.

DISCUSSION AND IMPLICATIONS

This study illuminates the complex experiences of Black older adults during the pandemic and underscores the imperative of addressing mental health and systemic barriers. Understanding ongoing challenges is crucial for developing targeted interventions and policies that promote long-term resilience and equitable healthcare for Black older adults.

Risk Factors for Poor Sleep Quality and Subjective Cognitive Decline in Older Adults Living in the United States During the COVID-19 Pandemic

BACKGROUND/OBJECTIVES

Poor sleep quality, depression, and anxiety are associated with subjective cognitive decline (SCD) and greater risk for developing cognitive impairment and Alzheimer's disease. The COVID-19 pandemic negatively impacted sleep habits and psychological well-being in many individuals, yet their relationship to SCD in this context remains understudied. We examined sociodemographic characteristics, depression, anxiety, and sleep changes during the pandemic (i.e., increased problems/poorer quality) and SCD in older individuals living in the US.

METHODS

In total, 288 older adults (Mage = 67.4 [7.4]) completed an online survey including a sociodemographic questionnaire, the Center for Epidemiologic Studies Depression Scale (Revised) (CES-D-10; depression), General Anxiety Disorder-7 (GAD-7; anxiety), the Everyday Cognition scale (ECog; SCD), and a question about increased sleep problems/worsened sleep quality during the pandemic. Hierarchical and logistic regression analyses were used to assess relations among sociodemographic factors, depression, anxiety, changes in sleep quality, and SCD.

RESULTS

Self-reported pandemic-related impairments in sleep were associated with greater SCD (β = 0.16, p = 0.01). Depression (β = 0.46, p < 0.001) and anxiety (β = 0.29, p < 0.001) were also associated with greater SCD. Depression (OR = 1.17, p < 0.001) and anxiety (OR = 1.15, p = 0.017) predicted reported poorer sleep during the pandemic.

CONCLUSIONS

Depression, anxiety, and poorer sleep quality during the COVID-19 pandemic were associated with greater SCD concerns. Greater depression and anxiety were also associated with the reported sleep problems/worsened sleep quality. Prevention and management of anxiety and depressive symptoms may help maintain sleep quality and reduce risk of cognitive decline.

Role of Gut Microbiota in Long COVID: Impact on Immune Function and Organ System Health

SARS-CoV-2 infection has led to a range of long-lasting symptoms, collectively referred to as long COVID. Current research highlights the critical role of angiotensin-converting enzyme 2 (ACE2) in regulating gut microbiota diversity, vascular function, and homeostasis within the renin-angiotensin system (RAS). ACE2 is utilized by the SARS-CoV-2 virus to enter host cells, but its downregulation following infection contributes to gut microbiota dysbiosis and RAS disruption. These imbalances have been linked to a range of long COVID symptoms, including joint pain, chest pain, chronic cough, fatigue, brain fog, anxiety, depression, myalgia, peripheral neuropathy, memory difficulties, and impaired attention. This review investigates the dysregulation caused by SARS-CoV-2 infection and the long-term effects it has on various organ systems, including the musculoskeletal, neurological, renal, respiratory, and cardiovascular systems. We explored the bidirectional interactions between the gut microbiota, immune function, and these organ systems, focusing on how microbiota dysregulation contributes to the chronic inflammation and dysfunction observed in long COVID symptoms. Understanding these interactions is key for identifying effective therapeutic strategies and interventional targets aimed at mitigating the impact of long COVID on organ health and improving patient outcomes.

Disparities and protective factors in pandemic-related mental health outcomes: a Louisiana-based study

Introduction

The COVID-19 pandemic has had a wide-ranging impact on mental health. Diverse populations experienced the pandemic differently, highlighting pre-existing inequalities and creating new challenges in recovery. Understanding the effects across diverse populations and identifying protective factors is crucial for guiding future pandemic preparedness. The objectives of this study were to (1) describe the specific COVID-19-related impacts associated with general well-being, (2) identify protective factors associated with better mental health outcomes, and (3) assess racial disparities in pandemic impact and protective factors.

