Analyzing the Impacts of COVID-19 Shelter-in-Place Policies on Depression, Social Isolation, & Loneliness in Older Adults

Abstract

During the start of the COVID-19 pandemic, emergency policies prioritized the prevention of community transmission of the virus without considering the impact on components of depression, social isolation, and loneliness. This study utilized a quantitative analysis of clinical measures of these constructs to determine the impact of initial shelter-in-place policies on the community-dwelling older adult population. The data source was administrative data from PEARLS, an evidence-based program serving community-dwelling older adults (n = 1820; mean age 72 years) in Washington, Maryland, Texas, and Florida (USA) from January 2015 to November 2021. A quantitative panel regression and quasi-experimental approach were applied, whereby causal mechanisms between the shelter-in-place policy in each of these states and related outcomes were analyzed. The difference-in-difference models predicted the change in clinical measures, adjusted for age, race, and insurance status. The quantitative results suggest that there was an increase in (1) clinically significant depression in Washington and Maryland; (2) suicidality in Washington, Maryland, and Florida; (3) social isolation and loneliness in Maryland and Florida; (4) financial hardship to pay for basic needs and provision of uncompensated caregiving in Maryland and Florida. For public health and policy, these results emphasize the importance of social safety nets and engaging in preventative interventions for the community-dwelling older adult population when enacting emergency pandemic policies.