Mental health and social interactions of older people with physical disabilities in England during the COVID-19 pandemic: a longitudinal cohort study

Findings Between June 3 and July 26, 2020, 5820 participants responded, 4887 of whom had full data available for both the pre-pandemic measures and the COVID-19 survey and were included in the analysis. During the COVID-19 pandemic, significantly more people with ADL impairment had clinically significant symptoms of depression (odds ratio 1 center dot 78 [95% CI 1 center dot 44-2 center dot 19]; p<0 center dot 0001), anxiety (2 center dot 23 [1 center dot 72-2 center dot 89]; p<0 center dot 0001), and loneliness (1 center dot 52 [1 center dot 26-1 center dot 84]; p<0 center dot 0001) than people without ADL impairment. Significantly more people with ADL impairment also had impaired sleep quality (1 center dot 44 [1 center dot 20-1 center dot 72]; p<0 center dot 0001) and poor quality of life than people without ADL impairment. The results were similar when disability was defined by impaired mobility. People with ADL impairment had less frequent real-time contact (0 center dot 70 [0 center dot 55-0 center dot 89]; p=0 center dot 0037) and written social contact (0 center dot 54 [0 center dot 45-0 center dot 64]; p<0 center dot 0001) with family than people without ADL impairment. Results for social contact were similar when disability was defined by Summary Background The COVID-19 pandemic has affected mental health, psychological wellbeing, and social interactions. People with physical disabilities might be particularly likely to be negatively affected, but evidence is scarce. Our aim was to evaluate the emotional and social experience of older people with physical disabilities during the early months of the COVID-19 pandemic in England. Methods In this longitudinal cohort study, we analysed data from the English Longitudinal Study of Ageing collected in 2018-19 and June-July, 2020, from participants aged 52 years and older and living in England. Physical disability was defined as impairment in basic and instrumental activities of daily living (ADL) and impaired mobility. Depression, anxiety, loneliness, quality of life, sleep quality, and amount of real-time and written social contact were assessed online or by computer-assisted telephone interviews. Comparisons of experiences during the COVID-19 pandemic of people with and without a physical disability were adjusted statistically for pre-pandemic outcome measures, age, sex, wealth, ethnicity, presence of a spouse or partner, number of people in the household, and chronic pain. All participants with full data available for both surveys were included in the analyses. Findings Between June 3 and July 26, 2020, 5820 participants responded, 4887 of whom had full data available for both the pre-pandemic measures and the COVID-19 survey and were included in the analysis. During the COVID-19 pandemic, significantly more people with ADL impairment had clinically significant symptoms of depression (odds ratio 1 & middot;78 [95% CI 1 & middot;44-2 & middot;19]; p<0 & middot;0001), anxiety (2 & middot;23 [1 & middot;72-2 & middot;89]; p<0 & middot;0001), and loneliness (1 & middot;52 [1 & middot;26-1 & middot;84]; p<0 & middot;0001) than people without ADL impairment. Significantly more people with ADL impairment also had impaired sleep quality (1 & middot;44 [1 & middot;20-1 & middot;72]; p<0 & middot;0001) and poor quality of life than people without ADL impairment. The results were similar when disability was defined by impaired mobility. People with ADL impairment had less frequent real-time contact (0 & middot;70 [0 & middot;55-0 & middot;89]; p=0 & middot;0037) and written social contact (0 & middot;54 [0 & middot;45-0 & middot;64]; p<0 & middot;0001) with family than people without ADL impairment. Results for social contact were similar when disability was defined by impaired mobility. Interpretation People with physical disability might be at particular risk for emotional distress, poor quality of life, and low wellbeing during the COVID-19 pandemic, highlighting the need for additional support and targeted mental health services. Copyright (c) 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license.

Automated summary

During the COVID-19 pandemic, individuals with ADL impairment were more likely to experience clinically significant symptoms of depression, anxiety, and loneliness compared to those without such impairment. They also reported poorer sleep quality and quality of life. This population had less social contact with family, indicating a need for additional support and mental health services.