Hostname: page-component-5db58dd55d-jnbmb Total loading time: 0 Render date: 2026-06-11T21:37:01.606Z Has data issue: false hasContentIssue false
  • English
  • Français

The impact of the COVID-19 pandemic on depression in community-dwelling older adults: a prospective cohort study

Published online by Cambridge University Press:  17 December 2021

Dae Jong Oh ,
Hee Won Yang ,
Seung Wan Suh ,
Seonjeong Byun ,
Tae Hui Kim ,
Kyung Phil Kwak ,
Bong Jo Kim ,
Shin Gyeom Kim ,
Jeong Lan Kim  and
Seok Woo Moon
...Show all authors
Dae Jong Oh
Affiliation:
Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, Korea
Hee Won Yang
Affiliation:
Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggido, Korea
Seung Wan Suh
Affiliation:
Department of Psychiatry, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
Seonjeong Byun
Affiliation:
Department of Psychiatry, Uijeongbu St. Mary's Hospital, Uijeongbu, Korea
Tae Hui Kim
Affiliation:
Department of Psychiatry, Yonsei University Wonju Severance Christian Hospital, Wonju, Korea
Kyung Phil Kwak
Affiliation:
Department of Psychiatry, Dongguk University Gyeongju Hospital, Gyeongju, Korea
Bong Jo Kim
Affiliation:
Department of Psychiatry, Gyeongsang National University School of Medicine, Jinju, Korea
Shin Gyeom Kim
Affiliation:
Department of Neuropsychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
Jeong Lan Kim
Affiliation:
Department of Psychiatry, School of Medicine, Chungnam National University, Daejeon, Korea
Seok Woo Moon
Affiliation:
Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Chungju Hospital, Chungju, Korea
Joon Hyuk Park
Affiliation:
Department of Neuropsychiatry, Jeju National University Hospital, Jeju, Korea
Seung-Ho Ryu
Affiliation:
Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Medical Center, Seoul, Korea
Dong Woo Lee
Affiliation:
Department of Neuropsychiatry, Inje University Sanggye Paik Hospital, Seoul, Korea
Seok Bum Lee
Affiliation:
Department of Psychiatry, Dankook University Hospital, Cheonan, Korea
Jung Jae Lee
Affiliation:
Department of Psychiatry, Dankook University Hospital, Cheonan, Korea
Jin Hyeong Jhoo
Affiliation:
Department of Psychiatry, Kangwon National University School of Medicine, Chuncheon, Korea
Jong Bin Bae
Affiliation:
Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggido, Korea
Ji Won Han
Affiliation:
Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggido, Korea
Ki Woong Kim*
Affiliation:
Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggido, Korea Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, Korea
*
Author for correspondence: Ki Woong Kim, E-mail: kwkimmd@snu.ac.kr
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

There are growing concerns about the impact of the COVID-19 pandemic on the mental health of older adults. We examined the effect of the pandemic on the risk of depression in older adults.

Methods

We analyzed data from the prospective cohort study of Korean older adults, which has been followed every 2 years. Among the 2308 participants who completed both the third and the fourth follow-up assessments, 58.4% completed their fourth follow-up before the outbreak of COVID-19 and the rest completed it during the pandemic. We conducted face-to-face diagnostic interviews using Mini International Neuropsychiatric Interview and used Geriatric Depression Scale. We performed generalized estimating equations and logistic regression analyses.

Results

The COVID-19 pandemic was associated with increased depressive symptoms in older adults [b (standard error) = 0.42 (0.20), p = 0.040] and a doubling of the risk for incident depressive disorder even in euthymic older adults without a history of depression (odds ratio = 2.44, 95% confidence interval 1.18–5.02, p = 0.016). Less social activities, which was associated with the risk of depressive disorder before the pandemic, was not associated with the risk of depressive disorder during the pandemic. However, less family gatherings, which was not associated with the risk of depressive disorder before the pandemic, was associated with the doubled risk of depressive disorder during the pandemic.

Conclusions

The COVID-19 pandemic significantly influences the risk of late-life depression in the community. Older adults with a lack of family gatherings may be particularly vulnerable.

