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Koppner J, Lindelöf A, Iredahl F, Nilsson S, Thorsell A, Larsen HI, Faresjö Å. Sense of coherence, mental health, and hair cortisol concentrations among older people during the COVID -19 pandemic: a cross-sectional study. BMC Public Health 2024; 24:1502. [PMID: 38840150 PMCID: PMC11151583 DOI: 10.1186/s12889-024-19034-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 06/03/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND A person's sense of coherence (SoC) is likely to affect coping when exposed to a life changing event like the COVID -19 pandemic, which impacted the older population especially hard, an age group that already suffers from a lot of mental illness. Thus, the aim of this study was to investigate the associations between SoC and mental health in older adults using both screening scales and hair cortisol concentrations (HCC). METHOD A cross-sectional design studying a cohort of 70-80 years old, N = 260, set in Swedish primary care during the pandemic years 2021-2022. Instruments used are sense of coherence 13 (SoC-13), EQ-5D-3L, Geriatric depression scale 20 (GDS-20), Hospital anxiety and depression scale (HADS), and Perceived stress scale 10 (PSS-10). Sociodemography and factors concerning SoC, and mental health are explored. HCC are measured using radioimmunoassay. Outcome measures are factors independently associated with SoC. Linear regression models were performed with SoC as dependent variable, and priory path analyses explored whether associations with SoC were direct, or indirect via anxiety. RESULTS SoC was significantly associated with anxiety (p < 0.001), perceived economic status (p = 0.003), belief in the future (p = 0.001), and perceived negative mental effect from the COVID -19 pandemic (p = 0.002). The latter was 96% indirectly associated with SoC (p < 0.001), whereas perceived economic status together with belief in the future was 82% directly associated with SoC (p = 0.17). HCC and sex were not significantly associated with SoC, but, noticeably, high HCC was equally distributed between women and men. Women reported significantly lower quality of life (p = 0.03), and more symptoms of anxiety (p = 0.001) and depression (p < 0.001). CONCLUSION Anxiety, belief in the future, perceived negative effect on mental health due to the pandemic, and perceived economic status were significantly associated with SoC. Anxiety is suggested to be important in explaining the association between perceived negative mental effect from the COVID-19 pandemic and SoC. Women reported significantly poorer mental health and life quality than men.
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Affiliation(s)
- Jenny Koppner
- Department of Health, Medicine and Caring Sciences, Division of General practice, Linköping University, Linköping, Sweden.
| | - Ann Lindelöf
- Department of Health, Medicine and Caring Sciences, Division of General practice, Linköping University, Linköping, Sweden
| | - Fredrik Iredahl
- Department of Health, Medicine and Caring Sciences, Division of General practice, Linköping University, Linköping, Sweden
| | - Staffan Nilsson
- Department of Health, Medicine and Caring Sciences, Division of General practice, Linköping University, Linköping, Sweden
| | - Annika Thorsell
- Department of Biomedical and Clinical Sciences/Center for Social and Affective Neuroscience, Medicine, Linköping University, Linköping, Sweden
| | - Hanna Israelsson Larsen
- Department of Health, Medicine and Caring Sciences, Division of General practice, Linköping University, Linköping, Sweden
| | - Åshild Faresjö
- Department of Health, Medicine and Caring Sciences, Division of Society and Health/Public Health, Linköping University, Linköping, Sweden
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Schmalbach I, Steudte-Schmiedgen S, Osmers A, Witthöft M, Drees P, Petrowski K. Longitudinal Assessment of Hair Cortisol as a Predictor of Psychological Symptoms During COVID-19. Psychoneuroendocrinology 2024; 163:106991. [PMID: 38412741 DOI: 10.1016/j.psyneuen.2024.106991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 02/12/2024] [Accepted: 02/12/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND There is a lack of evidence regarding enduring psychoneuroendocrine changes following an initial traumatic event, particular in the presence of an ongoing stressor. The coronavirus pandemic presents an opportunity to explore this matter. Consequently, the purpose of the present study was to investigate the impact of the ongoing pandemic (2021) on individuals, who experienced a first-time motor vehicle crash (MVC) at least 6 years earlier. To this end, we hypothesized that hair cortisol concentrations (HCC) following a first-time traumatic event positively predict symptoms of depression. METHOD We investigated N = 69 individuals (18 - 65 yrs.), who were victims of a MVC during 2010 - 2014. Hair strands were collected 10 days (t1) and 3 months after the MVC (t2), as well during the pandemic in 2021 (t3). To assess symptoms of depression, the participants filled out the Beck Depression Inventory at t1 - t3 and were additionally interviewed (Structured Clinical Interview for DSM-IV Axis I) at t1 and t2. Exclusion criteria conveyed a lifetime or acute mental disorder (incl. past trauma exposure). RESULTS Elevated pre-pandemic HCC following adversity (i.e., MVC) significantly predicted symptoms of depression in adults during the coronavirus pandemic (BDI: ß =.44, p =.010, R2 =.20), even after controlling for confounders. HCC significantly decreased over time, while in average psychological symptoms remained consistent. CONCLUSION Cortisol dysregulation in the past presents an enduring vulnerability to ongoing stress. In this regard, vulnerable groups may benefit from preventive measures. This finding validates the predictive power of HCC and extended past evidence in this regard, at the same time reinforcing the concept of the diathesis-stress model.
