The Impact of Loneliness on Late-Life Depression and Anxiety During the COVID-19 Pandemic

This study investigates the association of loneliness during the COVID-19 pandemic and the course of depressive, anxiety and sleep symptoms after psychological treatment in older adults.

During the first wave of the pandemic in 2020, we assessed additional, original data of 132 participants aged ≥60 years who had completed psychological treatment for late-life depression (LLD) in the context of a multicenter, randomized controlled trial (CBT-late). We measured loneliness using the UCLA Loneliness Scale. Depression, anxiety and sleep symptoms were assessed using the Geriatric Depression Scale (GDS), Geriatric Anxiety Inventory (GAI), and Insomnia Severity Index (ISI).

Participants with higher loneliness scores (n = 44) experienced a significant worsening of depressive and anxiety symptoms during the pandemic (estimated marginal mean difference (emmd) of change in GDS between post-treatment and COVID-19 visit: GDS_emmd= -4.61, [95% CI: -6.97 to -2.26], GAI_emmd= -2.21, [95% CI: -3.76 to -0.65]), while those with low to moderate loneliness (n = 72) maintained stable mild symptoms (GDS_emmd= -1.39, [95% CI: -3.00 to 0.22], GAI_emmd= -0.49, [95% CI: -1.69 to 0.72]). All patients reported increased sleep disturbances during the pandemic regardless of loneliness, while remaining in the range for sub-threshold insomnia.

Our results suggest an association of significant loneliness during the COVID-19 pandemic and a clinically relevant worsening of depressive and anxiety symptoms in older adults. Loneliness assessments and interventions may be incorporated into treatments for LLD, particularly during pandemics or other crises.