Pandemic-Induced Depression Among Older Adults with a History of Cancer During the COVID-19 Pandemic: Findings from the Canadian Longitudinal Study on Aging

Meghan J Bird; Grace Li; Andie MacNeil; Ying Jiang; Margaret de Groh; Esme Fuller-Thomson

doi:10.2147/CMAR.S421675

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 Sep 6:15:937-955. doi: 10.2147/CMAR.S421675. eCollection 2023.

Authors

Meghan J Bird^{1

2}, Grace Li³, Andie MacNeil^{1

2}, Ying Jiang⁴, Margaret de Groh⁴, Esme Fuller-Thomson^{1

2

5

6}

Affiliations

¹ Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada.
² Institute for Life Course and Aging, University of Toronto, Toronto, ON, Canada.
³ Department of Sociology, University of Victoria, Victoria, BC, Canada.
⁴ Applied Research Division, Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, ON, Canada.
⁵ Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
⁶ Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.

Abstract

Purpose: The objectives of this study were to identify the prevalence of, and factors associated with, incident and recurrent depression in a sample of older adults with a history of cancer during the COVID-19 pandemic.

Materials and methods: Data were drawn from four waves of the Canadian Longitudinal Study on Aging Comprehensive Cohort (n=2486 with cancer). The outcome of interest was a positive screen for depression based on the CES-D-10 during the autumn of 2020.

Results: Among older adults with cancer and no pre-pandemic history of depression (n=1765), 1 in 8 developed first onset depression during the pandemic. Among respondents with cancer and a history of depression (n=721), 1 in 2 experienced a recurrence of depression. The risk of both incident and recurrent depression was higher among those who were lonely, those with functional limitations, and those who experienced an increase in family conflict during the pandemic. The risk of incident depression only was higher among older women, those who did not engage in church or religious activities, those who experienced a loss of income during the pandemic, and those who became ill or had a loved one become ill or die during the pandemic. The risk of recurrent depression only was higher among those who felt isolated from others and those whose income did not satisfy their basic needs.

Conclusion: Health care providers should continue to screen and provide mental health support to their cancer patients and those with a lifetime history of cancer, with consideration for those with the aforementioned vulnerabilities.

Keywords: CLSA; COVID-19; cancer; depression; older adults.

Grants and funding

Funding for the Canadian Longitudinal Study on Aging (CLSA) is provided by the Government of Canada through the Canadian Institutes of Health Research (CIHR) under grant reference: LSA 94473 and the Canada Foundation for Innovation, as well as the following provinces, Newfoundland, Nova Scotia, Quebec, Ontario, Manitoba, Alberta, and British Columbia. Funding for support of the CLSA COVID-19 questionnaire-based study is provided by the Juravinski Research Institute, Faculty of Health Sciences, McMaster University, the Provost Fund from McMaster University, the McMaster Institute for Research on Aging, the Public Health Agency of Canada/CIHR grant reference CMO 174125 and the government of Nova Scotia. This research was supported, in part, by the Canadian Institutes of Health Research (CIHR) grant #172862, PI: Fuller-Thomson. Andie MacNeil received funding from the Public Health Agency of Canada to support this research.