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Affiliation(s)
- I Schmalbach
- Department of Medical Psychology and Medical Sociology, Johannes-Gutenberg University Mainz, Mainz, Germany
| | - S Steudte-Schmiedgen
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - A Osmers
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - M Witthöft
- Department of Clinical Psychology, Psychotherapy, and Experimental Psychopathology, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - P Drees
- University Hospital of the University Johannes-Gutenberg Mainz, Department for Orthopedics and Trauma Surgery, Mainz, Germany
| | - K Petrowski
- Department of Medical Psychology and Medical Sociology, Johannes-Gutenberg University Mainz, Mainz, Germany; Dresden University of Technology, Carl Gustav Carus Medical Faculty, Department of General Medicine/MK3, Dresden, Germany.
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3
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Biener I, Mueller TT, Lin J, Bao H, Steffen J, Hoerl M, Biere K, Matzel S, Woehrle T, König S, Keiler AM, Thieme D, Keppler O, Klein M, Weinberger T, Osterman A, Adorjan K, Choukér A. Endocannabinoids, endocannabinoid-like compounds and cortisone in head hair of health care workers as markers of stress and resilience during the early COVID-19 pandemic. Transl Psychiatry 2024; 14:71. [PMID: 38296973 PMCID: PMC10831098 DOI: 10.1038/s41398-024-02771-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 01/08/2024] [Accepted: 01/10/2024] [Indexed: 02/02/2024] Open
Abstract
The pandemic caused by SARS-CoV-2 impacted health systems globally, creating increased workload and mental stress upon health care workers (HCW). During the first pandemic wave (March to May 2020) in southern Germany, we investigated the impact of stress and the resilience to stress in HCW by measuring changes in hair concentrations of endocannabinoids, endocannabinoid-like compounds and cortisone. HCW (n = 178) recruited from multiple occupation and worksites in the LMU-University-Hospital in Munich were interviewed at four interval visits to evaluate mental stress associated with the COVID-19 pandemic. A strand of hair of up to 6 cm in length was sampled once in May 2020, which enabled retrospective individual stress hormone quantifications during that aforementioned time period. Perceived anxiety and impact on mental health were demonstrated to be higher at the beginning of the COVID-19 pandemic and decreased significantly thereafter. Resilience was stable over time, but noted to be lower in women than in men. The concentrations of the endocannabinoid anandamide (AEA) and the structural congeners N-palmitoylethanolamide (PEA), N-oleoylethanolamide (OEA) and N-stearoylethanolamide (SEA) were noted to have decreased significantly over the course of the pandemic. In contrast, the endocannabinoid 2-arachidonoylglycerol (2-AG) levels increased significantly and were found to be higher in nurses, laboratory staff and hospital administration than in physicians. PEA was significantly higher in subjects with a higher resilience but lower in subjects with anxiety. SEA was also noted to be reduced in subjects with anxiety. Nurses had significantly higher cortisone levels than physicians, while female subjects had significant lower cortisone levels than males. Hair samples provided temporal and measurable objective psychophysiological-hormonal information. The hair endocannabinoids/endocannabinoid-like compounds and cortisone correlated to each other and to professions, age and sex quite differentially, relative to specific periods of the COVID-19 pandemic.
