The impact of SARS-CoV-2 on emotional state among older adults in Latin America

Abstract

In Latin America, the volume of care of infected patients, higher presence of comorbidities among older adults, and restricted access to clinical controls have become this age group into one with the highest risk (Dubey etal., 2020). Under confinement circumstances, older people can experience feelings of helplessness and uncertainty about the future, difficulties to stay focused, anxiety, stress, agitation, withdrawal, and depression (Armitage and Nellums, 2020; Wang etal., 2020). Accordingly, a Consortium of universities, research centers, and clinical centers have joined forces to carry out research which seeks to know the emotional state of Latin American older adults during confinement by Coronavirus disease (COVID-19). The study included the following countries: Argentina, Bolivia, Chile, Colombia, Costa Rica, Ecuador, Guatemala, Honduras, Mexico, Nicaragua, Peru, Puerto Rico, Dominican Republic, and Venezuela. Between April and May, we carry out the piloting of the evaluation protocol, making cultural and linguistic adaptations. Later, between June and October, more than 7000 older adults were evaluated by telephone by an expert professional through filling out an online form. The protocol we used includes a sociodemographic and clinical questionnaire, information on confinement, lifestyles, and the abbreviated version of the Yesavage Geriatric Depression Scale (Martínez de la Iglesia etal., 2020). Sociodemographic characteristics of the final sample (n = 5245) show that 34% are men and 66% are women, with an average age of 69.61 years (SD = 7.28). Average schooling was 10.99 years (SD = 5.85) depending on the country, and 16.7% were illiterate. The major racial pattern of the population is Latin American mestizo (55.1%) followed by white (39.4%), South American indigenous (1.5%), and African American subjects (1.2%). Seventy-seven percentage of the participants have a monthly income, from retirement (45.9%) or independent work (26.4%), and 85% live with their spouses or relatives. Regarding quarantine, 86.7% of the respondents stated that they complied with the confinement measures, with an average of 123.15 days (SD = 42.43) of quarantine, which varies by country. Our data analysis has revealed that 30.27% of the older adults exhibit emotional disturbances. In Mexico and Peru, we have observed the highest levels of geriatric depression (38.9% and 38.1%, respectively) and in Venezuela the lowest (21.35%). Regression analysis shows that more years of schooling (OR = 0.943; IC95%: 0.93–0.95), having an economic income (OR = 0.764; IC95%: 0.64–0.90) and being a Latin American mestizo (OR = 0.832, IC95%: 0.71–0.98) are associated with reduced risk of geriatric depression. On the other hand, being widowed (OR = 1.428; IC95%: 1.10–1.85) or separated (OR = 1.352; IC95%: 1.01–1.82), lived in Bolivia (OR = 1.805; IC95%: 1.31–2.48), Mexico (OR = 2.320; IC95%: 1.70–3.16), and Peru (OR = 2.008; IC95%: 1.45–2.78) are associated with highest risk. This first multicenter study found that emotional status of older adults during the SARS-CoV-2 pandemic in Latin America varies depending on the country where they live and sociodemographic and socioeconomic factors. It is necessary for follow-up studies to validate diagnosis and analyze the greater risk of deterioration in the coming months.