Temporal depressive symptom networks in older adults during the COVID-19 pandemic

Older adults show high rates of depression with an increase during the COVID-19 pandemic. Social isolation and lifestyle disruptions contributed to loneliness, symptoms of depression, and reduced activity. For interventions, it is crucial to understand the development of symptoms of depression networks and changes over time under stressors such as pandemics. Yet, no COVID-19 longitudinal depression network study in older people exists. We therefore aimed to investigate changes in relationships between symptoms of depression in older adults during compared to the pre-COVID-19 period.

We conducted cross-lagged panel network analyses in four waves from the English Longitudinal Study of Ageing (ELSA), a representative dataset of the UK population over 50 years (initial N = 7223). We examined networks (1) between two pre-pandemic points, (2) from the second pre-pandemic to the first pandemic wave as maximum stressor, and (3) between two pandemic waves as repeated stressor.

While the pre- and pandemic networks showed consistent overall structures, some differences emerged. In the pre-pandemic network, feeling lonely and could not get going were the only nodes with positive out-expected influence, suggesting a central activating role. During the pandemic, additional symptoms developed stronger outgoing connections, suggesting a shift toward a broader set of symptoms driving network dynamics under prolonged stress.

Loneliness appears to play a key role in symptom development under acute and repeated stress. Findings suggest that dynamics in symptoms of depression networks in older adults are relatively stable, even during acute and repeated stress during the COVID-19 pandemic.