Loneliness and mental health during the COVID‐19 pandemic in older breast cancer survivors and noncancer controls

Abstract

BACKGROUND:The coronavirus disease 2019 (COVID-19) pandemic has had wide-ranging health effects and increased isolation. Older with cancer patients might be especially vulnerable to loneliness and poor mental health during the pandemic. METHODS: The authors included active participants enrolled in the longitudinal Thinking and Living With Cancer study of nonmetastatic breast cancer survivors aged 60 to 89 years (n = 262) and matched controls (n = 165) from 5 US regions. Participants completed questionnaires at parent study enrollment and then annually, including a web-based or telephone COVID-19 survey, between May 27 and September 11, 2020. Mixedeffects models were used to examine changes in loneliness (a single item on the Center for Epidemiologic Studies-Depression [CES-D] scale) from before to during the pandemic in survivors versus controls and to test survivor-control differences in the associations between changes in loneliness and changes in mental health, including depression (CES-D, excluding the loneliness item), anxiety (the State-Trait Anxiety Inventory), and perceived stress (the Perceived Stress Scale). Models were adjusted for age, race, county COVID-19 death rates, and time between assessments. RESULTS: Loneliness increased from before to during the pandemic (0.211; P = .001), with no survivor-control differences. Increased loneliness was associated with worsening depression (3.958; P < .001) and anxiety (3.242; P < .001) symptoms and higher stress (1.172; P < .001) during the pandemic, also with no survivor-control differences. CONCLUSIONS: Cancer survivors reported changes in loneliness and mental health similar to those reported by women without cancer. However, both groups reported increased loneliness from before to during the pandemic that was related to worsening mental health, suggesting that screening for loneliness during medical care interactions will be important for identifying all older women at risk for adverse mental health effects of the pandemic.

The Psychological Consequences of the COVID-19 Pandemic in Adults Treated for Childhood Cancer

“…At the same time and unexpectedly, we reported similar mental health among survivors and their general population peers of the same age and gender. This finding extends evidence reported by a study showing similar mental health in survivors of adult cancer during the COVID-19 pandemic and in adults without a cancer history [ 24 ]. Other divergent results have been reported by a study assessing the psychological distress during the COVID-19 pandemic in survivors of adult cancer and healthy controls, showing that cancer survivors reported a greater catastrophizing attitude in relation to the COVID-19 pandemic, while showing less psychological distress [ 25 ].…”

16 Months Follow Up of Patients’ Behavior and Mild COVID-19 Patterns in a Large Cohort of Cancer Patients During the Pandemic

“…Patients with persistent symptoms experienced significantly more sleeping troubles, self-isolation, increased consumption of stress-relieving drugs, or the need for psychological support. Loneliness was suggested to negatively affect patients’ mental health, especially in older patients ( 18 ). A systematic follow-up of infected cancer patients will help refine the clinical spectrum of long COVID and quantify the burden of additional physical and psychological morbidities and social consequences in this population.…”

Association between Quality of Life and Physical Functioning in a Gardening Intervention for Cancer Survivors

“…On the other hand, in a longitudinal cohort study, both breast cancer survivors and age-matched controls reported incident sleep disturbance and increased loneliness [ 76 ]. In both survivors and control participants, increased loneliness was associated with significantly worsening depression, anxiety, and higher stress [ 77 ].…”