Abstract
Objective: Loneliness and physical activity are important targets for research into the impact of COVID-19 because they have established links with mental health, could be exacerbated by social distancing policies, and are potentially modifiable. In this study, we aimed to identify whether loneliness and physical activity were associated with worse mental health during a period of mandatory social distancing in the UK.
Design: Population-based observational cohort study.
Setting: Mental health data collected online during COVID-19 from an existing sample of adults aged 50 and over taking part in a longitudinal study of aging. All had comparable annual data collected between 2015 and 2019.
Participants: Three-thousand two-hundred and eighty-one participants aged 50 and over.
Measurements: Trajectories of depression (measured by PHQ-9) and anxiety (measured by GAD-7) between 2015 and 2020 were analyzed with respect to loneliness, physical activity levels, and a number of socioeconomic and demographic characteristics using zero-inflated negative binomial regression.
Results: In 2020, PHQ-9 score for loneliness, adjusted for covariates, was 3.23 (95% CI: 3.01-3.44), an increase of around 1 point on all previous years in this group and 2 points higher than people not rated lonely, whose score did not change in 2020 (1.22, 95% CI: 1.12-1.32). PHQ-9 was 2.60 (95% CI: 2.43-2.78) in people with decreased physical activity, an increase of.5 on previous years. In contrast, PHQ-9 in 2020 for people whose physical activity had not decreased was 1.66, 95% CI: 1.56-1.75, similar to previous years. A similar relationship was observed for GAD-7 though the absolute burden of symptoms lower.
Conclusion: After accounting for pre-COVID-19 trends, we show that experiencing loneliness and decreased physical activity are risk factors for worsening mental health during the pandemic. Our findings highlight the need to examine policies which target these potentially modifiable risk factors.
| Original language | English |
|---|---|
| Pages (from-to) | 505-514 |
| Number of pages | 10 |
| Journal | International Psychogeriatrics |
| Volume | 33 |
| Issue number | 5 |
| Early online date | 17 Dec 2020 |
| DOIs | |
| Publication status | Published - May 2021 |
Bibliographical note
Funding Information:This paper represents an independent research part funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London. This research was also supported by the NIHR Collaboration for Leadership in Applied Health Research and Care South West Peninsula. Additional funding for the COVID-19 mental health questionnaire was provided by King’s College London and Stavanger University Hospital.
The authors would like to thank Ellie Pickering, Adam Bloomfield, and Ben Wood at the University of Exeter for project management and IT development related to the COVID-19 mental health questionnaire. We also thank the HRA for expediting ethical review, the PROTECT study PPI group, and all participants for taking the time to complete the questionnaire. Dr Siobhan O’Dwyer is supported by the National Institute for Health Research Applied Research Collaboration South West Peninsula. The views expressed in this publication are those of the author(s) and not necessarily those of the National Institute for Health Research or the Department of Health and Social Care.
Publisher Copyright:
© 2020 International Psychogeriatric Association.
Keywords
- anxiety
- COVID-19
- depression
- exercise
- loneliness
- mental health
- pandemic
- physical activity
ASJC Scopus subject areas
- Clinical Psychology
- Gerontology
- Geriatrics and Gerontology
- Psychiatry and Mental health
