How Did the COVID-19 Lockdown Pandemic Affect the Depression Symptomatology in Mediterranean Older Adults with Metabolic Syndrome?

Abstract

Background and aims: To control the COVID-19 spread, in March 2020, a forced home lockdown was established in Spain. In the present study, we aimed to assess the effect of mobility and social COVID-19-established restrictions on depressive symptomatology in older adults with metabolic syndrome. We hypothesize that severe restrictions might have resulted in detrimental changes in depressive symptomatology.

Methods: 2,312 PREDIMED-Plus study participants (men = 53.9%; mean age = 64.9 ± 4.8 years) who completed a COVID-19 lockdown questionnaire to assess the severity of restrictions/lockdown and the validated Spanish version of the Beck Depression Inventory-II (BDI-II) during the three established phases concerning the COVID-19 lockdown in Spain (prelockdown, lockdown, and postlockdown) were included in this longitudinal analysis. Participants were categorized according to high or low lockdown severity. Analyses of covariance were performed to assess changes in depressive symptomatology across lockdown phases.

Results: No significant differences in participant depression symptomatology changes were observed between lockdown severity categories (low/high) at the studied phases. During the lockdown phase, participants showed a decrease in BDI-II score compared to the prelockdown phase (mean (95% CI), -0.48 (-0.24, -0.72), P < 0.001); a nonsignificantly larger decrease was observed in participants allocated in the low-lockdown category (low: -0.59 (-0.95, -0.23), high: -0.43 (-0.67, -0.19)). Similar decreases in depression symptomatology were found for the physical environment dimension. The post- and prelockdown phase BDI-II scores were roughly similar.

Conclusions: The COVID-19 pandemic lockdown was associated with a decrease in depressive symptomatology that returned to prelockdown levels after the lockdown. The degree of lockdown was not associated with depressive symptomatology. The potential preventive role of the physical environment and social interactions on mental disorders during forced home lockdown should be further studied. This trial is registered with ISRCTN89898870. Retrospectively registered on 24 July 2014.

Figure 1

Mean changes in BDI-II score in Spanish older adults by studied phases (lockdown and postlockdown) and according to categories (low/high) of total lockdown score, physical environment, and social contact dimensions. ANCOVA adjusted for sex, age, intervention group, previous depression symptomatology, civil status, educational level, smoking habit, previous depression diagnosis, changes in MedDiet adherence, and recruitment center. ⁣^∗Significant changes in comparison to the prelockdown BDI-II score. Lockdown represents changes between lockdown vs. prelockdown BDI-II scores; postlockdown represents changes between postlockdown vs. prelockdown BDI-II scores.