The Relationship between Lifestyle, Mental Health, and Loneliness in the Elderly during the COVID-19 Pandemic

Abstract

The study focused on examining the relationship between well-being and various psychological factors such as loneliness, anxiety, depression, and stress, whilst also considering changes in lifestyle. A total of 108 elderly participants, with an average age of 70.38 years, were enrolled in this quantitative cross-sectional study. The research employed a battery of assessment tools including a Sociodemographic Data Questionnaire, Mini-Mental State Examination, Positive Mental Health Scale, Stress Perception Scale, Geriatric Anxiety Inventory, Geriatric Depression Scale (reduced version), Loneliness Scale, and International Physical Activity Questionnaire. Descriptive analysis was conducted in order to understand the distribution of scores across these variables, followed by the categorization of participants based on the reported alterations in eating and physical activity behaviors. Correlations between variables were assessed using Spearman correlation and an EBIC-LASSO network analysis. The findings indicated a potential detriment to the well-being of elderly individuals practicing social distancing, evidenced by heightened symptoms of loneliness, depression, anxiety, and stress, alongside the reported changes in dietary patterns and physical activity. The study underscores the importance of understanding the pandemic's impact on the well-being of older adults and advocates for longitudinal investigations to delineate the evolving effects of social distancing measures across different phases of the pandemic.

Keywords: COVID-19; aging; health promotion; loneliness; mental health.

Figure 1

Scores distributions of emotional, social, and psychological well-being of all the participants. Scores distributions of MHC-SF factor scores of emotional, social, and psychological well-being of all the participants as well as a classification of flourishing and languishing mental health based on these scores. (A) Distribution of emotional wellbeing factor, which represents the positive effects of life satisfaction; (B) Distribution of social wellbeing factor, which represents connectivity and beliefs of affiliation to social groups; (C) Distribution of psychological well-being factor, which represents individual perception of personal growth and life purpose; (D) Classification of mental health indicator based on the subscales scores – presented in percentage. Data from (A–C) are presented in mean and standard deviation.

Figure 2

Score distributions of mental health indicators of the sample: depression (A), anxiety (B), stress (C), and loneliness (D). (A) (Depression): The white band represents participants without depressive symptoms (scores below 5), and the light red band indicates the presence of depressive symptoms (scores above 5). (B) (Anxiety): The white band indicates the absence of anxiety symptoms (scores below 10), and the light red band shows the presence of anxiety symptoms (scores above 10). (C) (Stress): The white band denotes the absence of significant stress symptoms (scores below 14). The light red band represents the presence of significant stress symptomatology (scores between 14 and 26), and the dark red band indicates severe stress symptoms (scores above 27). (D) (Loneliness): The bands represent increasing levels of loneliness, with white indicating minimal loneliness (scores from 0 to 22), followed by progressively darker shades of red for mild loneliness (23 to 35 points), moderate loneliness (36 to 47 points), and intense loneliness (48 to 60 points).

Figure 3

This figure illustrates the comparison between participants who did not change their physical activity levels and those who decreased them during the lockdown. (A–C) depict these groups in terms of wellbeing characteristics. (D–G) present comparisons of the same groups regarding mental health aspects such as depression, anxiety, stress, and loneliness. Significant differences were found only in depression (D) and loneliness (G), and are marked with an asterisk (*).

Figure 4

Comparison between participants who did not change their eating behaviors and those who increased them during the lockdown. (A–C) show groups comparisons in relation to emotional, social and psychological wellbeing, respectively. (D–G) present comparisons of mental health indicator of depression, anxiety, stress, and loneliness, respectively. Significant differences (p < 0.05) were found in both anxiety and depression indicated with an asterisk (*). Data are presented in mean and standard deviation.

Figure 5

The association between well-being dimension, mental health indicators, and physical activity levels through a network analysis approach. Correlations (A), network analysis (B) and Centrality scores (C).