Loneliness in Older Adults with Major Depression Across the COVID-19 Pandemic

• Published in: The American journal of geriatric psychiatry 2022-04, Vol.30 (4), p.S82-S83
• Main Authors: Bhutani, Saumya, Schwartz, Rebecca, John, Majnu, Greenwald, Blaine
• Format: Article
• Language: English
• Subjects: Poster Number: EI-7
• ISSN: 1064-7481; 1545-7214
• DOI: 10.1016/j.jagp.2022.01.211

Loneliness has emerged as a distinct clinical construct with detrimental physical and mental health effects. During the COVID-19 outbreak and aftermath, studies examining loneliness in older adults reported mixed results with increased, decreased, and static levels of loneliness. These inconsistent findings likely relate to pandemic-related phenomena of amplified social isolation (e.g., quarantines, social distancing, remote work) for some, and an increased sense of social connectedness (e.g., shared interests, challenges and experiences, greater media engagement) for others.  To our knowledge, only one study has examined the effect of the COVID-19 pandemic on older adults with pre-existing major depression.  Most were resilient, with no overall change in depression, anxiety, and suicidality scores, however loneliness was not explicitly considered.  As such, since loneliness and depression are interrelated in older adults, we sought to examine whether loneliness in non-remitted older depressed patients was impacted during the COVID-19 pandemic. A brief survey instrument was developed that included relevant socio-demographic information, a modified Older Americans Resources and Services (OARS) scale for assessing perceived health status, a question on communication during the pandemic adapted from the Questionnaire for Assessing the Impact of the COVID-19 Pandemic in Older Adults (QAICPOA), a question on consumption of COVID-19 related news coverage, and the UCLA 3-item Loneliness Scale for three different time points:  prior to the pandemic (retrospective self-rating), during the height of the pandemic (defined as between the declaration of a formal pandemic in March 2020 until vaccinations began in December 2020) (retrospective self-rating), and currently at the time of survey administration in Fall 2021 (contemporaneous rating). To ensure a homogeneous patient population, eligibility criteria included a primary diagnosis of a major depressive disorder without psychosis, cognitive impairment, secondary psychiatric disorders, or a remitted state.  All patients were active registrants in the Zucker Hillside Hospital (ZHH) Geriatric Psychiatry Outpatient Clinic. A list of eligible patient names and contacts were generated through the IT department by abstracting information from the electronic health record.  As per Northwell's IRB review, this survey project met the criteria outlined in 45 CFR 46.101 for IRB exemption. Eligible patients were called and aske