Loneliness and mental health among the elderly in Poland during the COVID-19 pandemic

Mediating effect of social support and resilience between loneliness and depression in older adults: A systematic review and meta-analytic structural equation modeling

BACKGROUND

Loneliness is a powerful stressor for depression in older adults, and resilience and social support may mediate this relationship, while the evidence is limited. Hence, our study aims to explore the mediating role of social support and resilience between loneliness and depression and to test possible moderators.

METHODS

We searched 12 databases without language and publish time restrictions and obtained the correlation coefficients. This review constructed two-stage meta-analytical structural equality modeling (MASEA) to test the mediating effect of social support and resilience. Additionally, use one-stage MASEA to test the moderator effect of women proportion, published year, and country of study.

RESULTS

This study included 53 studies and 40, 929 older adults. Loneliness directly affected depression (β = 0.28, 95 % CI: 0.20, 0.36). Social support (β = 0.06, 95 % CI: 0.02, 0.09) and resilience (β = 0.15, 95 % CI: 0.12, 0.18) mediated the relationship. The proportion of women in the sample was moderator (χ2(5) = 11.10, p = 0.05). When the proportion exceeded 60 %, the path coefficient of loneliness and social support (β = -0.45, SE = 0.055) was larger than that of the subgroup below 60 % (β = -0.32, SE = 0.041).

LIMITATIONS

It was indefinite whether the evidence would be supported in longitudinal designs. Influenced by the original research data, it is impossible to calculate the model parameters of gender discrepancy.

CONCLUSIONS

Health aging policy-makers adopting social support and resilience intervention will help strengthen the coping skills of older adults confronting loneliness and reduce the risk of depression.

An in-person survey of the influence of the COVID-19 pandemic on physical function, functional capacity, cognitive function, and mental health among community-dwelling older adults in Japan from 2016 to 2022

BACKGROUND

The COVID-19 outbreak might have had several effects on older adults; however, much of the previous research only included self-report, cross-sectional, and online-survey data in the early stage of the pandemic. We conducted a face-to-face survey before and after the COVID-19 pandemic and investigated the influence of the pandemic on several functions to distinguish between changes due to aging and changes due to the pandemic using a linear mixed model.

METHODS

A total of 8 longitudinal surveys were conducted from 2016 to 2022. Physical function was assessed by weight, body mass index, body fat percentage, skeletal muscle mass index, calf circumference, grip strength, knee extension strength, the 5-times chair stand test, the timed up & go test and 5-m walking test. Functional capacity was measured using the Tokyo Metropolitan Institute of Gerontology index of competence, cognitive function was measured using the Trail Making Test - A, and mental health was measured using the Geriatric Depression Scale.

RESULTS

Of a total of 73 participants, 51 (69.9%) were female. The mean age at first participation was 71.82 years (SD = 4.64). The results of the linear mixed model showed that lower-limb muscle strength and body fat percentage and cognitive function changed significantly before and after the pandemic, while grip strength, functional capacity, and mental health did not.

CONCLUSIONS

The changes in these functions between before and after the pandemic might be attributed to the diminished opportunities for the independent older individuals to go out and engage in activities. Although functional capacity did not change, lower-limb muscle strength is important for functional independence. This decline might influence the functional capacity of these individuals in the future.

Association between the COVID-19 pandemic and mental health in very old people in Sweden

BACKGROUND

During the COVID-19 pandemic, Sweden implemented social distancing measures to reduce infection rates. However, the recommendation meant to protect individuals particularly at risk may have had negative consequences. The aim of this study was to investigate the impact of the COVID-19 pandemic on very old Swedish peoples' mental health and factors associated with a decline in mental health.

METHODS

We conducted a cross-sectional study among previous participants of the SilverMONICA (MONItoring of Trends and Determinants of CArdiovascular disease) study. Of 394 eligible participants, 257 (65.2%) agreed to participate. Of these, 250 individuals reported mental health impact from COVID-19. Structured telephone interviews were carried out during the spring of 2021. Data were analysed using the χ2 test, t-test, and binary logistic regression.

RESULTS

Of 250 individuals (mean age: 85.5 ± 3.3 years, 54.0% women), 75 (30.0%) reported a negative impact on mental health, while 175 (70.0%) reported either a positive impact (n = 4) or no impact at all (n = 171). In the binary logistic regression model, factors associated with a decline in mental health included loneliness (odds ratio [95% confidence interval]) (3.87 [1.83-8.17]) and difficulty adhering to social distancing recommendations (5.10 [1.92-13.53]). High morale was associated with positive or no impact on mental health (0.37 [0.17-0.82]).

