The immediate and longer-term impact of the COVID-19 pandemic on the mental health and wellbeing of older adults in England

ObjectiveTo evaluate changes in mental health and wellbeing before and during the initial and later phases of the COVID-19 pandemic and investigate whether patterns varied with age, sex, and socioeconomic status. DesignProspective cohort study. ParticipantsEnglish Longitudinal Study of Ageing cohort of 5146 community dwelling adults aged 52 years and older (53% women, average age 66.74 years, standard deviation 10.62) who provided data before the pandemic (2018-19) and at two occasions in 2020 (June-July and November-December). Main outcome measureDepression, poor quality of life, loneliness and anxiety. ResultsThe prevalence of clinically significant depressive symptoms increased from 12.5% pre-pandemic to 22.6% in June-July 2020, with a further rise to 28.5% in November-December. This was accompanied by increased loneliness and deterioration in quality of life. The prevalence of anxiety rose from 9.4% to 10.9% between June-July and November-December 2022. Women and non-partnered people experienced worse changes in mental health and wellbeing. Participants with less wealth had lowest levels of mental health before and during the pandemic. Higher socioeconomic groups had better mental health overall, but responded to the pandemic with more negative changes. Patterns of changes were similar across age groups, the only exception was for depression which showed a smaller increase in the 75+ age group than in the youngest age group (50-59 years). ConclusionsThese data showed that mental health and wellbeing continued to worsen as lockdown continued, and that socioeconomic inequalities persisted. Women and non-partnered people experienced greater deterioration in all mental health outcomes. The immediate provision of diagnosis of mental health problems and targeted psychological interventions should target and support sociodemographic groups of older people at higher risk of psychological distress. What is already known on this topic- The COVID-19 pandemic and mitigation measures have upended the economic and social lives of many, leading to widespread psychological distress. - During the early months of the pandemic, levels of depression, anxiety and loneliness were high and lower levels of wellbeing were reported across the adult population, with certain higher risk groups identified. - However, evidence from longitudinal studies of representative samples of older adults that include pre-pandemic data is scarce, and little is known about mental health beyond the initial period of the pandemic. Repeated assessments are needed in order to understand whether mental health and wellbeing levels recovered or continued to deteriorate throughout 2020. What this study adds- These data suggest that mental health and wellbeing deteriorated significantly during June-July 2020 compared with pre-pandemic levels and continued to deteriorate during the second national lockdown in November-December 2020, showing that older individuals did not adapt to circumstances. - Inequalities in experiences of mental ill-health and poor wellbeing during 2020 were evident, with women, individuals living alone and those with less wealth being particularly vulnerable. Furthermore, socioeconomic inequalities in mental health have persisted during the pandemic.