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

Abstract

Background and Objectives 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. Research Design and Methods Data were from monthly online questionnaires in the COVID-19 Coping Study of US adults aged ≥55 from April/May 2020 through April/May 2021 (N=4,024). Multimorbidity was defined as having ≥2 vs. <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. Results 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 non-linear over time, with worsening symptoms over the first six months of the pandemic (April/May to September/October 2020), followed by improvement in symptoms over the subsequent six 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 at the end of the follow-up. Discussion and Implications 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 adults, indicating adaptation to the ongoing pandemic.

Multimorbidity in African ancestry populations: a scoping review

“…Multimorbidity (MM), the co-occurrence of two or more chronic conditions in an individual, is a growing global challenge 1 2. MM is associated with increased premature mortality,2 lowered quality of life,3 diminished mental health,4 5 increased polypharmacy risk6 and intensified health services utilisation and associated costs, particularly in resource-poor settings 7…”