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Affiliation(s)
- Ingeborg Biener
- Laboratory of Translational Research "Stress and Immunity", Department of Anesthesiology, LMU University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Tonina T Mueller
- Department of Medicine I, LMU University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Jin Lin
- Department of Statistics, Ludwig-Maximilians-University Munich (LMU), Ludwigstr. 33, 80539, Munich, Germany
| | - Han Bao
- Department of Statistics, Ludwig-Maximilians-University Munich (LMU), Ludwigstr. 33, 80539, Munich, Germany
| | - Julius Steffen
- Department of Medicine I, LMU University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Marion Hoerl
- Laboratory of Translational Research "Stress and Immunity", Department of Anesthesiology, LMU University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Katharina Biere
- Laboratory of Translational Research "Stress and Immunity", Department of Anesthesiology, LMU University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Sandra Matzel
- Laboratory of Translational Research "Stress and Immunity", Department of Anesthesiology, LMU University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Tobias Woehrle
- Laboratory of Translational Research "Stress and Immunity", Department of Anesthesiology, LMU University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Simon König
- Institute of Doping Analysis und Sports Biochemistry Dresden (IDAS), Dresdner Str. 12, 01731, Kreischa, Germany
| | - Annekathrin M Keiler
- Institute of Doping Analysis und Sports Biochemistry Dresden (IDAS), Dresdner Str. 12, 01731, Kreischa, Germany
| | - Detlef Thieme
- Institute of Doping Analysis und Sports Biochemistry Dresden (IDAS), Dresdner Str. 12, 01731, Kreischa, Germany
| | - Oliver Keppler
- Max von Pettenkofer Institute, Virology, National Reference Center for Retroviruses, Faculty of Medicine, Ludwig-Maximilians-University Munich (LMU), Munich, Germany
- German Center for Infection Research (DZIF), partner site, Munich, Germany
| | - Matthias Klein
- Emergency Department, LMU University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
- Department of Neurology, LMU University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Tobias Weinberger
- Department of Medicine I, LMU University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Andreas Osterman
- Max von Pettenkofer Institute, Virology, National Reference Center for Retroviruses, Faculty of Medicine, Ludwig-Maximilians-University Munich (LMU), Munich, Germany
- German Center for Infection Research (DZIF), partner site, Munich, Germany
| | - Kristina Adorjan
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Nußbaumstr. 7, 80336, Munich, Germany
| | - Alexander Choukér
- Laboratory of Translational Research "Stress and Immunity", Department of Anesthesiology, LMU University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.
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Wang T, Li Q, Liu H, Shi Q, Yang F, Zhang B, Ahmed F, Jian W, Guo J. Gender difference in the relationship between personality traits and changes in depressive symptoms before and after the COVID-19 outbreak: A follow-up study among Chinese adults. J Affect Disord 2023; 326:49-56. [PMID: 36709830 PMCID: PMC9877321 DOI: 10.1016/j.jad.2023.01.085] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 12/26/2022] [Accepted: 01/21/2023] [Indexed: 01/28/2023]
Abstract
OBJECTIVES Increasing depressive symptoms have become an urgent public health concern worldwide. This study aims to explore the correlation between personality traits and changes in depressive symptoms before and after the COVID-19 outbreak and to examine the gender difference in this association further. METHODS Data were obtained from the China Family Panel Studies (CFPS, wave in 2018 and 2020). A total of 16,369 residents aged 18 and above were included in this study. Multinomial logistic regression analysis was used to examine whether personality traits were associated with changes in depressive symptoms. We also analyzed whether there was an interaction effect of gender and personality traits on depressive symptoms. RESULTS Conscientiousness, extroversion, and agreeableness are negatively associated with depressive symptoms, while neuroticism and openness are positively related. Gender moderates the relationship between personality traits and depressive symptoms. Compared to men, women have demonstrated a stronger association between neuroticism (OR = 0.79; 95 % CI = 0.66, 0.94), conscientiousness (OR = 1.40; 95 % CI = 1.15, 1.69), and persistent depressive symptoms. LIMITATIONS Given its longitudinal study design, it is insufficient to draw a causal inference between personality traits and depressive symptoms. CONCLUSION Personality traits and their various dimensions are correlated with changes in depressive symptoms. Persistent depressive symptoms are positively related to neuroticism and negatively associated with conscientiousness. Women demonstrate a stronger association between personality traits and persistent depressive symptoms. Thus, in Chinese adults' mental health intervention and prevention programs, personality and gender-specific strategies should be considered, especially in the context of the COVID-19 pandemic.
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Affiliation(s)
- Ting Wang
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
| | - Qiaosheng Li
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
| | - Haoran Liu
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
| | - Qiaoxin Shi
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
| | - Fan Yang
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
| | - Bo Zhang
- Department of Neurology and ICCTR Biostatistics and Research Design Center, Boston Children's Hospital, Harvard Medical School, 02115 Boston, MA, USA
| | - Farooq Ahmed
- Department of Anthropology, Quaid-I-Azam University Islamabad, Islamabad, Pakistan
| | - Weiyan Jian
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China.
| | - Jing Guo
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China.
