Associations of Social Isolation with Anxiety and Depression During the Early COVID-19 Pandemic: A Survey of Older Adults in London, UK

Abstract

The COVID-19 pandemic is imposing a profound negative impact on the health and wellbeing of societies and individuals, worldwide. One concern is the effect of social isolation as a result of social distancing on the mental health of vulnerable populations, including older people. Within six weeks of lockdown, we initiated the CHARIOT COVID-19 Rapid Response Study, a bespoke survey of cognitively healthy older people living in London, to investigate the impact of COVID-19 and associated social isolation on mental and physical wellbeing. The sample was drawn from CHARIOT, a register of people over 50 who have consented to be contacted for aging related research. A total of 7,127 men and women (mean age=70.7 [SD=7.4]) participated in the baseline survey, May–July 2020. Participants were asked about changes to the 14 components of the Hospital Anxiety Depression scale (HADS) after lockdown was introduced in the UK, on 23 rd March. A total of 12.8% of participants reported feeling worse on the depression components of HADS (7.8% men and 17.3% women) and 12.3% reported feeling worse on the anxiety components (7.8% men and 16.5% women). Fewer participants reported feeling improved (1.5% for depression and 4.9% for anxiety). Women, younger participants, those single/widowed/divorced, reporting poor sleep, feelings of loneliness and who reported living alone were more likely to indicate feeling worse on both the depression and/or anxiety components of the HADS. There was a significant negative association between subjective loneliness and worsened components of both depression (OR 17.24, 95% CI 13.20, 22.50) and anxiety (OR 10.85, 95% CI 8.39, 14.03). Results may inform targeted interventions and help guide policy recommendations in reducing the effects of social isolation related to the pandemic, and beyond, on the mental health of older people.

Social relationships and depression during the COVID-19 lockdown: longitudinal analysis of the COVID-19 Social Study

“…Our findings also have specific relevance to the social context of the COVID-19 pandemic, echoing some previous studies. For example, one cross-sectional study of 7127 UK older adults aged 70 on average who self-reported whether their mental health had changed, found that loneliness was associated with reporting a worsening of depression and anxiety symptoms, although this study did not objectively identify change in mental health (Robb et al, 2020 ). In our study, the association was relatively modest; the minimum difference on the PHQ-9 considered to indicate a clinically meaningful improvement in response to treatment being between 2.8 and 5 points (Löwe, Unützer, Callahan, Perkins, & Kroenke, 2004 ).…”

Medical Studies during the COVID-19 Pandemic: The Impact of Digital Learning on Medical Students’ Burnout and Mental Health

“…In particular, social isolation which took place during lockdown may have also had a significant effect in overall mental health. The effect of social isolation on mental health is evident through numerous studies and has already raised significant concerns [ 24 , 25 , 26 ]. It is argued that negative mental health impacts do not simply stop but continue following the lockdown period [ 27 ].…”

Effects of COVID-19 Infection Control Measures on Appointment Cancelation in an Italian Outpatient Memory Clinic

“…It is also possible that there may be an increased need for assessment of new patients in geriatric psychiatry settings as a result of the negative consequence of quarantine and social distancing measures. In fact, psychological symptoms due to stressor events can contribute to cognitive decline (20) and social isolation, reduced social network, and loneliness can lead to generalized anxiety and major depression disorders in older individuals (21)(22)(23). Further, during lockdown it is likely that many older persons reduced their physical activity levels (5), which may impair symptoms; for example, cardiorespiratory fitness is also associated with cognitive functioning in older persons (24).…”