Risk and Preventive Factors for Depressive Symptoms Among Older Chilean Adults During the SARS-CoV-2 Outbreak: A Longitudinal Study.

OBJECTIVE: To specifically examine the multiple factors related to the increase in depressive symptoms during the COVID-19 outbreak in older adults in Chile. METHOD: A longitudinal study was conducted using a dataset from a nationally representative survey cohort of Chilean older adults followed at three time points during the COVID-19 outbreak. The main outcome was depressive symptoms (Patient Health Questionnaire scale). The independent variables included: age, sex, educational level, geographic area, living alone, self-perceived health, self-reported resilience, loneliness, and social isolation. RESULTS: A total of 424 older adults were included. Female sex (ß = 0.95, 95% CI: 0.22 to 1.68) and loneliness (ß = 1.21, 95% CI: 1.05 to 1.37) were the main risk factors for an increase in depressive symptoms in older adults. In contrast, living outside the metropolitan region (ß=-0.70, 95% CI: -1.39 to -0.02), living in company (ß=-0.34, 95% CI:-1.24 to 0.56), having better self-perceived health (ß=-5.04, 95% CI:-6.33 to -3.75) and greater resilience (ß=-0.30, 95% CI: -0.38 to -0.23) were preventive factors. CONCLUSION: These results provide useful evidence to develop mental health prevention or control strategies for older adults. CLINICAL IMPLICATIONS: The findings highlight the importance of a holistic approach to health care for older adults that integrates strategies to address loneliness, foster resilience, and promote an active social life.

[Resilience in older people during the first wave of the COVID-19 pandemic in Chile: Perspective from the social determinants of health]. / Resiliencia en las personas mayores durante la primera ola pandémica de la COVID-19 en Chile: una perspectiva desde los determinantes sociales de la salud.

OBJECTIVE: To assess the association between social determinants of health (SDH) and resilience in older people during the first period of confinement in the COVID-19 pandemic in Chile. MATERIALS AND METHODS: An observational study with a cross-sectional design was conducted using a nationally representative survey data-set. In this survey, using a systematic randomization process, a subsample of people aged ≥60 years from the community were interviewed by telephone during the first wave of the COVID-19 pandemic in Chile. Resilience was assessed using the Brief Resilient Coping Scale (BRCS) and depressive symptoms using the Patient Health Questionnaire (PHQ-9) scale. The SDH considered were: age, sex, educational level, employment status, social isolation, loneliness, discontent with housing and health care needs. RESULTS: A total sample of 582 persons was obtained. The mean age was 71 years (SD: 7.64; 69% women). A significant association was obtained between low resilience and the following conditions: loneliness (OR: 1.776 [95% CI: 1.146-2.751]), high risk of social isolation (OR: 1.667 [95% CI: 1.149-2.419]), and depressive symptoms (OR: 2.602 [95% CI: 1.795-3.774]). Female gender was a protective factor (OR: 0.589 [95% CI: 0.406-0.855]). CONCLUSION: The SDH, such as loneliness and social isolation, are factors associated with low resilience in older people during the COVID-19 pandemic and may be taken into account in planning public health intervention strategies.

Resiliencia en las personas mayores durante la primera ola pandémica de la COVID-19 en Chile: una perspectiva desde los determinantes sociales de la salud / Resilience in older people during the first wave of the COVID-19 pandemic in Chile: Perspective from the social determinants of health

Objetivo: Evaluar la asociación entre los determinantes sociales de la salud (DSS) y la resiliencia en las personas mayores durante el primer periodo de confinamiento en la pandemia COVID-19 en Chile. Métodos: Se realizó un estudio observacional con diseño transversal utilizando los datos de una encuesta representativa a nivel nacional. En dicha encuesta, mediante un proceso de aleatorización sistemática, una submuestra de personas con edad ≥60 años de la comunidad fueron entrevistadas telefónicamente durante la primera ola pandémica de la COVID-19 en Chile. La resiliencia se evaluó utilizando la Brief Resilient Coping Scale (BRCS) y los síntomas depresivos con el Patient Health Questionnaire (PHQ-9). Los DSS considerados fueron: edad, género, nivel educacional, condición laboral, aislamiento social, soledad, insatisfacción de necesidades de vivienda y de atención en salud. Resultados: Se obtuvo una muestra total de 582 personas. La edad promedio fue de 71 años (DT: 7,64; 69% mujeres). Se obtuvo una asociación significativa entre una baja resiliencia y las siguientes condiciones: alta soledad (OR: 1,776 [IC 95%: 1,146-2,751]), alto riesgo de aislamiento social (OR: 1,667 [IC 95%: 1,149-2,419]), y síntomas depresivos (OR: 2,602 [IC 95%: 1,795-3,774]). El género femenino fue un factor protector (OR: 0,589 [IC 95%: 0,406-0,855]). Conclusión: Los DSS como la alta soledad y el aislamiento social son factores que se asocian con una baja resiliencia de las personas mayores durante la pandemia de la COVID-19, por lo que se deben tener en cuenta al momento de planificar estrategias de intervención en la salud pública. (AU)

Objective: To assess the association between social determinants of health (SDH) and resilience in older people during the first period of confinement in the COVID-19 pandemic in Chile. Materials and methods: An observational study with a cross-sectional design was conducted using a nationally representative survey data-set. In this survey, using a systematic randomization process, a subsample of people aged ≥60 years from the community were interviewed by telephone during the first wave of the COVID-19 pandemic in Chile. Resilience was assessed using the Brief Resilient Coping Scale (BRCS) and depressive symptoms using the Patient Health Questionnaire (PHQ-9) scale. The SDH considered were: age, sex, educational level, employment status, social isolation, loneliness, discontent with housing and health care needs. Results: A total sample of 582 persons was obtained. The mean age was 71 years (SD: 7.64; 69% women). A significant association was obtained between low resilience and the following conditions: loneliness (OR: 1.776 [95% CI: 1.146–2.751]), high risk of social isolation (OR: 1.667 [95% CI: 1.149-2.419]), and depressive symptoms (OR: 2.602 [95% CI: 1.795-3.774]). Female gender was a protective factor (OR: 0.589 [95% CI: 0.406-0.855]). Conclusion: The SDH, such as loneliness and social isolation, are factors associated with low resilience in older people during the COVID-19 pandemic and may be taken into account in planning public health intervention strategies. (AU)