Keywords

COVID-19depressive disorderlate-life depressionprospective cohort study

Information

Type
Original Article
Information
Psychological Medicine , Volume 53 , Issue 7 , May 2023 , pp. 2992 - 2999
Check for updates
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Ahmed, M. Z., Ahmed, O., Aibao, Z., Hanbin, S., Siyu, L., & Ahmad, A. (2020). Epidemic of COVID-19 in China and associated psychological problems. Asian Journal of Psychiatry, 51, 102092. doi:10.1016/j.ajp.2020.102092CrossRefGoogle Scholar
Ainsworth, B. E., Haskell, W. L., Whitt, M. C., Irwin, M. L., Swartz, A. M., Strath, S. J., … Leon, A. S. (2000). Compendium of physical activities: An update of activity codes and MET intensities. Medicine and Science in Sports and Exercise, 32 (Suppl 9), S498–S504.CrossRefGoogle ScholarPubMed
Blazer, D. G. (2003). Depression in late life: Review and commentary. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 58(3), 249–265. doi:10.1093/gerona/58.3.m249CrossRefGoogle Scholar
Choi, E. P. H., Hui, B. P. H., & Wan, E. Y. F. (2020). Depression and anxiety in Hong Kong during COVID-19. International Journal of Environmental Research and Public Health, 17(10), 3740. doi:10.3390/ijerph17103740.CrossRefGoogle Scholar
Ettman, C. K., Abdalla, S. M., Cohen, G. H., Sampson, L., Vivier, P. M., & Galea, S. (2020). Prevalence of depression symptoms in US adults before and during the COVID-19 pandemic. JAMA Network Open, 3(9), e2019686. doi:10.1001/jamanetworkopen.2020.19686CrossRefGoogle ScholarPubMed
Fancourt, D., Steptoe, A., & Bu, F. (2021). Trajectories of anxiety and depressive symptoms during enforced isolation due to COVID-19 in England: A longitudinal observational study. The Lancet. Psychiatry, 8(2), 141–149. doi:10.1016/S2215-0366(20)30482-XCrossRefGoogle Scholar
Gao, J., Zheng, P., Jia, Y., Chen, H., Mao, Y., Chen, S., … Dai, J. (2020). Mental health problems and social media exposure during COVID-19 outbreak. PLoS ONE, 15(4), e0231924. doi:10.1371/journal.pone.0231924CrossRefGoogle ScholarPubMed
Gonzalez-Sanguino, C., Ausin, B., Castellanos, M. A., Saiz, J., Lopez-Gomez, A., Ugidos, C., & Munoz, M. (2020b). Mental health consequences during the initial stage of the 2020 Coronavirus pandemic (COVID-19) in Spain. Brain Behavior and Immunity, 87, 172–176. doi:10.1016/j.bbi.2020.05.040CrossRefGoogle ScholarPubMed
Gonzalez-Sanguino, C., Ausin, B., Castellanos, M. A., Saiz, J., & Munoz, M. (2020a). Mental health consequences of the Covid-19 outbreak in Spain. A longitudinal study of the alarm situation and return to the new normality. Progress in Neuro-Psychopharmacology & Biological Psychiatry, 107, 110219. doi:10.1016/j.pnpbp.2020.110219.CrossRefGoogle Scholar
Han, J. W., Kim, T. H., Kwak, K. P., Kim, K., Kim, B. J., Kim, S. G., … Kim, K. W. (2018). Overview of the Korean longitudinal study on cognitive aging and dementia. Psychiatry Investigation, 15(8), 767–774. doi:10.30773/pi.2018.06.02CrossRefGoogle ScholarPubMed
Holmes, E. A., O'Connor, R. C., Perry, V. H., Tracey, I., Wessely, S., Arseneault, L., … Bullmore, E. (2020). Multidisciplinary research priorities for the COVID-19 pandemic: A call for action for mental health science. The Lancet. Psychiatry, 7(6), 547–560. doi:10.1016/S2215-0366(20)30168-1CrossRefGoogle Scholar
Hyland, P., Shevlin, M., McBride, O., Murphy, J., Karatzias, T., Bentall, R. P., … Vallieres, F. (2020). Anxiety and depression in the Republic of Ireland during the COVID-19 pandemic. Acta Psychiatrica Scandinavica, 142(3), 249–256. doi:10.1111/acps.13219CrossRefGoogle ScholarPubMed
