A recent longitudinal study conducted by the University of Toronto has shed light on the significant mental health impact that the COVID-19 pandemic has had on older adults with a previous stroke history.
The research involved analyzing data from over 500 older adults with stroke histories sourced from the Canadian Longitudinal Study on Aging. This comprehensive dataset tracks the health of older Canadians. The findings revealed a pronounced increase in depression rates among this demographic throughout the pandemic.
Andie MacNeil, the study’s lead author and a research assistant at the University of Toronto’s Factor-Inwentash Faculty of Social Work, highlighted the heightened vulnerability of stroke survivors to adverse mental health conditions such as depression. The pandemic exacerbated these vulnerabilities due to widespread disruptions in care for stroke patients, significantly affecting their physical and psychological health.
The study distinguished between participants who had previously experienced depression and those who had not before the pandemic. It found that 1 in 7 older adults with a stroke history reported experiencing depression for the first time during the pandemic. Among those with a prior depression history, the rate was even more alarming, with half of these individuals facing a recurrence or continuous depression throughout the pandemic period.
Grace Li, a co-author of the study and a PhD candidate at the University of Victoria, emphasized the struggles faced by stroke survivors during lockdowns, including those previously in good mental health. The study underscores the importance of screening for depression in older adults with a stroke history, including those without a prior history of the condition.
The research also identified risk factors for both the initial onset and recurrence of depression. Functional impairment was a significant risk factor among those with a history of depression, doubling the risk during the pandemic.
Aneisha Taunque, another co-author and research assistant at the University of Toronto, pointed out the specific high risk of depression among older adults with both a stroke and depression history. She noted the crucial role of functional status in this dynamic, exacerbated by the pandemic’s impact on rehabilitation services.
Difficulty in accessing healthcare services emerged as a critical factor, increasing the risk of new-onset depression threefold. Ishnaa Gulati, a Master of Public Health Student and co-author, highlighted the additional stressors for stroke patients, including delays in medical appointments and treatments and the stress of navigating healthcare access challenges.
The study also found that feelings of loneliness at the pandemic’s start significantly increased the risk of developing depression, especially among those who strictly adhered to physical distancing to mitigate COVID-19 risks. Esme Fuller-Thomson, the senior author and a professor at the University of Toronto, emphasized the established link between loneliness and depression risk.
Interestingly, among participants without a depression history, being an immigrant was associated with a roughly threefold increase in the risk of developing depression, likely due to the disproportionate impact of COVID-19 on communities with high immigrant populations.
Family stressors, including separation from family and caregiving challenges, were also identified as risk factors for both new and recurrent depression. Margaret de Groh, a Scientific Manager at the Public Health Agency of Canada, noted the increased depression risk due to pandemic-related family separations and caregiving difficulties.
A sensitivity analysis comparing pre-pandemic data further confirmed the pandemic’s unique impact on depression rates among older adults with a stroke history, underscoring the increased vulnerability of this group during the COVID-19 crisis.
The study’s findings are crucial for healthcare professionals, highlighting key risk factors for depression among stroke survivors. Fuller-Thomson expressed hope that these insights would guide targeted screening and interventions to support the mental health of this particularly vulnerable population.
More information: Andie MacNeil et al, Depression during the COVID-19 pandemic among older adults with stroke history: Findings from the Canadian Longitudinal Study on Aging, International Journal of Geriatric Psychiatry. DOI: 10.1002/gps.6062
Journal information: International Journal of Geriatric Psychiatry Provided by University of Toronto
