SG’s COVID-19 lockdown takes toll on older adults’ mental, financial wellbeing

During Singapore’s coronavirus disease 2019 (COVID-19) lockdown, older adults experienced a decrease in depressive symptoms accompanied by growing feelings of loneliness and lower physical activity (PA), according to a recent study.

Such curbs in movements also led to economic difficulties, with around 20 percent of older adults reporting that they had financial problems during lockdown.

“Our results suggest a need to look beyond the physical health impact of the pandemic itself and address the mental, PA, and financial repercussions of forced lockdown periods through targeted interventions especially for self-employed or retired older males with health problems who are facing financial challenges,” the researchers said.

The study included 496 participants (mean age 73.8±7.6 years, 54.6 percent women), of whom 34.1 percent were found to have clinically important worsening in loneliness. The mean loneliness score deteriorated during lockdown (p<0.001), a pattern that remained significant even after multivariable adjustment. [Int J Geriatr Psychiatry 2021;doi:10.1002/gps.5645]

Men (odds ratio [OR], 1.59, p=0.039), those of Indian ethnicity (vs Chinese; OR, 2.08; p=0.008), and respondents who were living alone (OR, 2.79; p=0.016) were significantly more likely to see a clinically relevant worsening in loneliness.

Similarly, the lockdown also had negative impacts on the participants’ PA and economic status, with 36.9 percent and 28.6 percent saying that they saw a decrease in PA and in the overall household income, respectively. In particular, participants who were not working were more likely to report a decline in PA (OR, 2.22; p=0.033), while those in nonwhite-collar jobs were at risk of financial difficulties (β, 3.57; p<0.001).

Both decreased PA (vs no change or increased PA: OR, 1.66; p=0.025) and experiencing financial problems (OR, 1.98; p=0.012) were significant indicators of a clinically important worsening of loneliness.

Despite such disruptions in lifestyle, economic, and social wellbeing, the researchers detected a statistically significant decrease in overall depression score during lockdown (p=0.011), which remained true even after adjusting for covariates. Similarly, the prevalence of depression dropped from 4.84 percent before to 2.22 percent during lockdown (p=0.024).

Financial problems (OR, 2.41; p=0.015), along with chronic kidney disease (OR, 2.48; p=0.026) emerged as significant predictors of a clinically important worsening in depressive symptoms.

“In our population-based, multi-ethnic study in older Asian adults living in Singapore, we found a significant increase in loneliness during a 2-month COVID-19 lockdown, coupled with a small but significant reduction in depressive symptoms,” the researchers said.

“Our results suggest that, although the mental health and PA consequences of the lockdown were substantial, the financial impact was less pronounced. Public health efforts to improve social support and counselling, PA involvement, and financial assistance may be warranted to address the effects of similar lockdowns in the future,” they added.