Jawaid, A. (2020). Protecting older adults during social distancing. Science, 368(6487), 145. doi:10.1126/science.abb7885CrossRefGoogle ScholarPubMed
Ju, Y., Zhang, Y., Wang, X., Li, W., Ng, R. M. K., & Li, L. (2020). China's mental health support in response to COVID-19: Progression, challenges and reflection. Globalization and Health, 16(1), 102. doi:10.1186/s12992-020-00634-8CrossRefGoogle ScholarPubMed
Kahlon, M. K., Aksan, N., Aubrey, R., Clark, N., Cowley-Morillo, M., Jacobs, E. A., … Tomlinson, S. (2021). Effect of layperson-delivered, empathy-focused program of telephone calls on loneliness, depression, and anxiety among adults during the COVID-19 pandemic: A randomized clinical trial. JAMA Psychiatry, 78(6), 616–622. doi:10.1001/jamapsychiatry.2021.0113.CrossRefGoogle ScholarPubMed
Kim, J. Y., Park, J. H., Lee, J. J., Huh, Y., Lee, S. B., Han, S. K., … Woo, J. I. (2008). Standardization of the Korean version of the geriatric depression scale: Reliability, validity, and factor structure. Psychiatry Investigation, 5(4), 232–238. doi:10.4306/pi.2008.5.4.232CrossRefGoogle ScholarPubMed
Klaiber, P., Wen, J. H., DeLongis, A., & Sin, N. L. (2021). The ups and downs of daily life during COVID-19: Age differences in affect, stress, and positive events. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 76(2), e30–e37. doi:10.1093/geronb/gbaa096CrossRefGoogle ScholarPubMed
Lee, D. Y., Lee, K. U., Lee, J. H., Kim, K. W., Jhoo, J. H., Kim, S. Y., … Woo, J. I. (2004). A normative study of the CERAD neuropsychological assessment battery in the Korean elderly. Journal of the International Neuropsychological Society: JINS, 10(1), 72–81. doi:10.1017/S1355617704101094CrossRefGoogle ScholarPubMed
Lee, J. H., Lee, K. U., Lee, D. Y., Kim, K. W., Jhoo, J. H., Kim, J. H., … Woo, J. I. (2002). Development of the Korean version of the consortium to establish a registry for Alzheimer's disease assessment packet (CERAD-K): Clinical and neuropsychological assessment batteries. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 57(1), P47–P53. doi:10.1093/geronb/57.1.p47CrossRefGoogle Scholar
Lei, L., Huang, X., Zhang, S., Yang, J., Yang, L., & Xu, M. (2020). Comparison of prevalence and associated factors of anxiety and depression among people affected by versus people unaffected by quarantine during the COVID-19 epidemic in Southwestern China. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research, 26, e924609. doi:10.12659/MSM.924609CrossRefGoogle ScholarPubMed
Liu, C. H., Zhang, E., Wong, G. T. F., Hyun, S., & Hahm, H. C. (2020). Factors associated with depression, anxiety, and PTSD symptomatology during the COVID-19 pandemic: Clinical implications for U.S. young adult mental health. Psychiatry Research, 290, 113172. doi:10.1016/j.psychres.2020.113172CrossRefGoogle ScholarPubMed
Mazza, C., Ricci, E., Biondi, S., Colasanti, M., Ferracuti, S., Napoli, C., … Roma, P. (2020). A nationwide survey of psychological distress among Italian people during the COVID-19 pandemic: Immediate psychological responses and associated factors. International Journal of Environmental Research and Public Health, 17(9), 3165. doi:10.3390/ijerph17093165.CrossRefGoogle ScholarPubMed
McPherson, M., Smith-Lovin, L., & Cook, J. M. (2001). Birds of a feather: Homophily in social networks. Annual Review of Sociology, 27, 415–444.CrossRefGoogle Scholar
Meeks, T. W., Vahia, I. V., Lavretsky, H., Kulkarni, G., & Jeste, D. V. (2011). A tune in ‘a minor’ can ‘b major’: A review of epidemiology, illness course, and public health implications of subthreshold depression in older adults. Journal of Affective Disorders, 129(1–3), 126–142. doi:10.1016/j.jad.2010.09.015CrossRefGoogle Scholar