CONCLUSIONS

A high percentage of very old people reported a negative impact on mental health from the COVID-19 pandemic, primarily from loneliness and difficulty adhering to social distancing measures, while high morale seemed to be a protective factor.

Interactive changes in depression and loneliness symptoms prior to and during the COVID-19 pandemic: A longitudinal network analysis

OBJECTIVES

Depression and loneliness co-occur frequently. This study examined interactive changes between depression and loneliness among older adults prior to and during the COVID-19 pandemic from a longitudinal network perspective.

METHODS

This network study was based on data from three waves (2016-2017, 2018-2019, and 2020) of the English Longitudinal Study of Ageing (ELSA). Depression and loneliness were measured with the eight-item version of the Center for Epidemiologic Studies Depression Scale (CESD-8) and three item version of the University of California Los Angeles (UCLA) Loneliness Scale, respectively. A network model was constructed using an Ising Model while network differences were assessed using a Network Comparison Test. Central symptoms were identified via Expected Influence (EI).

RESULTS

A total of 4,293 older adults were included in this study. The prevalence and network of depression and loneliness did not change significantly between the baseline and pre-pandemic assessments but increased significantly from the pre-pandemic assessment to during COVID-19 assessment. The central symptom with the strongest increase from pre-pandemic to pandemic assessments was "Inability to get going" (CESD8) and the edge with the highest increase across depression-loneliness symptom communities was "Lack companionship" (UCLA1) - "Inability to get going" (CESD8). Finally, "Feeling depressed" (CESD1) and "Everything was an effort" (CESD2) were the most central symptoms over the three assessment periods.

CONCLUSIONS

The COVID-19 pandemic was associated with significant changes in the depression-loneliness network model. The most changed symptoms and edges could be treatment targets for reducing the risk of depression and loneliness in older adults.

Social isolation, loneliness, and mental health among older adults during COVID-19: a scoping review

COVID-19 continues to have detrimental effects worldwide, especially on vulnerable populations. The burden of mental health concerns and psychological well-being resulting from social isolation and loneliness induced by COVID-19 are increasingly recognized in old age. The aim is to determine the extent of social isolation and loneliness among older adults, the methodologies used, the effect on mental health during COVID-19, and review intervention strategies and lifestyle changes to improve the current situation through the recommendations of the studies included. The articles published on PubMed, ProQuest, and Scopus databases from December 2019 to December 2021 with the following keywords ("Older Adults" "Social Isolation," "Loneliness," "Mental Health," "COVID-19") in English were included. Older adults have faced a serious burden of social isolation and adverse mental health effects during COVID-19. Anxiety, depression, stress, and insomnia are the major mental health concerns among older adults worldwide. It is suggested that spousal support and social networks, adaptive organizational change, and a responsive public sector are critical in reducing the obstacles to older adults. COVID-19 resilience among the aging population can be remarkable if adequately cared for with senior-friendly pandemic-related intervention strategies, policies and legislation.

The impact of isolation on comorbidity of PTSD symptoms and depression: evidence from PTRP-5-6 in China

BACKGROUND

The Omicron pandemic struck Shanghai, China, resulting in impairments of both physical and psychological health on those patients who were confirmed and transferred to the Fangcang shelters. The way of isolation led to high risk of posttraumatic stress symptoms (PTSS) and depressive symptoms among the patients in Fangcang shelters. We aim to estimate the prevalence and comorbidity of PTSS and depressive symptoms in patients from China's Fangcang shelters during the epidemic.

METHODS

Demographic information questionnaire, the posttraumatic stress disorder checklist for DSM-5 (PCL-5), and Patient Health Questionnaire (PHQ-9) were used in the study. The data were collected online via mobile phones during 10th April to 20th April, 2022, as part of our Psychological Trauma Recover Project-5-6 (PTRP-5-6), a longitudinal study focusing on individuals who have experienced trauma.

RESULTS

A total of 336 subjects were included in the analysis. The results revealed (1) the prevalence of depressive symptoms, and PTSS were 30.1% (cut-off = 10) and 6% (cut-off = 33); (2) Multiple logistic regression showed that female (OR = 3.04, p < 0.05), suffering from dyspnea (OR = 5.83, p < 0.05) or gastrointestinal symptoms (OR = 6.38, p < 0.05) were risk factors for PTSS; higher education level (OR = 3.27, p < 0.05) and suffering from dizziness or headache (OR = 2.46, p < 0.05) were risk factors for depressive symptoms; (3)Respectively, 85% of the patients who reported PTSS also experienced depressive symptoms, 16.8% of the patients who reported depressive symptoms presented PTSS.

