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

Author:

Cheng Greta Jianjia12ORCID,Wagner Abram L1ORCID,O’Shea Brendan Q1ORCID,Joseph Carly A1,Finlay Jessica M3ORCID,Kobayashi Lindsay C1ORCID

Affiliation:

1. Department of Epidemiology, University of Michigan School of Public Health , Ann Arbor, Michigan , USA

2. Brain, Environment, Aging, and Mobility (BEAM) Lab, Department of Epidemiology, University of Pittsburgh School of Public Health , Pittsburgh, PA , USA

3. Social Environment and Health Program, Institute for Social Research, University of Michigan , Ann Arbor, Michigan , USA

Abstract

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 U.S. adults aged ≥55 from April/May 2020 through April/May 2021 (N = 4,024). Multimorbidity was defined as having ≥2 versus <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 nonlinear over time, with worsening symptoms over the first 6 months of the pandemic (April/May to September/October 2020), followed by improvement in symptoms over the subsequent 6 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 throughout 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 individuals, indicating their adaptation to the ongoing pandemic.

Funder

Michigan Institute for Clinical and Health Research Postdoctoral Translational Scholar Program

National Institute on Aging

National Research Service Award Individual Postdoctoral Fellowship

Publisher

Oxford University Press (OUP)

Subject

Life-span and Life-course Studies,Health Professions (miscellaneous),Health (social science)

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