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Mistry SK, Ali AM, Yadav UN, Huda MN, Khanam F, Kundu S, Khan JR, Hossain MB, Anwar A, Ghimire S. Change in prevalence over time and factors associated with depression among Bangladeshi older adults during the COVID-19 pandemic. Psychogeriatrics 2023; 23:230-242. [PMID: 36584687 DOI: 10.1111/psyg.12925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 11/12/2022] [Accepted: 12/15/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND Globally, the COVID-19 pandemic seriously affected both physical and mental health conditions. This study aims to assess changes in the prevalence of depression among older adults during the COVID-19 pandemic in Bangladesh and explore the correlates of depression in pooled data. METHODS This study followed a repeated cross-sectional design and was conducted through telephone interviews on two successive occasions during the COVID-19 pandemic (October 2020 and September 2021) among 2077 (1032 in 2020-survey and 1045 in 2021-survey) older Bangladeshi adults aged 60 years and above. Depression was measured using the 15-item Geriatric Depression Scale (GDS-15). The binary logistic regression model was used to identify the factors associated with depression in pooled data. RESULTS A significant increase in the prevalence of depression was noted in the 2021 survey compared to the 2020 survey (47.2% versus 40.3%; adjusted odds ratio (aOR): 1.40, 95% confidence interval (CI): 1.11-1.75). Depression was significantly higher among participants without a partner (aOR 1.92, 95% CI 1.45-2.53), with a monthly family income of <5000 BDT (aOR: 2.65, 95% CI 1.82-3.86) or 5000-10 000 BDT (aOR: 1.30, 95% CI 1.03-1.65), living alone (aOR 2.24, 95% CI 1.40-3.61), feeling isolated (aOR 3.15, 95% CI 2.49-3.98), with poor memory/concentration (aOR 2.02, 95% CI 1.58-2.57), with non-communicable chronic conditions (aOR 1.34, 95% CI 1.06-1.69), overwhelmed by COVID-19 (aOR 1.54, 95% CI 1.18-2.00), having difficulty earning (aOR 1.49, 95% CI 1.15-1.92) or obtaining food (aOR 1.56, 95% CI 1.17-2.09) during COVID-19 pandemic, communicating less frequently (aOR 1.35, 95% CI 1.07-1.70) and needing extra care (aOR 2.28, 95% CI 1.75-2.96) during the pandemic. CONCLUSIONS Policymakers and public health practitioners should provide immediate mental health support initiatives for this vulnerable population during the COVID-19 pandemic and beyond. Policymakers should also invest in creating safe places to practise mindful eating, exercise, or other refuelling activities as a means of preventing and managing depression.
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Affiliation(s)
- Sabuj K Mistry
- ARCED Foundation, Dhaka, Bangladesh.,Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia.,BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh.,Department of Public Health, Daffodil International University, Dhaka, Bangladesh
| | | | - Uday N Yadav
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia.,National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia
| | - Md Nazmul Huda
- ARCED Foundation, Dhaka, Bangladesh.,School of Medicine, Western Sydney University, Campbeltown, Australia
| | - Fouzia Khanam
- Department of Public Health, North South University, Dhaka, Bangladesh
| | - Satyajit Kundu
- Global Health Institute, North South University, Dhaka, Bangladesh.,School of Public Health, Southeast University, Nanjing, China
| | - Jahidur R Khan
- School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Md Belal Hossain
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh.,School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Afsana Anwar
- Health and Nutrition, Social Assistance and Rehabilitation for the Physically Vulnerable (SARPV), Cox's Bazar, Bangladesh
| | - Saruna Ghimire
- Department of Sociology and Gerontology and Scripps Gerontology Centre, Miami University, Oxford, Ohio, USA
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Kanes SJ, Dennie L, Perera P. Targeting the Arginine Vasopressin V 1b Receptor System and Stress Response in Depression and Other Neuropsychiatric Disorders. Neuropsychiatr Dis Treat 2023; 19:811-828. [PMID: 37077711 PMCID: PMC10106826 DOI: 10.2147/ndt.s402831] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 03/23/2023] [Indexed: 04/21/2023] Open
Abstract