Miller, M. D., Paradis, C. F., Houck, P. R., Mazumdar, S., Stack, J. A., Rifai, A. H., … Reynolds, C. F. III. (1992). Rating chronic medical illness burden in geropsychiatric practice and research: Application of the Cumulative Illness Rating Scale. Psychiatry Research, 41(3), 237–248.CrossRefGoogle ScholarPubMed
Oh, D. J., Han, J. W., Kim, T. H., Kwak, K. P., Kim, B. J., Kim, S. G., … Kim, K. W. (2020). Epidemiological characteristics of subsyndromal depression in late life. The Australian and New Zealand Journal of Psychiatry, 54(2), 150–158. doi:10.1177/0004867419879242CrossRefGoogle ScholarPubMed
Ozdin, S., & Bayrak Ozdin, S. (2020). Levels and predictors of anxiety, depression and health anxiety during COVID-19 pandemic in Turkish society: The importance of gender. The International Journal of Social Psychiatry, 66(5), 504–511. doi:10.1177/0020764020927051CrossRefGoogle Scholar
Palgi, Y., Shrira, A., Ring, L., Bodner, E., Avidor, S., Bergman, Y., … Hoffman, Y. (2020). The loneliness pandemic: Loneliness and other concomitants of depression, anxiety and their comorbidity during the COVID-19 outbreak. Journal of Affective Disorders, 275, 109–111. doi:10.1016/j.jad.2020.06.036CrossRefGoogle ScholarPubMed
Pan, K. Y., Kok, A. A. L., Eikelenboom, M., Horsfall, M., Jorg, F., Luteijn, R. A., … Penninx, B. (2020). The mental health impact of the COVID-19 pandemic on people with and without depressive, anxiety, or obsessive-compulsive disorders: A longitudinal study of three Dutch case-control cohorts. The Lancet. Psychiatry, 8(2), 121–129. doi:10.1016/S2215-0366(20)30491-0.CrossRefGoogle ScholarPubMed
Pierce, M., Hope, H., Ford, T., Hatch, S., Hotopf, M., John, A., … Abel, K. M. (2020a). Mental health before and during the COVID-19 pandemic: A longitudinal probability sample survey of the UK population. The Lancet. Psychiatry, 7(10), 883–892. doi:10.1016/S2215-0366(20)30308-4CrossRefGoogle ScholarPubMed
Pierce, M., McManus, S., Jessop, C., John, A., Hotopf, M., Ford, T., … Abel, K. M. (2020b). Says who? The significance of sampling in mental health surveys during COVID-19. The Lancet. Psychiatry, 7(7), 567–568. doi:10.1016/S2215-0366(20)30237-6CrossRefGoogle ScholarPubMed
Racine, N., Hetherington, E., McArthur, B. A., McDonald, S., Edwards, S., Tough, S., & Madigan, S. (2021). Maternal depressive and anxiety symptoms before and during the COVID-19 pandemic in Canada: A longitudinal analysis. The Lancet. Psychiatry, 8(5), 405–415. doi:10.1016/S2215-0366(21)00074-2CrossRefGoogle Scholar
Santini, Z. I., Jose, P. E., York Cornwell, E., Koyanagi, A., Nielsen, L., Hinrichsen, C., … Koushede, V. (2020). Social disconnectedness, perceived isolation, and symptoms of depression and anxiety among older Americans (NSHAP): A longitudinal mediation analysis. Lancet Public Health, 5(1), e62–e70. doi:10.1016/S2468-2667(19)30230-0CrossRefGoogle ScholarPubMed
Sheehan, D. V., Lecrubier, Y., Sheehan, K. H., Amorim, P., Janavs, J., Weiller, E., … Dunbar, G. C. (1998). The Mini-International Neuropsychiatric Interview (M.I.N.I.): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. The Journal of Clinical Psychiatry, 59 (Suppl 20), 22–33; quiz 34-57.Google ScholarPubMed
Shi, L., Lu, Z. A., Que, J. Y., Huang, X. L., Liu, L., Ran, M. S., … Lu, L. (2020). Prevalence of and risk factors associated with mental health symptoms among the general population in China during the coronavirus disease 2019 pandemic. JAMA Network Open, 3(7), e2014053. doi:10.1001/jamanetworkopen.2020.14053CrossRefGoogle Scholar