CONCLUSION

In the context of COVID-19, the comorbidity rate of PTSS and depressive symptoms among patients in Fangcang shelters increased with the severity of depressive symptoms.

Choice Preference of Middle-Aged and Elderly People on Integrated Medical Services and Elderly Care Model: A Cross-Sectional Study

Facing the increasingly severe aging situation, China has started to implement the "integrated medical services and elderly care (IMSEC)" policy, which covers a variety of IMSEC models. However, there is currently little research on middle-aged and elderly people's choice preference for these IMSEC models and their associated factors. Through the face-to-face questionnaire method, the choice preference of middle-aged and elderly people aged 45 years and over in Zhejiang Province, China, to the IMSEC model is explored. Through the multinomial logistic regression model, the influencing factors of choice preference are analyzed. A total of 1034 people are included in 2022. Their choice preference for the 4 major types of IMSEC models are Home IMSEC model (48.07%), Community IMSEC model (23.79%), Institutional IMSEC model (21.76%), and Internet Plus IMSEC model (6.38%). "C1. Home elderly care and contracted with a family doctor" is the most chosen subtype, accounting for 34.53%. The rural elderly are more likely to choose "Home IMSEC model" (OR(95%CI) = 2.977(1.343-6.601)). Elderly people with relatively large life care needs are more likely to choose "Institutional IMSEC model" (OR(95%CI) = 1.114(1.042-1.190)). Moreover, age, education, and self-reported health status are also influencing factors of choice preference. The government should focus on promoting the development of the "Home IMSEC model" and increase the promotion of "Internet Plus IMSEC model." In addition, the life care service capacity and spiritual comfort capacity of IMSEC institutions, as well as the medical service capacity of the community, need to be enhanced.

Impact of COVID-19 on Lifestyle: A Sample of Iranian Older Adults

The COVID-19 pandemic and prolonged quarantine affect the health behaviors of older adults. We investigated the changes in older adults' lifestyles during the pandemic in a sample of 1020 people aged 60 years old and over in Tehran. The results revealed that the COVID-19 pandemic had a positive impact on nutritional behaviors and social support while having a negative impact on physical activity and anxiety in older adults. Due to the greater deterioration of health behaviors among unmarried older adults, low socio-economic status, and COVID-19 inpatients, policymakers must pay attention to interventions to promote healthy lifestyles.

Social isolation, depression, nutritional status and quality of life during COVID-19 among Chinese community-dwelling older adults: a cross-sectional study

OBJECTIVE

This survey investigated the relationship between social isolation, depression, nutritional status and quality of life among community-dwelling older adults during COVID-19.

DESIGN

This was a cross-sectional survey study.

SETTING

Communities in Pudong New Area, Shanghai, China that have contracted with Renji Hospital, affiliated with Shanghai Jiao Tong University School of Medicine.

PARTICIPANTS

From May to July 2022, 406 community-dwelling older adults were selected by convenience sampling in Shanghai, China.

PRIMARY AND SECONDARY OUTCOME MEASURES

The Lubben Social Network Scale, Geriatric Depression Scale, 36-item Short Form Health Survey Scale and risk assessment of malnutrition were used in older adults. Mediation models were constructed to determine the mediating role of depression and nutritional status on social isolation and quality of life among older adults.

RESULTS

The prevalence of social isolation among older adults in the community was 44.3%. The total social isolation score in community-dwelling older adults was positively associated with the total malnutrition risk and quality of life scores, and negatively associated with depression (p<0.01). Logistic regression demonstrated that living alone, loss of families or friends during COVID-19 and depression were risk factors for social isolation among community-dwelling older adults (p<0.05). Social isolation could directly affect the quality of life (β=0.306). In addition, depression (β=0.334) and nutritional status (β=0.058) had a significant mediating effect on the relationship between social isolation and quality of life.

CONCLUSIONS

Our findings showed that the prevalence of social isolation among older adults increased during COVID-19. Depression and nutritional status played parallel mediating roles on the effect of social isolation on quality of life. Community workers and healthcare providers should develop intervention plans to improve the status of social isolation in older adults, eliminating existing and ongoing adverse effects.

