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In The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry

OBJECTIVE : To investigate mental health status and associated factors among caregivers of older adults during the COVID-19 epidemic in China.

METHODS : From March 1 to 31, 2020, 916 caregivers of older adults participated in an online cross-sectional survey on the prevalence of anxiety, depression, and sleep problems. The seven-item Generalized Anxiety Disorder Scale (GAD-7) was administered to measure anxiety symptoms, the two-item Patient Health Questionnaire (PHQ-2) was used to assess depressive symptoms, and a self-developed questionnaire was used to assess sleep quality and duration. Six questions about COVID-19-related experiences were used to assess community-level infection contact and the level of exposure to media information. The prevalence rates of anxiety, depression and sleep problems were computed. The Wald χ2 were applied to compare the differences between subgroups. Multiple logistic regression analyses were performed to investigate factors associated with anxiety, depression, sleep problems, and multimorbidity.

RESULTS : The prevalence rates of anxiety, depression, and sleep problems were 46.8%, 29.8%, and 10.8%, respectively. Approximately 263 participants (28.7%) presented with two or more mental health problems. Being female (OR, 2.254; 95% CI, 1.510-3.363), having community-level COVID-19 contact (OR, 1.856; 95% CI, 1.189-2.898), and having a mental disorder (OR, 3.610; 95% CI, 1.644-7.930) were associated with increased risk of multimorbidity among caregivers. Caregivers who preferred positive information (OR, 0.652; 95% CI, 0.472-0.899) had reduced risk of multimorbidity.

CONCLUSION : Anxiety and depression were common among caregivers of older adults during the COVID-19 epidemic. Being female and having community-level COVID-19 contact were independent risk factors for experiencing multiple mental health problems. Preexisting mental disorders increased the risk of multimorbidity among caregivers, while enhanced access to positive media information decreased the risk of multimorbidity.

Li Qiuxuan, Zhang Haifeng, Zhang Ming, Li Tao, Ma Wanxin, An Cuixia, Chen Yanmei, Liu Sha, Kuang Weihong, Yu Xin, Wang Huali


COVID-19, anxiety, caregiver, depression, multimorbidity, older adults