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Exploring Psychological Resiliency of Older Adults with Diabetes

Studies suggest that exposure to the COVID-19 pandemic has been associated with a variety of different mental health consequences including reports of depression, loneliness, and insomnia. People who are more than 65 years of age and those with underlying medical conditions such as type 2 diabetes and obesity are particularly vulnerable to negative outcomes from COVID-19. Until now, few investigations have identified and separated the mental health consequences of exposure to the COVID-19 pandemic from preexisting factors in this age group. A new prospective study of a large cohort of older adults with type 2 diabetes and overweight/obesity from across the U.S. has explored this subject with surprising results.

The prospective study, published in the journal Diabetes Care, showed that from pre-COVID to during the COVID-19 pandemic, the prevalence of mild or greater symptoms of depression increased by 1.6 times (from 19.3% to 30.4% of participants), while loneliness rose by 1.8 times (from 12.3% to 22.1% of participants). Reports of insomnia remained stable in the cohort (at 33.3x% and 31.5%, respectively). More than half of the study participants remained free of clinically significant levels of adverse mental health conditions during the COVID-19 pandemic.

“Many older adults have demonstrated psychological resiliency amid the pandemic, but sex and race/ethnicity did play an important role in these outcomes,” says Ariana M. Chao, PhD, CRNP, Assistant Professor of Nursing at the University of Pennsylvania School of Nursing (Penn Nursing) and the lead author of the article. “Women, relative to men, had greater odds of depressive symptoms, anxiety, loneliness, and perceived COVID-19 threat. Compared with participants who were non-Hispanic White, those from underrepresented groups tended to report lower levels of depressive symptoms, loneliness, and insomnia. For example, 32.9% of women versus 26.1% of males reported symptoms of mild or greater depression during the pandemic.”

The article, Changes in the Prevalence of Symptoms of Depression, Loneliness, and Insomnia in U.S. Older Adults with Type 2 Diabetes During the COVID-19 Pandemic: The Look AHEAD Study,” is available online. “We were fortunate,” said study co-author Thomas Wadden at the Perelman School of Medicine at the University of Pennsylvania, “to have been evaluating these more than 2800 participants in the Look AHEAD study for nearly 20 years, thus giving us a clear picture of their mental health and other functioning before and after the COVID-19 pandemic.” Other study authors included: Jeanne M. Clark of the Johns Hopkins University School of Medicine; Kathleen M. Hayden, Marjorie J. Howard, and Lynne E. Wagenknecht, all of the Wake Forest School of Medicine; Karen C. Johnson of the University of Tennessee Health Science Center; Blandine Laferrere of the Columbia University Irving Medical Center; Jeanne M. McCaffery of the University of Connecticut; Rena R. Wing of the Warren Alpert Medical School of Brown University; Susan Z. Yanovski of the National Institute of Diabetes and Digestive and Kidney Diseases; and the Look AHEAD Research Group.

This study was funded by the National Institutes of Health through cooperative agreements with the National Institute on Aging (AG058571) and National Institute of Diabetes and Digestive and Kidney Diseases (DK57136, DK57149, DK56990, DK57177, DK57171, DK57151, DK57182, DK57131, DK57002, DK57078, DK57154, DK57178).