Methods

A cross-sectional survey of Louisiana residents was conducted in summer 2020, yielding a sample of 986 Black and White adults. The exposure was overall pandemic impact, measured using the Epidemic-Pandemic Impacts Inventory, and the outcome was general well-being (GWB), measured with the General Well-Being Schedule. Potential protective factors included social support, resilience, and social cohesion. Linear regression models were constructed to examine the association between pandemic impact and GWB, with each protective factor added as an effect modifier. These relationships were further assessed for differences by race.

Results

Pandemic stressors can be grouped into social, health, work, finance, and family-related impacts. Black persons displayed higher levels of pandemic impact as well as lower levels of social support, resilience, and social cohesion (p < 0.0001), highlighting existing racial disparities, though Black respondents and White respondents exhibited no differences in general-well being. Social support, resilience, and social cohesion were identified as protective factors for both groups (p < 0.0001, respectively), but these protective effects deteriorated as pandemic impacts increased. The addition of a pandemic impact by race interaction term was also significant in each model (p = 0.0020, p < 0.0001, and p = 0.0095, respectively) and showed that the protective effects of social support and resilience deteriorated more rapidly for Black persons than White persons, while the protective effects of social cohesion deteriorated more rapidly for White persons than Black persons.

Discussion

This study emphasizes the importance of psychosocial resources in buffering the mental health impact of pandemics. It also suggests greater vulnerability for marginalized communities lacking access to crucial support systems. Findings underscore the need for targeted interventions that bolster access to social support, promote resilience, and strengthen social cohesion, particularly within minority groups. Additionally, policymakers should consider proactive measures to assist in recovery and mitigate the disproportionate impact of future crises on vulnerable populations.

Attitudes and perceptions toward the COVID-19 risk-mitigation strategies among racially and ethnically diverse older adults in the United States and Puerto Rico: a qualitative study

OBJECTIVES

There is limited qualitative research investigating how risk-mitigation strategies during the COVID-19 pandemic impacted the lives of diverse older adults, who met criteria for mild to severe generalized anxiety or depression and minor to moderate disability. This study aims to address this gap by examining how racially and ethnically diverse older adults with at least mild mental health symptoms and minor physical disability in the United States and Puerto Rico adapted to guidelines during COVID-19. It aims to inform the medical community and policymakers of potential threats to these older adults' well-being given the COVID-19 burden.

DESIGN

Based on descriptive qualitative inquiry and phenomenological perspectives, we conducted semi-structured interviews over the phone with a racially and ethnically diverse sample of older (age 60+), predominantly minoritized adults (N = 100) in four states and territories across the United States and Puerto Rico in 2021. Interviews were recorded, coded, and analyzed using a thematic analysis approach.

RESULTS

Findings centered on five themes: (1) Previous experiences with the healthcare system and cultural beliefs related to trust and distrust led to mixed attitudes toward COVID-19 risk-mitigation strategies; (2) Compliance with COVID-19 mitigation strategies ensured safety and addressed fear of illness; (3) Compliance led to isolation due to interrupted social relations; (4) Isolation and disrupted social networks negatively impacted mental health and finances, and (5) Coping strategies and embracing support reduced the effects of social isolation.

CONCLUSION

This study underscores the importance of increasing support and social connectedness during a pandemic and beyond to ensure the well-being of older adults in racially and ethnically diverse communities. It highlights the resiliency of older adults in identifying strategies to cope with negative impacts. We recommend safeguarding economic security through policy efforts toward financial safety nets during health crises and collaborative approaches with community-based organizations to mitigate social isolation.

A review of neurological health disparities in Peru

Peru is a historically unique and culturally diverse Latin American country. As a low-to-middle-income country (LMIC), Peru faces health implications from the spread of communicable diseases as well as a growing rate of noncommunicable diseases, both of which have been worsened by the recent COVID-19 pandemic's impact on the national health system. Over the past two decades, the country has aimed to improve health access for its population through various efforts described in this review. Despite this, there are notable neurological health disparities that exist today. This narrative review investigates such disparities through the leading neurological contributors to the national burden of disease in the country, including migraine headaches, cerebrovascular disease, and dementia. Public health disparities that contribute to other major neurological diseases in the country, including epilepsy, neurocysticercosis, Chagas disease, multiple sclerosis, traumatic brain injury, traumatic and non-traumatic spinal cord injuries are also investigated. We also explore potential solutions for overcoming the various neurological health disparities covered in this review that may be applied through public policies, as well as in similar LMICs in Latin America. By overcoming such disparities, the country may be able to successfully address the major contributors of neurological disease burden and create a healthcare environment that can sustainably and equitably improve health outcomes for Peruvian people.

