Symptoms of Anxiety and Depression Among Community Dwelling Older Adults: Impact of Covid-19


  • Tara Seibert Indiana University School of Medicine
  • Anthony Perkins Indiana University School of Medicine
  • Nicole Fowler Indiana University School of Medicine



Background and Hypothesis: 

Symptoms of anxiety and depression are prevalent in adults age 65 and older. Numerous factors impact the mental health of older adults including changes in overall health, isolation, and financial stress. Emotional support reduces the risk of mental illness. 12.2% of adults 65 and older “rarely” or “never” receive the social and emotional support they need. We hypothesize that the Covid-19 pandemic and associated shelter in place orders will increase symptoms of anxiety and depression in community dwelling older adults.  



We conducted a secondary analysis of data collected pre and post Covid-19 from a sample in Indiana from the Caregiver Outcomes of Alzheimer’s Disease Screening Trial (COADS) and a national sample from the Understanding America Study (UAS). 1,299 and 2,465 adults age 65 and older from Indiana and a nationwide sample, respectively, answered the Patient Health Questionnaire-4 (PHQ-4). The PHQ-4 is a validated 4-item screening tool for symptoms of anxiety and depression. Mean PHQ-4 scores were compared pre and post Covid-19 for both samples to explore the impact of Covid-19 on symptoms of anxiety and depression in this population.  



No significant change in PHQ-4 scores pre and post Covid-19 were observed between the Indiana (1.23, 1.13, p-value=0.474) or the national samples (1.38, 1.35, p-value=0.793). An increase was observed in national depression scores, determined by a PHQ-4 subset score, post Covid-19 compared to pre Covid-19, but not statistically significantly higher (0.54, 0.56, p-value=0.679).  


Conclusions and Implications: 

In a sample of 3,764 participants, the mental health of adults age 65 and older nationwide remained steady despite unprecedented pandemic and social isolation. The mental health of older adults is known to be an important topic and the potential for the pandemic to exacerbate symptoms of anxiety or depression makes this a critical issue for both clinicians and researchers.  

Author Biographies

Anthony Perkins, Indiana University School of Medicine

Department of Biostatistics

Nicole Fowler, Indiana University School of Medicine

Indiana University Center for Aging Research

Regenstrief Institute, Inc.

Center for Health Innovation and Implementation Science, Indiana Clinical and Translational Science Institute