The Impact of COVID-19 on Loneliness, Mental Health, and Health Service Utilisation Among Older Adults with Multimorbidity in Primary Care: A Prospective Cohort Study

Abstract

Background:
The COVID-19 pandemic has impacted the psychological health and health service utilization of older adults with multimorbidity, who are particularly vulnerable.
Aim:
Describe changes in loneliness, mental health problems, and attendance to scheduled medical care before and after the onset of COVID-19 pandemic.
Design and setting:
Telephone survey on a pre-existing cohort of older adults with multimorbidity in primary care.
Method:
Mental health and health service utilization outcomes were compared to the outcomes before the onset of COVID-19 outbreak in Hong Kong using paired t-tests, Wilcoxon’s signed-rank test, and McNemar’s test. Loneliness measured by De Jong Gierveld Loneliness Scale. Secondary outcomes: anxiety, depression, and insomnia, measured by 9-item Patient Health Questionnaire, 7-item Generalized Anxiety Disorder, and Insomnia Severity Index. Appointments attendance data were extracted from a computerized medical record system. Socio-demographic factors associated with outcome changes were examined by linear regression and generalized estimating equations.
Results:
Data collected from 583 older adults. Significant increases in loneliness, anxiety, and insomnia, after onset of COVID-19 outbreak. Missed medical appointments over a 3-month period increased from 16.5% one year ago to 22.0% after onset of the outbreak. In adjusted analysis, female, living alone, and having more than four chronic conditions were independently associated with increased loneliness. Females were more likely to have increased anxiety and insomnia.
Conclusion:
Psychosocial health of older patients with multimorbidity markedly deteriorated and missed medical appointments substantially increased after COVID-19 outbreak.

Rights

This article is Open Access: CC BY-NC 4.0 licence (http://creativecommons.org/licences/by-nc/4.0/).

Cite as

Downloadable citations

Identifiers

DOI

https://dx.doi.org/10.3399/bjgp20X713021