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. 2025 Apr 23;190(5-6):e901-e906.
doi: 10.1093/milmed/usae398.

A Brief Report on Sex-Specific Differences in Persistent Depression, Anxiety, and Loneliness Among Canadian Veterans During the COVID-19 Pandemic

Colleen Webber  1 , Alyson L Mahar  2 , Kate St Cyr  3 , Heidi Cramm  4 , Christina Reppas-Rindlisbacher  5   6 , Shailee Siddhpuria  7 , Julie Hallet  8 , Paula A Rochon  5 , Nicola T Fear  9
Affiliations

A Brief Report on Sex-Specific Differences in Persistent Depression, Anxiety, and Loneliness Among Canadian Veterans During the COVID-19 Pandemic

Colleen Webber et al. Mil Med. .

Abstract

Introduction: Older adults are at increased risk of severe illness and mortality from Coronavirus disease of 2019 (COVID-19) infection. However, public health strategies aimed at reducing spread of COVID-19 may have resulted in increased mental health symptoms, particularly among older adults. Currently, little is known about whether older Veterans were more likely to experience persistent mental health symptoms during the COVID-19 pandemic than non-Veterans. The objectives of the current study were to (1) compare differences in persistent symptoms of anxiety, depression, and loneliness among a sample of Canadian Armed Forces Veterans and non-Veterans ≥55 years of age and (2) to evaluate potential sex-specific differences in persistent mental health symptoms.

Material and methods: The data for this study are drawn from a longitudinal survey of Canadian adults (55 years and older) during the COVID-19 pandemic. Ethical approval was received from the Women's College Hospital Research Ethics Board. Participants completed a baseline survey of sociodemographic, mental health-related, and COVID-19-related variables in May 2020 and 8 follow-up surveys monthly between May 2020 and January 2021. Modified Poisson regression models with robust standard errors were used to estimate risk of persistent symptoms of anxiety, depression, and loneliness.

Results: Eight hundred twenty-nine participants (13.7% [n = 114] Veterans) were included in the analysis of persistent depressive symptoms, 859 participants (14.0% [n = 120] Veterans) were included in the analysis of persistent anxiety symptoms, and 862 (13.9% [n = 120] Veterans) were included in the analysis of persistent symptoms of loneliness. When comparing male Veterans and non-Veterans, there were small but statistically insignificant differences in persistent symptoms of anxiety (adjusted relative risk [aRR], 0.59; 95% confidence interval [CI], 0.24-1.46), depression (aRR, 1.54; 95% CI, 0.63-3.77), or loneliness (aRR, 0.79; 95% CI, 0.36-1.75); similar small but statistically insignificant differences were observed in persistent symptoms of anxiety (aRR, 1.26; 95% CI, 0.51-3.09), depression (aRR, 1.16; 95% CI, 0.49-2.73), and loneliness (aRR, 1.33; 95% CI, 0.61-2.90) when comparing female Veterans to female non-Veterans.

Conclusions: Qualitative, but statistically nonsignificant sex-specific differences in persistent symptoms of anxiety, depression, and loneliness during the early months of the COVID-19 pandemic were observed in this study comparing Veterans and non-Veterans. Additional sex-stratified analyses using larger samples or qualitative interviews may be useful in understanding the unique mental health experiences of older men, women, and gender diverse Veterans during the COVID-19 pandemic.

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Conflict of interest statement

Dr. P.A.R. holds the Retired Teachers of Ontario/Lesenseignantes et enseignants retraités de l’Ontario (RTOERO) Chair in Geriatric Medicine at the University of Toronto. Dr. N.T.F. is part funded by a grant from the UK Ministry of Defence and is a trustee (unpaid) of a charity supporting the health and well-being of the UK Armed Forces community.

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