JMIR Publications

ABSTRACT

Background:

The depression level among US adults significantly increased during the Coronavirus Disease 2019 (COVID-19) pandemic and age disparity in depression during the pandemic were reported in recent studies. Delay or avoidance of medical care is one of the collateral damages caused by the COVID-19 pandemic and it can lead to increased morbidity and mortality.

Objective:

The present study aims to assess the prevalence of depression and delay of care among US middle-aged adults and older adults during the pandemic, as well as investigate the role of delay of care in depression among those two age groups.

Methods:

This cross-sectional study used the 2020 Health and Retirement Study (HRS) COVID-19 Project (Early, Version 1.0) data. Univariate analyses, bivariate analyses, and binary logistic regression were applied. US adults older than 46 years old were included. Depression was measured by Composite International Diagnostic Interview Short Form (CIDI-SF). Delay of care were measured by four items: delay of surgery, delay of seeing a doctor, delay of dental care, and delay of other care. Univariate analyses, bivariate analyses, and binary logistic regression were conducted.

Results:

More than half of participants were older than 65 years old (58.23%) and 274 participants (8.75%) had depression during the pandemic. Delay of dental care was positively associated with depression among both middle-aged adults (OR=2.05, 95%CI=1.04-4.03, P<0.05) and older adults (OR=3.08, 95%CI=1.07-8.87, P<0.05). Delay of surgery was positively associated with depression among older adults (OR=3.69, 95%CI=1.06-12.90, P<0.05). Self-reported pain was positively related to depression among both age groups. Middle-aged adults who reported higher education level (some college of above) or worse self-reported health had higher likelihood to have depression. While perceived more loneliness was positively associated with depression among older adults, financial difficulty was positively associated with depression among middle-aged adults.

Conclusions:

This study found that depression among middle-aged and older adults during the pandemic was also prevalent. The study highlighted the collateral damage of the COVID-19 pandemic by identifying the effect of delay of surgery and dental care on depression during the pandemic. Although surgery and dental care cannot be delivered by telehealth, telehealth services can still be provided to address patients’ concern on delay of surgery and dental care. Moreover, the implementation of tele-mental health services is also needed to address mental health symptoms among US middle-aged and older adults during the pandemic. Future research that uses more comprehensive Clinical Trial: N/A