A longitudinal examination of the protective effect of resilience against anxiety among older adults with high COVID-related worry

This longitudinal study of community dwelling older adults (N = 453) examined consequences of COVID-related worries on changes in anxiety symptoms before relative to during the pandemic. We further evaluated if pre-COVID psychological resilience (PR) buffered the impact of COVID-related worry. Pre-COVID data were collected in September 2018. COVID-related worry and COVID anxiety symptoms were collected in October 2020 (Wave 2). Controlling for pre-COVID anxiety symptoms, we examined if COVID-related worries (e.g. I'm worried that I might die from COVID-19) were associated with increased anxiety symptoms, and whether pre-COVID PR moderated the association between COVID-related worries and prospective increases in anxiety symptoms. COVID-related worries were associated with increased anxiety symptoms (β = 0.005, p < .01), whereas pre-COVID PR was associated with a decrease in anxiety symptoms (β = -0.029, p < .05). PR moderated the association; COVID-related worries were associated with greater increases in anxiety symptoms among those with low pre-COVID PR (Model η2 = 0.35). Thus, the extent to which COVID-related worries influenced psychological health was dependent on pre-COVID levels of PR. We conclude the combined vulnerabilities of low pre-COVID PR and high COVID-related worries significantly increased the psychological consequences of COVID-19 for our sample of older adults.

Effects of vaccination against COVID-19 on the emotional health of older adults

Background: The COVID-19 pandemic significantly impacted the mental and emotional health of the elderly, especially those from low to middle-income countries. However, COVID-19 vaccination may reduce this influence. Therefore, we aimed to estimate the effect of vaccination against COVID-19 on the emotional health of older adults. Methods: We selected a national, random, and stratified sample of non-hospitalized adults aged 60 to 79 years from Peru who intended to receive or had already received the COVID-19 vaccine during recruitment. During June and July 2021, the assessed outcomes were the fear, anxiety, and worry about COVID-19, general anxiety, and depression at baseline and after a month. We estimated the adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) for each altered emotional health outcomes in those who had one and two doses, compared with those who were not vaccinated using multilevel logistic regression with mixed effects. Results: We recruited 861 older adults with 20.8% of loss to follow-up. At baseline, 43.9% had received only one dose of the vaccine, and 49.1% had two doses. In the analysis during follow-up, those who had two doses had less fear (aOR: 0.19; CI 95%: 0.07 to 0.51) and anxiety to COVID-19 (aOR: 0.45; CI 95%: 0.22 to 0.89), compared to unvaccinated. We observed no effects in those with only one dose. Conclusions: Two doses of COVID-19 vaccination in older adults improves their perception of COVID-19 infection consequences. This information could be integrated into the vaccination campaign as an additional beneficial effect.

Associations Among Loneliness, Purpose in Life and Subjective Cognitive Decline in Ethnoracially Diverse Older Adults Living in the United States

Subjective cognitive decline (SCD), which precedes Mild Cognitive Impairment and dementia, may be affected by purpose in life (PiL) and loneliness in older adults. We investigated associations among PiL, loneliness, and SCD in US Latino (n = 126), Black (n = 74), Asian (n = 33), and White (n = 637) adults. Higher PiL predicted lower SCD in all groups (p-values < .012), except Black participants. Lower loneliness predicted lower SCD in Latino and White groups (p-values < .05), and PiL moderated this association in White adults. PiL and loneliness may play important roles in cognitive decline. Differential predictors of SCD suggest differential targets for preventing cognitive decline and dementia across ethnoracial groups.

COVID-19 mortality and deprivation: pandemic, syndemic, and endemic health inequalities

COVID-19 has exacerbated endemic health inequalities resulting in a syndemic pandemic of higher mortality and morbidity rates among the most socially disadvantaged. We did a scoping review to identify and synthesise published evidence on geographical inequalities in COVID-19 mortality rates globally. We included peer-reviewed studies, from any country, written in English that showed any area-level (eg, neighbourhood, town, city, municipality, or region) inequalities in mortality by socioeconomic deprivation (ie, measured via indices of multiple deprivation: the percentage of people living in poverty or proxy factors including the Gini coefficient, employment rates, or housing tenure). 95 papers from five WHO global regions were included in the final synthesis. A large majority of the studies (n=86) found that COVID-19 mortality rates were higher in areas of socioeconomic disadvantage than in affluent areas. The subsequent discussion reflects on how the unequal nature of the pandemic has resulted from a syndemic of COVID-19 and endemic inequalities in chronic disease burden.