Health and well-being of the Portuguese citizens: impacts of the COVID-19

BACKGROUND

COVID-19 pandemic placed unprecedented pressure on societies and healthcare systems around the world. Over the last years, measures imposed in almost all countries dealing with the pandemic sent the entire world into an extensive crisis and thus into a deep global recession. Since the outbreak began, many European countries have faced three/four waves of pandemic. Portugal has mainly dealt with three waves (March/April'2020; October/November'2020; January/February'2021), the third being the deadliest one. The purpose of this article is to provide evidence on the impact of the COVID-19 on health-related quality of life (HRQol) and well-being (W-B) of Portuguese citizens. It aims to (i) characterize these outcomes during the COVID-19 pandemic; (ii) compare them to pre-COVID-19 Portuguese population; and (iii) identify the social determinants that may affect these outcomes during the COVID-19 pandemic.

METHODS

This study used data from a survey that collected data on HRQoL, W-B, satisfaction with life, economic and labour impacts, access to healthcare, mental and physical health, amongst others. The survey was implemented by telephone to a representative random sample of 1,255 respondents from the general adult Portuguese population, stratified by sex, age group and region. Data was collected during the end of the second national lockdown. For comparison purposes, we have also used two other representative databases from the general Portuguese population: (i) data from before the pandemic (n = 1,006); and (ii) data from a survey conducted during the first lockdown, (n = 904).

RESULTS

Looking at health and access to healthcare, 4% of citizens had their surgeries postponed or cancelled because of COVID-19, more than a quarter had medical appointments or complementary exams postponed or cancelled, with 7% over 65 years old with surgeries cancelled or postponed and 32% medical appointments. COVID-19 pandemic also impacted negatively on the HRQoL of citizens, especially in the first lockdown. Half of the respondents reported feeling nervous, anxious, or on edge, about 45% of citizens felt sad or depressed. Sleeping problems were reported for almost 39% of citizens, and loneliness is reported by 29% of citizens. For about 70-85% of citizens, these feelings were more so than before the pandemic. Citizens with fair/strong economic stability were the most economically affected by the pandemic.

CONCLUSIONS

We provided evidence on the impact of COVID-19 on health and W-B of Portuguese citizens. Their health was worse than before the pandemic and the access to healthcare was highly affected.

Exploring Loneliness, Fear and Depression among Older Adults during the COVID-19 Era: A Cross-Sectional Study in Greek Provincial Towns

BACKGROUND

With the onset of the COVID-19 pandemic, life changed abruptly for older adults in Greece. Social isolation, lockdowns, the fear of serious illness and death, all contributed to an increased risk of developing depression.

OBJECTIVE

To explore the presence and severity of depression in older adults in Greek provincial towns during the pandemic and to explore any possible relationships with loneliness and fear.

METHODS

A convenience sample of 200 participants aged >65, completed a socio-demographic form, the Revised UCLA Loneliness Scale, the Geriatric Depression-15 Scale (GDS-15) and the COVID-19 Fear Scale (FCV-19S). Data were collected from April to May 2022.

RESULTS

The average age of participants was 76.6 years and 35.5% of the participants presented depressive symptoms (mean prevalenceof depression 5 ± 3.7). A moderate to low level of loneliness (mean value 39 ± 11.3) and a moderate level of COVID-19 fear (mean value 18.9 ± 6.5) were also experienced. Higher levels of loneliness were found among participants with lower perceived health status and among those participants registered in Primary Health and Social Care (PHSC) services. Loneliness was positively correlated with depression (r = 0.7, p < 0.001), and increased loneliness and depression were associated with an increase in fear of COVID-19 (r = 0.2, p = 0.01 for both).

CONCLUSIONS

During the pandemic, older adults experienced loneliness, fear of COVID-19 and depression which were positively associated with each other. It is imperative to develop PHSC policies that are aimed at addressing the mental health problems of the older population, which have been caused by the COVID-19 pandemic, through developing their resilience, offering psychological support and promoting social connections.

COVID-19 pandemic impact on mental health in a large representative sample of older adults from the Lombardy region, Italy

BACKGROUND

We aimed to assess the prevalence of depressive and anxiety symptoms, hopelessness and insomnia in the older adults before and during the COVID-19 pandemic identifying subgroups at higher risk of mental distress.

METHODS

Within the Lost in Lombardy project, a web-based cross-sectional study was conducted on a representative sample of 4400 older adults aged 65 years or more from the Lombardy region recruited between November 17th and 30th 2020.