A healthy stress response is critical for good mental and overall health and promotes neuronal growth and adaptation, but the intricately balanced biological mechanisms that facilitate a stress response can also result in predisposition to disease when that equilibrium is disrupted. The hypothalamic-pituitary-adrenal (HPA) axis neuroendocrine system plays a critical role in the body's response and adaptation to stress, and vasopressinergic regulation of the HPA axis is critical to maintaining system responsiveness during chronic stress. However, exposure to repeated or excessive physical or emotional stress or trauma can shift the body's stress response equilibrium to a "new normal" underpinned by enduring changes in HPA axis function. Exposure to early life stress due to adverse childhood experiences can also lead to lasting neurobiological changes, including in HPA axis function. HPA axis impairment in patients with depression is considered among the most reliable findings in biological psychiatry, and chronic stress has been shown to play a major role in the pathogenesis and onset of depression and other neuropsychiatric disorders. Modulating HPA axis activity, for example via targeted antagonism of the vasopressin V1b receptor, is a promising approach for patients with depression and other neuropsychiatric disorders associated with HPA axis impairment. Despite favorable preclinical indications in animal models, demonstration of clinical efficacy for the treatment of depressive disorders by targeting HPA axis dysfunction has been challenging, possibly due to the heterogeneity and syndromal nature of depressive disorders. Measures of HPA axis function, such as elevated cortisol levels, may be useful biomarkers for identifying patients who may benefit from treatments that modulate HPA axis activity. Utilizing clinical biomarkers to identify subsets of patients with impaired HPA axis function who may benefit is a promising next step in fine-tuning HPA axis activity via targeted antagonism of the V1b receptor.
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Affiliation(s)
- Stephen J Kanes
- EmbarkNeuro, Oakland, CA, USA
- Correspondence: Stephen J Kanes, EmbarkNeuro, Inc, 1111 Broadway, Suite 1300, Oakland, CA, 94607, USA, Tel +1 610 757 7821, Email
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The relationship of adverse childhood experiences, hair cortisol, C-reactive protein, and polygenic susceptibility with older adults' psychological distress during the COVID-19 pandemic. Mol Psychiatry 2022; 27:5038-5048. [PMID: 36198766 PMCID: PMC9533280 DOI: 10.1038/s41380-022-01805-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 09/02/2022] [Accepted: 09/14/2022] [Indexed: 01/14/2023]
Abstract
Adverse childhood experiences (ACEs) are linked to poorer mental health outcomes, and growing evidence implicates biological and genetic pathways from early adversity to psychopathology. However, little is known about the relationship of ACEs and their underlying biological and genetic mechanisms with older people's mental health responses to the COVID-19 pandemic. We tested the associations of ACEs, hair cortisol, C-reactive protein (CRP), and polygenic scores (PGS) with depression, anxiety, and loneliness among older adults during the COVID-19 pandemic, accounting for the potential interplay of ACEs with biological and genetic risk markers. Data were drawn from the English Longitudinal Study of Ageing, a prospective cohort study of older adults living in England. Retrospective information on ACEs were collected in 2006/7, while CRP and hair cortisol were measured at wave 6 (2012/13). Psychological distress was assessed before the pandemic (2018-19) and at two COVID-19 assessments in 2020 (June-July and November-December). Associations were tested on 2050 participants using linear/logistic regression models adjusted for pre-pandemic outcome measures and mixed-effect models to assess changes before and during the pandemic. The results showed that ACEs were associated with higher levels of depression (OR = 2.55[95%CI:1.81,3.59]) anxiety (OR = 1.84[95%CI:1.13,3.01]), and loneliness (b = 0.28[95%CI:0.14,0.42]) during the pandemic. Hair cortisol was related to an increased risk of depression (OR = 1.15[95%CI:1.04,1.26]), and CRP was associated with greater loneliness scores (b = 0.16[95%CI:0.03,0.30]). The relationship between cortisol and psychological distress was larger among participants with ACEs (e.g., ORdepression = 1.07[95%CI:1.00,1.14]). Further, individuals with high CRP experienced greater increases in feelings of loneliness from before to during the pandemic, compared to those with lower CRP levels (interaction effect=0.23; 95%CI:0.1-0.37). Individuals with 2+ ACEs experienced greater increases in depressive symptoms compared to those with none (interaction effect=2.09; 95%CI:1.1-3.98). Higher levels of hair cortisol were also related to worse changes in depressive symptoms across timepoints (interaction effect=1.84;95%CI:1.41-2.41). These results highlight the lasting impact of biosocial vulnerabilities on older adults' mental health responses to new environmental stressors. They also implicate biological mechanisms in the pathophysiology of later-life psychological distress.
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