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Factors Associated with Depression in Older Adults Living Alone during the COVID-19 Pandemic

  • Hong, Eun Hye (College of Nursing, Yonsei University) ;
  • Lee, Kyung Hee (College of Nursing.Mo-Im Kim Nursing Research Institute, Yonsei University)
  • Received : 2022.06.29
  • Accepted : 2022.11.29
  • Published : 2022.12.31

Abstract

Purpose: The aims of this study were to examine the rate of depression among older adults living alone and to identify factors associated with depression in older adults living alone during the COVID-19 pandemic. Methods: A secondary data analysis was performed using data from the 2020 Korea Community Health Survey. The study participants were 18,824 older adults aged 65 years and over living alone. The data of the complex sample design was analyzed with consideration for weights, stratification, and clustering. Complex sample multiple logistic regression was conducted to identify factors associated with depression in older adults living alone during the COVID-19 pandemic. Results: The results showed that the rate of depression in older adults living alone was 6.3%. Older adults living alone with decreased physical activity, decreased hours of sleep, and an increased or similar frequency of meeting with friends or neighbors were found to be more likely to have depression. In terms of factors related to the practice of COVID-19 infection prevention and control rules, not disinfecting regularly and not wearing a mask indoors were related to depression. For health-related factors, fair or poor self-rated health status, not having breakfast every day, and feeling stressed were related to depression. Conclusion: It is recommended to develop tailored interventions to prevent depression among older adults living alone by considering the factors related to their depression during the COVID-19 pandemic.

Keywords

Acknowledgement

This research was supported by Basic Science Research Program through the National Research Foundation of Korea(NRF) funded by the Ministry of Education (No. NRF-2020R1A6A1A03041989).

