Having dementia and reduction in social participation are associated with increased depression and anxiety during the COVID-19 pandemic

Newswise — Tokyo, May 8, 2023 -- Data from the National Health and Aging Trends Study (NHATS), a study that represents the population at a national level, has shown that older adults in the United States who have dementia and limited participation in activities have a higher chance of experiencing depression and anxiety.

The Journal of Alzheimer’s Disease Reports 7(1) has published a study conducted by a group of researchers from Tohoku University Graduate School of Medicine, National Cancer Center's Exploratory Oncology Research and Clinical Trial Center, and Tokyo Metropolitan Institute of Medical Science in Japan. The researchers arrived at the aforementioned conclusions through their analysis.

Older adults with dementia have faced numerous challenges to their health and well-being due to the COVID-19 pandemic. The implementation of strict physical distancing measures to safeguard vulnerable populations, including older adults with dementia, has heightened the risk of social isolation within this group.

Engaging in meaningful activities plays a crucial role in providing individuals with dementia a sense of continuity, self-identity, and overall quality of life. However, the pandemic's physical distancing measures may hinder such participation, ultimately leading to the decline of mental well-being. Based on quantitative data, it has been observed that people with dementia have experienced a deterioration in mental health during the first lockdown and the second wave of the pandemic. Nevertheless, few studies have included older adults who do not have dementia as a control group, and information regarding the level of activity participation is scarce.

The researchers analyzed data collected from 4,548 older adults who lived within the community and had participated in two or more NHATS survey rounds between the years 2018 and 2021. The primary goal of this study was to examine the longitudinal connection between activity participation and mental health in people with dementia during the pandemic.

The findings

Through multivariable binomial logistic regression analyses, the study's researchers discovered that older adults with dementia had an increased likelihood of experiencing symptoms of depression and anxiety, both before and during the COVID-19 pandemic. In 2020, the onset of the pandemic and the resulting lifestyle changes caused by various restrictions led to an overall increase in the level of depressive symptoms. The risk of depressive symptoms and anxiety was also found to be higher in individuals with poor activity participation. Additionally, the association between dementia and worse mental health outcomes persisted even after controlling for activity participation. However, there was no interaction effect between the year of follow-up and dementia for depressive symptoms and anxiety.

Balancing infection management and dementia care

The study's findings suggest that mental health deterioration was more significant during the onset of the pandemic compared to other one-year periods investigated, indicating widespread mental health challenges in the community-dwelling population. Rapid lifestyle changes and reduced social contact due to COVID-19 may have led to chronic psychological distress in older adults with dementia, who are dependent on care in daily life. Furthermore, individuals with dementia may be more vulnerable to reduced contact than those without dementia due to the increased risk of dementia associated with loneliness and social isolation. Therefore, dementia care and support services should prioritize addressing emotional and social needs using accessible means while under long-term restrictions.