COVID-19, Aging, and Mental Health: Lessons From the First Six Months

Vahia, Ipsit V.

doi:10.1016/j.jagp.2020.05.029

Cited by 28 publications

(27 citation statements)

References 24 publications

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“…2 This debate is particularly acute for older adults who are at highest risk of deleterious outcomes from COVID-19. 3,4 Data informing this debate are limited, and we know of no published studies about the experiences of vulnerable older adults like those with major depressive disorder (MDD). Therefore, we conducted a mixed-methods study in older adults with MDD to assess their experience during the pandemic, including changes in quantitative depression and anxiety scores from scores obtained before the pandemic.…”

Section: Introductionmentioning

confidence: 99%

Experiences of American Older Adults with Pre-existing Depression During the Beginnings of the COVID-19 Pandemic: A Multicity, Mixed-Methods Study

Hamm

Brown

Karp

et al. 2020

The American Journal of Geriatric Psychiatry

122

154

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To determine the effect of the COVID-19 pandemic on the mental health of older adults with pre-existing major depressive disorder (MDD). Participants: Participants were 73 community-living older adults with pre-existing MDD (mean age 69 [SD 6]) in Los Angeles, New York, Pittsburgh, and St Louis. Design and Measurements: During the first 2 months of the pandemic, the authors interviewed participants with a semistructured qualitative interview evaluating access to care, mental health, quality of life, and coping. The authors also assessed depression, anxiety, and suicidality with validated scales and compared scores before and during the pandemic. Results: Five themes from the interviews highlight the experience of older adults with MDD: 1) They are more concerned about the risk of contracting the virus than the risks of isolation. 2) They exhibit resilience to the stress and isolation of physical distancing. 3) Most are not isolated socially, with virtual contact with friends and family. 4) Their quality of life is lower, and they worry their mental health will suffer with continued physical distancing. 5) They are outraged by an inadequate governmental response to the pandemic. Depression, anxiety, and suicidal ideation symptom scores did not differ

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Section: Introductionmentioning

confidence: 99%

Experiences of American Older Adults with Pre-existing Depression During the Beginnings of the COVID-19 Pandemic: A Multicity, Mixed-Methods Study

Hamm

Brown

Karp

et al. 2020

The American Journal of Geriatric Psychiatry

122

154

View full text Add to dashboard Cite

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“… 10 Some people also present with atypical symptoms such as altered mental state, including increased cognitive impairment (especially among those with dementia), agitation, refusal of care, and apathy. 11 , 12 …”

Section: Introductionmentioning

confidence: 99%

Prevalence, management, and outcomes of SARS-CoV-2 infections in older people and those with dementia in mental health wards in London, UK: a retrospective observational study

Livingston

Rostamipour

Gallagher

et al. 2020

The Lancet Psychiatry

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Background People living in group situations or with dementia are more vulnerable to infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Older people and those with multimorbidity have higher mortality if they become infected than the general population. However, no systematic study exists of COVID-19-related outcomes in older inpatients in psychiatric units, who comprise people from these high-risk groups. We aimed to describe the period prevalence, demographics, symptoms (and asymptomatic cases), management, and survival outcomes of COVID-19 in the older inpatient psychiatric population and people with young-onset dementia in five National Health Service Trusts in London, UK, from March 1 to April 30, 2020.Methods In this retrospective observational study, we collected demographic data, mental health diagnoses, clinical diagnosis of COVID-19, symptoms, management, and COVID-19-related outcome data of inpatients aged 65 years or older or with dementia who were already inpatients or admitted as inpatients to five London mental health Trusts between March 1 and April 30, 2020, and information about available COVID-19-related resources (ie, testing and personal protective equipment). Patients were determined to have COVID-19 if they had a positive SARS-CoV-2 PCR test, or had relevant symptoms indicative of COVID-19, as determined by their treating physician. We calculated period prevalence of COVID-19 and analysed patients' characteristics, treatments, and outcomes.Findings Of 344 inpatients, 131 (38%) were diagnosed with COVID-19 during the study period (period prevalence 38% [95% CI 33-43]). The mean age of patients who had COVID-19 was 75•3 years (SD 8•2); 68 (52%) were women and 47 (36%) from ethnic minority groups. 16 (12%) of 131 patients were asymptomatic and 121 (92%) had one or more disease-related comorbidity. 108 (82%) patients were compulsorily detained. 74 (56%) patients had dementia, of whom 13 (18%) had young-onset dementia. On average, sites received COVID-19 testing kits 4•5 days after the first clinical COVID-19 presentation. 19 (15%) patients diagnosed with COVID-19 died during the study period, and their deaths were determined to be COVID-19 related.Interpretation Patients in psychiatric inpatient settings who were admitted without known SARS-CoV-2 infection had a high risk of infection with SARS-CoV-2 compared with those in the community and had a higher proportion of deaths from COVID-19 than in the community. Implementation of the long-standing policy of parity of esteem for mental health and planning for future COVID-19 waves in psychiatric hospitals is urgent.Funding None.

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“…Brain health disorders have a global reach impacting every human either directly or indirectly. In COVID and similar pandemics, due to social and physical distancing, unemployment and underemployment, stress, and other factors, there have been significant increases in issues such as depression, anxiety, social isolation, substance abuse, loneliness, and cognitive decline in older adults [5][6][7][8][9][10][11][12]. In addition, as observed after the SARS pandemic, it is expected that COVID survivors may endure long term cognitive and psychiatric consequences, including suicide, post-traumatic stress disorders and depression [13].…”

Section: The Brain Our Interconnected Economy and Covidmentioning

confidence: 99%