References

  1. World Health Organization (WHO). WHO director-general's opening remarks at the media briefing on COVID-19 - 11 March 2020 [Internet]. Geneva: WHO; 2020 [cited 2021 Oct 1]. Available from: https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020
  2. World Health Organization (WHO). WHO Coronavirus (COVID -19) dashboard. Global situation [Internet]. Geneva: WHO; 2022 [cited 2022 Sep 27]. Available from: https://covid19.who.int
  3. Korea Disease Control and Prevention Agency (KDCA). Coronavirus (COVID-19). Cases in Korea [Internet]. Cheongju: KDCA; 2022 [cited 2022 Sep 26]. Available from: http://ncov.kdca.go.kr/bdBoardList_Real.do?brdId=1&brdGubun=11&ncvContSeq=&contSeq=&board_id=&gubun=
  4. Ministry of Health and Welfare (MOHW). Press release. Announcement of the results of the COVID-19 national mental health survey in the first quarter of 2021 [Internet]. Sejong: MOHW; 2021 [cited 2022 Feb 16]. Available from: http://www.mohw.go.kr/react/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&CONT_SEQ=365582#
  5. Briggs R, McDowell CP, De Looze C, Kenny RA, Ward M. Depressive symptoms among older adults pre-and post-COVID19 pandemic. Journal of the American Medical Directors Association. 2021;22(11):2251-2257. https://doi.org/10.1016/j.jamda.2021.09.003
  6. Robbins R, Weaver MD, Czeisler ME, Barger LK, Quan SF, Czeisler CA. Associations between changes in daily behaviors and self-reported feelings of depression and anxiety about the COVID-19 pandemic among older adults. The Journals of Gerontology: Series B Psychological Sciences and Social Sciences. 2022;77(7):e150-e159. https://doi.org/10.1093/geronb/gbab110
  7. Kim HY, Kim KY, Kim SA, Yoon HC, Jin SH, Jang EH, et al. Changes in health behavior, mental health, and the degree of practice of quarantine rules according to the psychological concerns of local residents during the COVID-19 outbreak. Korean Public Health Research. 2021;47(4):107-119. https://doi.org/10.22900/kphr.2021.47.4.008
  8. Kim DJ. Effect of changes in daily life and psychological factors due to COVID-19 on depression in the elderly. Journal of the Korea Entertainment Industry Association. 2022;16(3):187-196. https://doi.org/10.21184/jkeia.2022.4.16.3.187
  9. Liang W, Duan Y, Shang B, Hu C, Baker JS, Lin Z, et al. Precautionary behavior and depression in older adults during the COVID-19 pandemic: an online cross-sectional study in Hubei, China. International Journal of Environmental Research and Public Health. 2021;18(4):1853. https://doi.org/10.3390/ijerph18041853
  10. Ministry of Health and Welfare (MOHW). Coronavirus (COVID -19). Press release. The COVID-19 Central Disaster and Safety Countermeasures Headquarters regular briefing on August 23 [Internet]. Sejong: MOHW; 2020 [cited 2022 Jun 15]. Available from: http://ncov.mohw.go.kr/tcmBoardView.do?brdId=&brdGubun=&dataGubun=&ncvContSeq=359131&contSeq=359131&board_id=140&gubun=BDJ
  11. Park JH, Lee MH. A study on the experience of COVID-19 on the life change of the elderly living alone. The Korean Governance Review. 2021;28(3):221-243. https://doi.org/10.17089/kgr.2021.28.3.008
  12. Kim SA, Kwon MJ, Seo KW. Factors influencing depression: Comparison between elders living alone and elders not living alone. Journal of Korean Gerontological Nursing. 2019;21(2): 51-60. https://doi.org/10.17079/jkgn.2019.21.2.51
  13. Kim HR, Kim EH. Prevalence of depression and its risk factors between elderly living alone and elderly living with others in Korea. Journal of the Korean Data Analysis Society. 2014;16 (1):463-477.
  14. Lee SY. A study on the predictors of depressive symptoms among the elderly people living alone. Journal of Social Science. 2011;30(1):181-202. https://doi.org/10.18284/jss.2011.06.30.1.181
  15. Korea Disease Control and Prevention Agency (KDCA). 2020 Korea community health survey raw data user guide [Internet]. Cheongju: KDCA. 2021 [cited 2021 Sep 18]. Available from: https://chs.kdca.go.kr/chs/mnl/mnlBoardMain.do
  16. Choi HS, Choi JH, Park KH, Joo KJ, Ga H, Ko HJ, et al. Standardization of the Korean version of patient health questionnaire-9 as a screening instrument for major depressive disorder. Journal of the Korean Academy of Family Medicine. 2007;28 (2):114-119.
  17. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine. 2001;16(9):606-613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x
  18. Central Disaster and Safety Countermeasures Headquarters (CDSCHQ). Basic guidelines on social distancing in daily life 4th ed [Internet]. Sejong: CDSCHQ; 2020 [cited 2021 Oct 1]. Available from: https://www.mju.ac.kr/bbs/mjukr/616/71660/artclView.do
  19. Jung KH, Oh YH, Kang EN, Kim KR, Lee YK, Oh MA, et al. 2017 National survey of older Koreans. Sejong: Ministry of Health and Welfare & Korea Institute for Health and Social Affairs; 2017 November. Report No.: 11-1352000-000672-12.
  20. Jo KH, Ryu SY, Han MA, Choi SW, Shin MH, Park J. Cross-sectional associations between Particulate Matter (PM2.5) and depression (PHQ-9) in the elderly. Journal of Health Informatics and Statistics. 2021;46(2):163-170. https://doi.org/10.21032/jhis.2021.46.2.163
  21. Sams N, Fisher DM, Mata-Greve F, Johnson M, Pullmann MD, Raue PJ, et al. Understanding psychological distress and protective factors amongst older adults during the COVID-19 pandemic. The American Journal of Geriatric Psychiatry. 2021; 29(9):881-894. https://doi.org/10.1016/j.jagp.2021.03.005
  22. Ghram A, Briki W, Mansoor H, Al-Mohannadi AS, Lavie CJ, Chamari K. Home-based exercise can be beneficial for counteracting sedentary behavior and physical inactivity during the COVID-19 pandemic in older adults. Postgraduate Medicine. 2021;133(5):469-480. https://doi.org/10.1080/00325481.2020.1860394
  23. Mishra R, Park C, York MK, Kunik ME, Wung SF, Naik AD, et al. Decrease in mobility during the COVID-19 pandemic and its association with increase in depression among older adults: A longitudinal remote mobility monitoring using a wearable sensor. Sensors. 2021;21(9):3090. https://doi.org/10.3390/s21093090
  24. Blake MJ, Trinder JA, Allen NB. Mechanisms underlying the association between insomnia, anxiety, and depression in adolescence: Implications for behavioral sleep interventions. Clinical Psychology Review. 2018;63:25-40. https://doi.org/10.1016/j.cpr.2018.05.006
  25. Litwin H, Levinsky M. Social networks and mental health change in older adults after the COVID-19 outbreak. Aging & Mental Health. 2022;26(5):925-931. https://doi.org/10.1080/13607863.2021.1902468
  26. Fingerman KL, Ng YT, Zhang S, Britt K, Colera G, Birditt KS, et al. Living alone during COVID-19: Social contact and emotional well-being among older adults. The Journals of Gerontology: Series B. 2021;76(3):e116-e121. https://doi.org/10.1093/geronb/gbaa200
  27. Noguchi T, Hayashi T, Kubo Y, Tomiyama N, Ochi A, Hayashi H. Living alone and depressive symptoms among older adults in the COVID-19 pandemic: Role of non-face-to-face social interactions. Journal of the American Medical Directors Association. 2022;S1525-8610(22)00802-7. https://doi.org/10.1016/j.jamda.2022.10.014
  28. Han AR, Park YH. Face mask usage, knowledge and behavior of face mask usage in older adults living alone in the COVID-19 era. Journal of Korean Academy of Nursing. 2021;51(2):203-216. https://doi.org/10.4040/jkan.20252
  29. Jun HJ, Jeong YJ. Factors contributing to depression in community-dwelling older adult during COVID-19: Using data from the 2020 community health survey. Journal of Korean Gerontological Nursing. 2022;24(1):55-64. https://doi.org/10.17079/jkgn.2022.24.1.55
  30. Kim YB, Lee SH. Gender differences in the relationship between living alone and depressive symptoms in elderly Korean adults. Iranian Journal of Public Health. 2019;48(3):465-473. https://doi.org/10.18502/ijph.v48i3.890