Sociodemographic Differences in COVID-19 Self-Reported Symptoms by Ethnicity and Older Adults in Bolivia

The effects of COVID-19 revealed the fragility of health systems in the LAC region, with greater risk of death in older people than in younger people, as well as greater vulnerability to infection due to living with people aged 30–59 years, who have a higher prevalence of COVID-19. On the other hand, there is not much information on inequalities in the incidence of COVID-19 in indigenous people, a population with lower immunological resistance. The objectives are: 1) To determine the association between sociodemographic variables with self-reported COVID-19 symptoms. 2) To investigate whether this relationship shows inequalities by ethnicity and age. For that purpose I conducted a cross-sectional analysis using the 2020 Household Survey and investigated the association between sociodemographic variables and self -reported COVID-19 symptoms and explore the contribution of factors such as employment type, household living arrangements, years of education, age, ethnicity, gender, current status of working and residence area. I performed bivariate analysis to establish trends. Subsequently using logistic regressions to establish the risks to self-reported COVID-19 symptoms. A fully interacted model is analysed by ethnicity. I found those who were living alone were less likely than those living in a Couple with/without relatives’ household arrangement to self-reported COVID-19 symptoms (OR = 0.79, 95% CI: 0.66–0.94, p < .01). Odds of the older persons aged 45–59 (OR = 1.44, 95% CI: 1.27–1.62, p < .05) were relatively more likely than younger people (OR = 1.19, 95% CI: 1.05–1.35, p < .01). Indigenous living in a couple with/without children household arrangement were less likely than non-Indigenous (OR = 0.75, 95% CI: 0.62–0.90, p < .01). Odds of Indigenous people of age 30–44 (OR = 1.26, 95% CI: 1.04–1.53, p < .01) were more likely than non-Indigenous. Odds of Indigenous persons of age 45–59 (OR = 1.59, 95% CI: 1.32–1.91, p < .05) were more likely than non-Indigenous (OR = 1.32, 95% CI: 1.12–1.55, p < .01). As conclusions, 45–59 age group shows higher risk factors and those aged 60 + show lower risks. These are increased in people working in managerial, administrative and professional, and technical positions, those living in a household with/without relatives, men, those living in urban areas, and/or non-indigenous people.

Impact of COVID-19 on life experiences reported by a diverse cohort of older adults with diabetes and obesity

OBJECTIVE

This study aimed to measure the impact of the COVID-19 pandemic on self-reported life experiences in older adults with diabetes and obesity.

METHODS

Participants were surveyed in 2020 regarding negative and positive impacts of the pandemic across domains of personal, social, and physical experiences. A cumulative negative risk index (a count of all reported negative impacts of 46 items) and a positive risk index (5 items) were characterized in relation to age, sex, race/ethnicity, BMI, and multimorbidity.

RESULTS

Response rate was high (2950/3193, 92%), average age was 76 years, 63% were women, and 39% were from underrepresented populations. Women reported more negative impacts than men (6.8 vs. 5.6; p < 0.001 [of 46 items]) as did persons with a greater multimorbidity index (p < 0.001). Participants reporting African American/Black race reported fewer negative impacts than White participants. Women also reported more positive impacts than men (1.9 vs. 1.6; p < 0.001 [of 5 items]).

CONCLUSIONS

Older adults with diabetes and obesity reported more positive impacts of the pandemic than negative impacts, relative to the number of positive (or negative) items presented. Some subgroups experienced greater negative impacts (e.g., for women, a greater multimorbidity index). Efforts to reestablish personal, social, and physical health after the pandemic could target certain groups.

Impact of quarantine due to COVID-19 pandemic on health and lifestyle conditions in older adults from Centro American countries

BACKGROUND

The impact of quarantine in older adults have been reported in several studies with contradictory results, reporting from negative effects to no significant outcomes or even beneficial consequences. Heterogeneity in aging plays a role in each region, the aim of this study is to analyze the impact of quarantine on health conditions (physical and mental) and lifestyle in older adults in five Centro American countries during COVID-19 pandemic.