RESULTS

The prevalence of depressive symptoms increased by +112 % during the pandemic, anxiety symptoms by +136 %, insufficient sleep by +12 %, unsatisfactory sleep by +15 %. Feelings of hopelessness were more frequent among women compared to men and increased with increasing age. A worsening in each of the four specific mental health outcomes was more frequently observed in women (OR = 1.50, depression; OR = 1.31, anxiety; OR = 1.57, sleep quality; OR = 1.38, sleep quantity), in subjects who decreased their physical activity during the pandemic (OR = 1.64, depression; OR = 1.48, anxiety; OR = 2.05, sleep quality; OR = 1.28, sleep quantity), and with increasing number of pre-existing chronic diseases. The use of at least one psychotropic drug - mostly antidepressants/anxiolytics - increased by +26 % compared to pre-pandemic.

LIMITATIONS

Pre-pandemic symptoms were retrospectively reported during the Covid pandemic. Potential information and recall bias should not be ruled out.

CONCLUSIONS

If confirmed by future longitudinal studies, our findings could support evidence-based health and welfare policies on responding to this pandemic and on how to promote mental health and wellbeing, should future waves of infection emerge.

Loneliness and Mental Health in Response to Early and Late COVID-19 Outbreak: A Cross-Sectional Study of Czech Adults Aged 50 and Over

The unpredictable spread of the COVID-19 pandemic, national lockdowns, and public health measures implemented in the Czech Republic had a negative effect on older adults' mental health and loneliness. The 2,631 older adults in 2020 and 2,083 older adults in 2021 used in this study formed a nationally representative sample of the Survey of Health, Ageing and Retirement in Europe (SHARE). Almost every third older adult experienced feelings of loneliness in both stages of the COVID-19 outbreak. Loneliness increased in 2021 in those individuals who reported their physical health as poor, who felt nervous, sad or depressed, and who had ever left their home since the outbreak. According to age-related drivers of loneliness, feelings of loneliness were prevalent (40% vs. 45%) among younger retirees in both waves. In both data sets, declared feelings of sadness or depression were the strongest sustainable predictor of loneliness (2020 and 2021 models, OR = 3.69; 95% CI [2.90, 4.69] and OR = 2.55; [1.97, 3.30]). Being a woman and feeling nervous equated with a higher likelihood of feeling lonely compared to counterparts. Policy makers should therefore aim to carefully improve psychosocial and health-related consequences faced by this vulnerable population during the pandemic and beyond.

Prevalence of Depression and Related Factors among Patients with Chronic Disease during the COVID-19 Pandemic: A Systematic Review and Meta-Analysis

The management of chronic diseases in the midst of the COVID-19 pandemic is especially challenging, and reducing potential psychological harm is essential. This review aims to determine the prevalence of depression during the COVID-19 pandemic in patients with chronic disease, and to characterize the impacts of related factors. A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The meta-analysis was performed using StatsDirect software. The review identified 33 articles with a total of 50,905 patients with chronic diseases. Four meta-analyses were performed to estimate the prevalence of depression. In diabetic patients, the prevalence ranged from 17% (95% CI = 7-31) (PHQ-9) to 33% (95% CI = 16-51) (PHQ-8); in obese patients, the prevalence was 48% (95% CI = 26-71); and in hypertensive patients, the prevalence was 18% (95% CI = 13-24). The factors significantly associated with depression were female sex, being single, deterioration in the clinical parameters of diabetes, a decrease in self-care behavior, reduced physical activity and sleep time and fear of contagion. The COVID-19 pandemic has significantly increased levels of depression among persons with chronic disease. Pandemics and other emergency events have a major impact on mental health, so early psychological interventions and health management policies are needed to reinforce chronic patients' physical and mental health.

The Initial Response to COVID-19 Disruptions for Older People with HIV in Ukraine

Ukraine imposed a COVID-19 lockdown in March 2020. From April to June 2020, we surveyed 123 older people with HIV (OPWH) by phone to assess their mental health, engagement in HIV and other healthcare, and substance use using standardised scales. Variables of key interest were symptoms of depression and symptoms of anxiety. Univariate and multivariable Firth logistic regression models were built to assess factors associated with: (1) symptoms of depression, and (2) symptoms of anxiety. Findings indicated high suicidal ideation (10.6%); 45.5% met the screening criteria for moderate to severe depression; and 35.0% met the criteria for generalised anxiety disorder (GAD). Independent correlates of having moderate to severe depression included being female (AOR: 2.83, 95%CI = 1.19-7.05), having concerns about potential barriers to HIV treatment (AOR: 8.90, 95%CI = 1.31-104.94), and active drug use (AOR: 34.53, 95%CI = 3.02-4885.85). Being female (AOR: 5.30, 95%CI = 2.16-14.30) and having concerns about potential barriers to HIV treatment (AOR: 5.33, 95%CI = 1.22-28.45) were independently correlated with GAD, and over half (58.5%) were willing to provide peer support to other OPWH. These results highlight the impact of the COVID-19 restrictions in Ukraine on mental health for OPWH and support the need to screen for psychiatric and substance use disorders, potentially using telehealth strategies.