Sonderskov, K. M., Dinesen, P. T., Santini, Z. I., & Ostergaard, S. D. (2020). The depressive state of Denmark during the COVID-19 pandemic. Acta Neuropsychiatrica, 32(4), 226–228. doi:10.1017/neu.2020.15CrossRefGoogle ScholarPubMed
Tan, W., Hao, F., McIntyre, R. S., Jiang, L., Jiang, X., Zhang, L., … Tam, W. (2020). Is returning to work during the COVID-19 pandemic stressful? A study on immediate mental health status and psychoneuroimmunity prevention measures of Chinese workforce. Brain Behavior and Immunity, 87, 84–92. doi:10.1016/j.bbi.2020.04.055CrossRefGoogle Scholar
Thorisdottir, I. E., Asgeirsdottir, B. B., Kristjansson, A. L., Valdimarsdottir, H. B., Jonsdottir Tolgyes, E. M., Sigfusson, J., … Halldorsdottir, T. (2021). Depressive symptoms, mental wellbeing, and substance use among adolescents before and during the COVID-19 pandemic in Iceland: A longitudinal, population-based study. The Lancet. Psychiatry, 8(8), 663–672. doi:10.1016/S2215-0366(21)00156-5.CrossRefGoogle ScholarPubMed
Van Orden, K. A., Bower, E., Lutz, J., Silva, C., Gallegos, A. M., Podgorski, C. A., … Conwell, Y. (2020). Strategies to promote social connections among older adults during ‘social distancing’ restrictions. The American Journal of Geriatric Psychiatry, 29(8), 816–827. doi:10.1016/j.jagp.2020.05.004.CrossRefGoogle ScholarPubMed
van Tilburg, T. G., Steinmetz, S., Stolte, E., van der Roest, H., & de Vries, D. H. (2020). Loneliness and mental health during the COVID-19 pandemic: A study among Dutch older adults. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 76(7), e249–e255. doi:10.1093/geronb/gbaa111.CrossRefGoogle Scholar
Vistisen, H. T., Sonderskov, K. M., Dinesen, P. T., & Ostergaard, S. D. (2021). Psychological well-being and symptoms of depression and anxiety across age groups during the second wave of the COVID-19 pandemic in Denmark. Acta Neuropsychiatrica, 33(6), 331–334. doi:10.1017/neu.2021.21.CrossRefGoogle ScholarPubMed
Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., Ho, C. S., … Ho, R. C. (2020a). Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. International Journal of Environmental Research and Public Health, 17(5), 1729. doi:10.3390/ijerph17051729Google ScholarPubMed
Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., McIntyre, R. S., … Ho, C. (2020b). A longitudinal study on the mental health of general population during the COVID-19 epidemic in China. Brain Behavior and Immunity, 87, 40–48. doi:10.1016/j.bbi.2020.04.028CrossRefGoogle ScholarPubMed
World Health Organization. (2020) Mental health and psychosocial considerations during the COVID-19 outbreak. Geneva: World Health Organization.Google Scholar
World Health Organization. (2021) WHO Coronavirus Disease (COVID-19) Dashboard. https://covid19.who.int (accessed February 18th, 2021).Google Scholar
Yang, Y., Li, W., Zhang, Q., Zhang, L., Cheung, T., & Xiang, Y. T. (2020). Mental health services for older adults in China during the COVID-19 outbreak. The Lancet. Psychiatry, 7(4), e19. doi:10.1016/S2215-0366(20)30079-1CrossRefGoogle Scholar
Zhou, J., Liu, L., Xue, P., Yang, X., & Tang, X. (2020). Mental health response to the COVID-19 outbreak in China. American Journal of Psychiatry, 177(7), 574–575. doi:10.1176/appi.ajp.2020.20030304CrossRefGoogle Scholar
Supplementary material: File

Oh et al. supplementary material

Table S1

Download Oh et al. supplementary material(File)
File 60.4 KB