METHOD

In this cross-sectional study, n = 712 older adults 60 years and older from Mexico, Guatemala, El Salvador, Honduras and Costa Rica were assessed by telephone. Sociodemographic data, physical and mental health, lifestyle and quarantine conditions were asked previous informed consent.

RESULTS

In general, mean of days in quarantine at the moment of the study was 142 days (approximately four months and three weeks). In the analysis of the impact of the days in quarantine effects were found on the frequency of falls, functional ability in Activities of Daily Living (ADL), general cognitive function, memory, orientation, language, frequency of drinking alcohol, having a balanced diet, and being active cognitively. Some differences were found between countries.

CONCLUSIONS

Effects of quarantine on older adults in Centro America, requires attention of governments and healthcare to prevent long term morbidity and disability, and to promote healthy aging.

COVID-19 and decent work: A bibliometric analysis

BACKGROUND

The COVID-19 pandemic impacted the Sustainable Development Goals (SDGs). Among these impacts, those related to the SDG 8 can be highlighted. Consequently, the literature has addressed aspects related to economic growth and decent work.

OBJECTIVE

This article aimed to evaluate the impact of the COVID-19 pandemic on decent work according to the literature.

METHODS

For this, a bibliometric analysis was conducted. Data from Web of Science were collected, and VOSviewer software was used to perform the analysis.

RESULTS

Regarding the results, four main clusters that govern the subject were identified. A first cluster (identified in red) evidenced the consequences of the pandemic to the generation of informal work, increasing poverty and the impacts on gender issues. A second cluster (identified in blue) addresses mental health and stress issues, especially for nurses professionals who experience a situation in the COVID-19 pandemic. The green cluster focused on unemployment, precarious employment, and work conditions, which were highly related to coronavirus contagion. Finally, the yellow cluster evidenced the final consequences when there is a substantial public health problem.

CONCLUSIONS

The results presented here can be helpful to researchers interested in the, as it allows a broad and condensed view of important information about a relevant topic for sustainable economic development.

Practical Solutions to Address COVID-19-Related Mental and Physical Health Challenges Among Low-Income Older Adults

Low-income older adults are disproportionately impacted by the COVID-19 pandemic. In this perspective article, we review the context in which low-income older people experience the pandemic and the mental and physical health consequences they have faced to date. Then, we offer practical solutions to help improve low-income older adults' sleep, physical activity, nutrition, and stress that require no or low financial commitment. We argue that governments, communities, and organizations should make greater efforts to promote healthy living for low-income older adults in times of health emergencies to ensure their ability to be universally adopted, regardless of income and resources.

Stress, resilience, and coping strategies in a sample of community-dwelling older adults during COVID-19

Assessing the impact of the COVID-19 pandemic on perceived stress in older adults is critical to understanding how to best support elderly individuals navigating stressful situations, with the aim to lessen the impact of stressors on their brain health. Here, we collected measures on perceived stress, resilience, and behavioral coping strategies, in the context of the COVID-19 pandemic, in a cross-sectional sample of 141 community dwelling older adults (mean age = 74.4 ± 8.4, 59% females) who were part of two longitudinal observational studies in Massachusetts, U.S. Our results indicate that participants demonstrated moderate levels of stress related to COVID-19 and showed relatively high levels of resilience. Higher resilience was associated with greater use of adaptive coping behaviors and less use of maladaptive coping behaviors. The use of maladaptive coping strategies was associated with more stress. Moreover, hierarchical regression analyses revealed that resilience was the strongest unique predictor of stress, thus, largely accounting for the observed coping-outcome associations. Individual differences in resilience levels moderated the effects of two coping strategies (planning and self-blame) on stress. Specifically, planning was associated with increased levels of stress for people with low resilience. In contrast, high personal resilience attenuated the negative effect of self-blame on their stress levels. Taken together, our findings suggest that resilience is critical for coping with stress during the COVID-19 pandemic. Future approaches for augmenting resilience could prove to be important potential interventions to help support older adults navigating stressful situations as well as lessen adverse effects on neurocognitive and mental health in the future.