COVID-19 Pandemic Increased Rates of Depression in Older Adults With Cancer

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A new study found that 1 in 8 older adults with cancer and no history of depression developed the condition for the first time during the COVID-19 pandemic.

Older adults with a history of cancer during the COVID-19 pandemic were at a significant risk of developing incident or recurrent depression, according to a new study published in the journal Cancer Management and Research.1

Previous research has shown that people with cancer are more likely to experience depression than people without the disease. This can lead to numerous adverse health outcomes, including lower quality of life, decreased immune function, higher mortality, increased visits to the emergency department, and longer stays at the hospital.

“Older adults with cancer also have to navigate the stress of being particularly vulnerable to severe COVID-19 related morbidity and mortality,” Andie MacNeil, a co-author on the study, said in a release.2 “While strict adherence to lockdowns was an important step for many cancer patients to minimize their risk of COVID-19 infection, for many individuals this also meant forgoing social support, which is an important source of strength during cancer treatment and recovery.”

Investigators from the University of Toronto conducted a study to examine the prevalence of incident and recurrent depression among older adults with a history of cancer during the COVID-19 pandemic. Data was gathered from the Canadian Longitudinal Study on Aging Comprehensive Cohort, a prospective study that followed 50000 men and women between the ages of 45 to 85 for over 20 years in Canada.

The new study’s cohort included 2486 participants from the original study who had cancer and completed a follow-up, as well as 2 questionnaires called COVID Spring and COVID Autumn. The participants were also given the 10-item Center for Epidemiologic Studies Depression Scale to determine their history of depression prior to the COVID-19 pandemic.

The primary study outcome was a positive screen for depression during the autumn of 2020.

Investigators found that 1 in 8 older adults with cancer and no history of depression developed the condition for the first time during the COVID-19 pandemic. Nearly 1 in 2 participants with a history of depression experienced a recurrence during the pandemic.

Additionally, the study found that a higher proportion of individuals with cancer and a history of pre-pandemic depression were female, unmarried, renting their homes, had obesity, reported feeling lonely, experienced chronic pain, and were more likely to experience stressors related to COVID-19.

Study limitations include that depression was based on self-reports, that several covariates were dichotomized for the analysis, and that the Canadian Longitudinal Study on Aging Comprehensive Cohort database excluded residents who were living in long-term care institutions.

“The findings of our study indicate the substantial impact the pandemic had on the mental health of individuals with cancer,” Meghan Bird, first author on the study, said in a release. “Even among those with no history of depression, the pandemic took a significant toll on worsening their mental health.”

References
1. Bird MJ, Li G, MacNeil A, et al. Pandemic-Induced Depression Among Older Adults with a History of Cancer During the COVID-19 Pandemic: Findings from the Canadian Longitudinal Study on Aging. Cancer Manag Res. 2023;15:937-955. https://doi.org/10.2147/CMAR.S421675
2. High levels of depression found among Canadian older adults with cancer during the COVID-19 pandemic. News Release. University of Toronto. September 7, 2023. Accessed September 7, 2023. https://www.eurekalert.org/news-releases/1000730
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