Geriatric Patients with Depression Showing Resiliency During COVID-19 Pandemic

Megan E. Hamm, PhD

The ongoing coronavirus disease 2019 (COVID-19) pandemic has been difficult for most, but it has been especially challenging for older adults in the US with pre-existing mental health conditions.

A team, led by Megan E. Hamm, PhD, University of Pittsburgh, Department of General Internal Medicine, determined the overall effect of the COVID-19 pandemic on the mental health of geriatric adults with pre-existing major depressive disorder (MDD).

The investigators examined 73 community-living older adults with pre-existing MDD living in Los Angeles, New York, Pittsburgh, and St. Louis. The mean age of the patient population was 69 years old.

The researchers interviewed each individual during the first 2 months with a semistructured qualitative interview evaluating access to care, mental health, quality of life, and coping.

The investigators also assessed depression, anxiety, and suicidality with validated scales and compared the scores both before and during the pandemic.

The team identified 5 separate themes from interviews highlighting the experience of geriatric adults.

The patients were more concerned by the risk of contracting the virus than by the risks of social isolation. The investigators also found the older patients exhibited resilience to the stress and isolation of physical distancing.

However, the majority of the participants are not isolated socially and are in virtual contact with both friends and family.

The quality of life was also lower, with many worrying their mental health will suffer with continued physical distancing.

The final theme was that the participants were outraged by an inadequate governmental response to the pandemic.

Ultimately, the depression, anxiety and suicidal ideation symptom scores did not differ from scores before the COVID-19 pandemic.

Overall, mental health has worsened among US adults during the pandemic.

According to a new US Centers for Disease Control and Prevention (CDC) report on surveys of US adults in late June, more than 40% are experiencing elevated adverse mental health conditions associated with the pandemic.

Among the surveyed population, those who were disproportionally affected were younger adults, racial/ethnic minorities, essential workers and adult caregivers. They reported worse health outcomes, increased substance use, and elevated suicide risk.

These findings suggest a great need for both public health response and policy to increase intervention and prevention efforts to address associated mental health conditions.

Results from the survey showed that, overall, 40.9% of 5470 respondents who completed surveys during June reported an adverse mental or behavioral health condition.

While the mental health outcomes has touched all age groups, older adults with depression might be a demographic that needs specific attention.

“Most older adults with pre-existing MDD show resilience in the first 2 months of the COVID-19 pandemic but have concerns about the future,” the authors wrote. “Policies and interventions to provide access to medical services and opportunities for social interaction are needed to help to maintain mental health and quality of life as the pandemic continues.”

The study, “Experiences of American Older Adults with Pre-existing Depression During the Beginnings of the COVID-19 Pandemic: A Multicity, Mixed-Methods Study,” was published online in The American Journal of Geriatric Psychiatry.