Mental Health, Financial Hardship, and Social Connections Among Older Adults With Probable COVID-19 Infection: A Longitudinal Cohort Study

Background: Little is currently known regarding the impact that contracting COVID-19 may have on the individual’s mental health and psychosocial outcomes. We investigated the immediate and longer-term impact (over 4-6 months) of probable COVID-19 infection on mental health (depression and anxiety), wellbeing (quality of life and loneliness), financial hardship, and social interactions among older people living in England.Methods: Data were analysed from 5146 older adults participating in the English Longitudinal Study of Ageing who provided data before the pandemic (2018-19) and at two COVID-19 assessments in 2020 (June-July and November-December). The associations of probable COVID-19 infection (first COVID-19 assessment) with depression, anxiety, poor quality of life (QoL), loneliness, financial hardship, and  social contact with family/friends at the first and second COVID-19 assessments were tested using linear/logistic regression and were adjusted for pre-pandemic outcome measures.Findings: Participants with probable infection had higher levels of depression and anxiety, poorer QoL, and greater loneliness scores compared with those without probable infection at both the first (ORdepression=1·62[95%CI:1·16,2·26]; ORanxiety=1·59[95%CI:1·00,2·51]; bpoorQoL=1·34[95%CI:0·66,2·02]; bloneliness=0·49[95%CI:0·25,0·74]) and second (ORdepression=1·56[95%CI:1·17,2·09]; ORanxiety=1·55[95%CI:1·02,2·37];bpoorQoL=1·38[95%CI:0·74,2·03]; bloneliness=0·31[95%CI:0·04;0·58]) assessments. Participants with probable infection also experienced greater financial difficulties than those without infection at the first assessment (OR=1·50[95%CI:1·10,2·05]). The levels of social contact were similar in participants with and without probable infection.Interpretation: Probable COVID-19 infection is associated with longer-term deterioration of mental health and wellbeing and short-term increases in financial hardship among older adults.Funding Information: This study was funded by the ESRC/UKRI, National Institute on Aging, and UK Government Departments co-ordinated by NIHR.Declaration of Interests: All authors declare no conflict of interests.Ethics Approval Statement: All respondents provided informed consent. Ethical approval for the regular ELSA study was obtained from the National Research Ethics Service. The ELSA COVID-19 Substudy has been approved by the University College London Research Ethics Committee.