A cross-sectional study of the psychological impact of the COVID-19 pandemic on camped refugees in Ghana

Vulnerable populations such as camped refugees are often exposed to spread of infectious diseases because of their living conditions, limited resources available to them and exclusion from social services. This study examined the psychological state of camped refugees in Ghana during the COVID-19 pandemic and how their background characteristics predict the severity of the pandemic's psychological impact. It covered 763 refugees aged 15 years and above resident in two (Krisan = 316 and Ampain = 447) camps. Nine COVID-19 Anxiety Scale indicators were used to examine the psychological state of camped refugees. A composite indicator was derived to examine the overall psychological impact. Logistic regression was used to examine the factors that were associated with severe psychological impact. The multivariate analysis revealed that sex of the respondent, marital status and age of head of household were the only socio-demographic factors associated with having a severe psychological impact of the pandemic. There was very strong evidence that respondents who had moderate (OR = 1.74, 95% CI = 1.12, 2.7) and high (OR = 1.66, 95% CI = 1.05, 2.63) knowledge of the disease had increased odds of severe psychological impact. Also, those with moderate (OR = 2.97, 95% CI = 1.78, 4.97) and high (OR = 12.98, 95% CI = 7.86, 21.42) adherence had increased odds of severe psychological impact. None of the pre-existing health conditions and challenges were not significantly associated with severe psychological impact. The limited number of significant socio-demographic covariates suggests that severe psychological impact of the pandemic was a problem in the general population, and thus interventions should target the general population of camped refugees. Also, health education should not only focus on enhancing knowledge and promoting preventive measures but also on managing psychological distress.

Predictors of Psychological Distress across Three Time Periods during the COVID-19 Pandemic in Poland

BACKGROUND

Since the onset of COVID-19, public health policies and public opinions changed from stringent preventive measures against spread of COVID-19 to policies accommodating life with continued, diminished risk for contracting COVID-19. Poland is a country that demonstrated severe psychological impact and negative mental health. The study aims to examine psychological impact and changes in levels of depression, anxiety, and stress among three cross-sectional samples of Polish people and COVID-19-related factors associated with adverse mental health.

METHODS

In total, 2324 Polish persons participated in repeated cross-sectional studies across three surveys: Survey 1 (22 to 26 March 2020), Survey 2 (21 October to 3 December 2020), and Survey 3 (3 November to 10 December 2021). Participants completed an online survey, including Impact of Event Scale-Revised (IES-R), Depression, Anxiety, and Stress Scale (DASS-21), demographics, knowledge, and concerns of COVID-19 and precautionary measures.

RESULTS

A significant reduction of IES-R scores was seen across surveys, while DASS-21 scores were significantly higher in Survey 2. There was significant reduction in the frequency of following COVID-19 news, recent COVID-19 testing, and home isolation from Survey 1 to 3. Being emale was significantly associated with higher IES-R and DASS-21 scores in Surveys 1 and 2. Student status was significantly associated with higher DASS-21 across surveys. Chills, myalgia, and fatigue were significantly associated with high IES-R or DASS-21 scores across surveys. Frequency of wearing masks and perception that mask could reduce risk of COVID-19 were significantly associated with higher IES-R and DASS-21 scores.

CONCLUSION

Conclusions: The aforementioned findings indicate a reduction in the level of the measured subjective distress andin the frequency of checking COVID-19 news-related information across three periods during the pandemic in Poland.

