Multimorbidity and Mental Health Trajectories Among Middle-Aged and Older U.S. Adults During the COVID-19 Pandemic: Longitudinal Findings From the COVID-19 Coping Study.
Multimorbidity and Mental Health Trajectories Among Middle-Aged and Older U.S. Adults During the COVID-19 Pandemic: Longitudinal Findings From the COVID-19 Coping Study.
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DOI：
10.1093/geroni/igac047
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发表时间：
2022
影响因子：
7
通讯作者：
Kobayashi, Lindsay C.
中科院分区：
文献类型：
--
作者：
Cheng, Greta Jianjia;Wagner, Abram L.;O'Shea, Brendan Q.;Joseph, Carly A.;Finlay, Jessica M.;Kobayashi, Lindsay C.
这项研究旨在研究COVID-19大流行开始时的多重抑郁与随后的抑郁症状，焦虑症状和孤独的纵向轨迹之间的关联，在12个月的随访中，中年和老年人。数据来自2020年4月/5月至2021年4月/5月期间美国55岁以上成年人COVID-19应对研究的每月在线问卷（N = 4，024）。 多发病定义为基线时有≥2种慢性疾病与<2种慢性疾病。每月评估心理健康结果，包括抑郁症状（8项流行病学研究中心抑郁量表）、焦虑症状（5项Beck焦虑量表）和孤独（3项UCLA孤独量表）。我们使用多变量调整的人口和磨损加权混合效应线性模型来研究多发病和心理健康症状之间的纵向关联。大流行发作时的多发病与基线时抑郁（B = 0.37; 95%CI：0.16-0.59）和焦虑（B = 0.39; 95%CI：0.15-0.62）症状升高相关。 所有三种心理健康结果的症状变化随时间呈非线性变化，在大流行的前6个月（2020年4月/5月至9月/10月）症状恶化，随后6个月（2020年9月/10月至2021年4月/5月）症状改善。患有多种疾病的中老年人的焦虑症状和孤独感的变化速度比没有患有多种疾病的中老年人更快，并且在整个随访期间心理健康症状持续升高。研究结果强调了在COVID-19大流行期间，患有多发性硬化症的中年和老年人所经历的独特和持续的心理健康风险。观察到的症状改善强调了这些人的心理弹性，表明他们对正在进行的大流行病的适应。
This study aimed to examine the associations between multimorbidity at the COVID-19 pandemic onset and subsequent longitudinal trajectories of depressive symptoms, anxiety symptoms, and loneliness in middle-aged and older adults over a 12-month follow-up. Data were from monthly online questionnaires in the COVID-19 Coping Study of U.S. adults aged ≥55 from April/May 2020 through April/May 2021 (N = 4,024). Multimorbidity was defined as having ≥2 versus <2 chronic conditions at baseline. Mental health outcomes were assessed monthly as depressive symptoms (8-item Center for Epidemiologic Studies Depression scale), anxiety symptoms (5-item Beck Anxiety Inventory), and loneliness (3-item UCLA Loneliness Scale). We used multivariable-adjusted population- and attrition-weighted mixed-effects linear models to examine the longitudinal associations between multimorbidity and mental health symptoms. Multimorbidity at the pandemic onset was associated with elevated depressive (b = 0.37; 95% CI: 0.16–0.59) and anxiety (b = 0.39; 95% CI: 0.15–0.62) symptoms at baseline. Changes in symptoms for all three mental health outcomes were nonlinear over time, with worsening symptoms over the first 6 months of the pandemic (April/May to September/October 2020), followed by improvement in symptoms over the subsequent 6 months (September/October 2020 to April/May 2021). Middle-aged and older adults with multimorbidity experienced faster rates of change in anxiety symptoms and loneliness than those without multimorbidity, with persistently elevated mental health symptomatology throughout the follow-up. Results highlight the unique and persistent mental health risks experienced by middle-aged and older adults with multimorbidity during the COVID-19 pandemic. The observed improvements in symptoms underscore the mental resilience of these individuals, indicating their adaptation to the ongoing pandemic.
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