Pre-existing mental health disorders and fear of COVID-19 pandemic: Data from a phone survey in community-dwelling older adults recruited in the NutBrain study

Background: COVID-19 has caused a parallel epidemic of fear, anxiety,
depression, stress, and frustration, particularly among the most fragile and
vulnerable individuals, such as older people and those with previous mental
health disorders. The present study aims to investigate the association
between pre-existing mental health disorders, particularly depressive
symptoms and Mild Cognitive Impairment (MCI), and the fear of COVID-19
and to explore which cognitive domains were involved in coping with fear in
older people.
Materials and methods: In April 2020, we conducted a phone-interview
questionnaire on community-dwelling older adults living in Lombardy Region
(Italy) who participated in the NutBrain study. At baseline, socio-demographic
characteristics along with lifestyles, and medical history were recorded.
Participants underwent a neuropsychological battery exploring the global
cognitive function and specific cognitive domains, to detect cases of MCI.
The Center for Epidemiologic Studies Depression scale (CES-D) was used
for screening depressive symptoms. During the phone survey, respondents
were assessed using a structured questionnaire querying about fear of the
COVID-19 pandemic. We performed multivariate logistic regression models
to study the association between MCI and depressive symptomatology and
fear. We also explored which cognitive domains were associated with fear.
Odds Ratios (OR) with Confidence Intervals (95%CI) were estimated adjusting
for potential confounders.
Results: Out of the 351 respondents (mean age 73.5 6.1 years, 59.8%
women, 49.1% high education), at baseline, 22.9% had MCI and 18.8% had
Frontiers in Psychiatry 01 frontiersin.org
Perdixi et al. 10.3389/fpsyt.2022.995308
depressive symptoms. In the multivariate analyses gender, age, and body mass
index were significantly associated with the fear score. Considering different
domains of fear, MCI was associated with fear of being infected themselves
(OR 2.55, 95%CI 1.39–4.70) while depressive symptoms were associated with
fear of contagion for family members (OR 2.38, 95%CI 1.25–4.52). Impaired
executive cognitive function was positively associated with the highest tertile
of the fear score (OR 3.28, 95%CI 1.37–7.74) and with fear of contagion for
themselves (OR 3.39, 95%CI 1.61-7.17).
Conclusion: Older adults experienced different fear reactions, particularly
when suffering from neurocognitive disorders and depressive symptoms;
executive dysfunction was associated with increased fear. These results
highlighted the need to pay attention to the psychological effects of the
outbreak of COVID-19 to target intervention, especially among vulnerable
subgroups of individuals.