Anxiety, Distress and Stress among Patients with Diabetes during COVID-19 Pandemic: A Systematic Review and Meta-Analysis

The prevalence of mental health disorders has increased during the COVID-19 pandemic. Patients with chronic diseases, such as diabetes, are a particularly vulnerable risk group. This study aims to assess the levels and prevalence of anxiety, distress, and stress in patients with diabetes during the COVID-19 pandemic. A systematic review was conducted in CINAHL, Cochrane, LILACS, Medline, SciELO, and Scopus in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Thirty-seven articles with a total of 13,932 diabetic patients were included. Five meta-analyses were performed. The prevalence of anxiety was 23% (95% CI = 19–28) in T1DM and 20% (95% CI = 6–40) in T2DM patients. For diabetes distress it was 41% (95% CI = 24–60) for T1DM and 36% in T2DM patients (95% CI = 2–84). For stress, the prevalence was 79% (95% CI = 49–98) in T1DM patients. People with diabetes have significant psychiatric comorbidity as well as psychological factors that negatively affect disease management, increasing their vulnerability in an emergency situation. To establish comprehensive care in diabetic patients addressing mental health is essential, as well as including specific policy interventions to reduce the potential psychological harm of the COVID-19 pandemic.

Mental Health Consequences of COVID-19 Pandemic Period in the European Population: An Institutional Challenge

The worldwide spread of SARS-CoV-2 has been responsible for an infectious pandemic, with repercussions on socio-economic aspects and on the physical and mental health of the general population. The present systematic review aimed to evaluate the data belonging to the European framework, analyzing the population by age group. Original articles and reviews on the state of mental health of the general European population have been researched starting from 2021. Initially, a total of 1764 studies were found, among which a total of 75 were selected. Youth were the age group most affected by pandemic consequences on mental health, with emotional and behavioral alterations observed from a third to more than a half of children and adolescents examined. Among both adolescents and adults, the female gender had a higher prevalence of psychopathological symptoms. The main risk factors were poor social support, economic difficulties, and, in particular, unemployment or job changes. Additional individual risk factors were the perception of loneliness, the presence of pre-pandemic mental illness/distress, and some personality traits, such as neuroticism, impulsiveness, and the use of maladaptive coping strategies. Unexpectedly, the elderly maintained good resilience towards change, even if a stress factor was represented by the feeling of loneliness and poor social contact. As regards suicidal behaviors, among adolescents, there was an increase in attempts of 25%, with a greater risk for the female gender. This risk increased also among adults, in association with symptoms of anxiety and depression, and poor socio-environmental conditions. In conclusion, some population groups were found to be at greater risk of psychological burden during pandemic waves, thus representing priority targets for socio-health interventions.

Loneliness and Depression among Community Older Adults during the COVID-19 Pandemic: A cross-sectional study

BACKGROUND

Social isolation has been recommended for reducing older adults' mortality and severe cases of COVID illness. That has resulted in unavoidable consequences of mental ill-health. This study aimed to examine the impact of the COVID-19 lockdown on the development of loneliness and depression and to analyse the factors associated with these conditions among community-dwelling older adults in Jordan.

METHODS

A cross-sectional survey was conducted with a random sample of 456 community older adults contacted by telephone three weeks after the first pandemic lockdown in April 2020. The study instrument included the screening three-item UCLA Loneliness Scale, the Geriatric Depression Scale, and relevant medical and functional history.

RESULTS

The mean age was 72.48 ± 6.84 years, and 50.2% were women. 41.4% were lonely, and of those 62% had a positive screen for depression. The mean UCLA score was significantly higher during the lockdown than before. Loneliness was significantly associated with being unmarried, having never worked previously, and being functionally dependent. Lonely participants were 1.65 times more likely to have depression. Likewise, a previous history of depression and cognitive impairment, multimorbidity, poor self-perceived health, and concern about contracting COVID infection were significant predictors of depression.

CONCLUSION

The COVID-19 pandemic has had a heavy toll on older adults' mental health, particularly those with multimorbidity, baseline functional dependence, and those with a previous history of depression and cognitive impairment. Targeting these high-risk groups is important in order to minimize loneliness, depression, and subsequent increased morbidity. Using all-inclusive language might minimize ageism and the fear of catching an infection.

Morbidities Worsening Index to Sleep in the Older Adults During COVID-19: Potential Moderators

Older adults were considered a vulnerable group for the COVID-19 infection and its consequences, including problems with sleep.

