New research conducted by the University of Toronto sheds light on the significant mental health impacts of the COVID-19 pandemic on older adults suffering from peptic ulcer disease (PUD), a painful condition characterized by gastric sores in the stomach or upper part of the small intestine.
This study focused on a subset of older adults from the Canadian Longitudinal Study on Aging, a nationwide dataset. The sample included 1,140 older adults with PUD, among whom 689 had a history of depression prior to the pandemic, and 451 had no prior history of depression. Leveraging longitudinal data, the researchers compared the mental health trajectories of those with and without a history of depression. Their findings have been published in PLOS ONE.
For older adults with PUD and no prior history of depression, approximately 13% experienced depression for the first time during the COVID-19 pandemic. This marked a substantial increase compared to pre-pandemic depression rates (2015-2018).
In cases where older adults had a history of depression, roughly 46.6% experienced recurrent or persistent depression during the pandemic.
“One of the major risk factors for depression in later life is having a previous history of depressive episodes,” explained co-author Hannah Dolhai, a former research assistant at the ILCA. “Older adults with a history of depression who also had to navigate challenges with managing their chronic illness during the pandemic are a vulnerable subpopulation of Canadians.”
The research also highlighted various risk factors contributing to depression among those with PUD, such as difficulties in accessing healthcare.
“We found that individuals who reported challenges with healthcare access during the pandemic had a higher risk for depression. It’s important to think about the potential cascading mental health consequences of the healthcare restrictions that occurred during COVID-19,” said co-author Andie MacNeil, a research assistant at the FIFSW and Institute for Life Course and Aging. “While the shift towards telemedicine helped maintain healthcare continuity for many individuals, it is not always accessible or preferable for some patients.”
Additional risk factors for depression in older adults with PUD included feelings of loneliness at the start of the pandemic and experiencing functional limitations.
“Loneliness is a well-established risk factor for depression. For many older adults, the physical distancing limitations early in the pandemic meant increased time alone and declines in social support. Although these guidelines were important to protect the health of Canadians, they can also had unintended mental health consequences. It is important to find ways to foster social connection even when staying apart,” said co-author Grace Li, a PhD candidate in the Sociology Department at the University of Victoria.
Women exhibited a higher risk of depression when compared to men.
“During the pandemic, many women experienced increased household labour and caregiving responsibilities due to school closures and restrictions in other community services, like older adult day programs. This exacerbation of gender-role stress may have impacted the mental health of many women,” said co-author Margaret de Groh, Scientific Manager at the Public Health Agency of Canada.
Ying Jiang, a Senior Epidemiologist at the Public Health Agency of Canada, noted that previous research has shown how symptoms such as chronic pain can severely disrupt functional status and significantly reduce the quality of life in patients suffering from PUD. “It is unsurprising that this relationship persisted during the pandemic, with those experiencing reduced functional status facing a higher risk of depression,” Jiang said.
In conclusion, the research highlights the need for targeted screening and intervention to address the elevated risk of depression among older adults, as the mental health needs of many may continue in the post-COVID era.