Changes in Air-Pollution-Related Information-Seeking Behaviour during the COVID-19 Pandemic in Poland

Low air quality in Poland is a problem of particularly high urgency. Therefore, Poles must be aware of air quality levels, also during the COVID-19 pandemic. The study aimed to compare air-pollution-related information-seeking behaviour between the pre- and intra-pandemic periods as well as between the actual and theoretical machine-learning-forecasted intra-pandemic models. Google Trends search volumes (GTSVs) in Poland for air-pollution-related keywords were collected between January 2016 and January 2022. To investigate the changes that would have occurred without the outbreak of the pandemic, Seasonal Autoregressive Integrated Moving Average (SARIMA) machine-learning models were trained. Approximately 4,500,000 search queries were analysed. Between pre- and intra-pandemic periods, weighted mean GTSVs changed by −39.0%. When the actual intra-pandemic weighted mean GTSVs were compared to the intra-pandemic forecasts, the actual values were lower by −16.5% (SARIMA’s error = 6.2%). Compared to the pre-pandemic period, in the intra-pandemic period, the number of search queries containing keywords connected with air pollution decreased. Moreover, the COVID-19 pandemic might have facilitated the decrease. Possible causes include an attention shift towards everyday problems connected to the pandemic, worse mental health status and lower outdoor exposure that might have resulted in a lower intensity of non-pandemic-related active information-seeking behaviour.

The Effects of COVID-19 lockdown on neuropsychiatric symptoms in patients with dementia or mild cognitive impairment: A systematic review and meta-analysis

The COVID-19 pandemic may have a disproportionate impact on people with dementia/mild cognitive impairment (MCI) due to isolation and loss of services. The aim of this systematic review was to investigate the effects of the COVID-19 lockdown on neuropsychiatric symptoms (NPS) in people living with dementia/MCI. Two authors searched major electronic databases from inception to June 2021 for observational studies investigating COVID-19 and NPS in people with dementia/MCI. Summary estimates of mean differences in NPS scores pre- versus post-COVID-19 were calculated using a random-effects model, weighting cases using inverse variance. Study quality and risk of bias were assessed by the Newcastle-Ottawa Scale. From 2730 citations, 21 studies including 7139 patients (60.0% female, mean age 75.6 ± 7.9 years, 4.0% MCI) with dementia were evaluated in the review. Five studies found no changes in NPS, but in all other studies, an increase in at least one NPS or the pre-pandemic Neuropsychiatric Inventory (NPI) score was found. The most common aggravated NPS were depression, anxiety, agitation, irritability, and apathy during lockdown, but 66.7% of the studies had a high bias. Seven studies including 420 patients (22.1% MCI) yielded enough data to be included in the meta-analysis. The mean follow-up time was 5.9 ± 1.5 weeks. The pooled increase in NPI score before compared to during COVID-19 was 3.85 (95% CI:0.43 to 7.27; P = 0.03; I²  = 82.4%). All studies had high risk of bias. These results were characterized by high heterogeneity, but there was no presence of publication bias. There is an increase in the worsening of NPS in people living with dementia/MCI during lockdown in the COVID pandemic. Future comparative studies are needed to elucidate whether a similar deterioration might occur in people without dementia/MCI.

Loneliness and mental well-being in the Polish population during the COVID-19 pandemic: a cross-sectional study

OBJECTIVE

There is a growing concern that the restrictions imposed due to the COVID-19 pandemic could lead to increased loneliness and mental disorders, which are considered a major public health problem. The aim of the study was to assess loneliness, anxiety, depression and irritability in the Polish population during the COVID-19 pandemic.

DESIGN

A cross-sectional study. The study participants completed an online questionnaire using the computer-assisted web interview technique. Data were collected using Revised UCLA Loneliness Scale and Hospital Anxiety and Depression Scale.

SETTING

Poland.

PARTICIPANTS

This study was conducted between 6 October and 12 October 2020, in a representative sample of 890 Polish residents.

PRIMARY OUTCOME MEASURES

Self-reported loneliness; sociodemographic and COVID-19 pandemic factors associated with loneliness, anxiety, depression and irritability.

RESULTS

The analyses showed a moderately high degree of loneliness in 22%, symptoms of anxiety in 27%, depression in 14% and irritability in 33% of the respondents. The increasing severity of anxiety, depression and irritation in the study group was accompanied by higher loneliness. Generally, younger people, both tested positive for SARS-CoV-2 and those who experienced home quarantine, scored higher in both scales.

CONCLUSIONS

It is necessary to identify those most vulnerable to loneliness, anxiety and depression during a crisis to assess health needs and proactively allocate resources during and after the pandemic. Loneliness, anxiety, depression and irritability are important factors to consider in a population of younger, disadvantaged people, who tested positive for SARS-CoV-2, people who were quarantined at home, and people who believe that their physical and mental health is worse than in the pre-pandemic period. It is important to cater for the mental health of individuals during the COVID-19 pandemic and to promote psychological interventions to improve mental well-being in potentially vulnerable social groups.