The impact of shielding during the COVID-19 pandemic on mental health: evidence from the English Longitudinal Study of Ageing

  1. Giorgio Di Gessa
  2. Debora Price

Reviewed by

Read the full article

Listed in

Log in to save this article

Abstract

During the COVID-19 pandemic, older and clinically vulnerable people were instructed to shield or stay at home. Policies restricting social contact and human interaction pose a risk to mental health, but we know very little about the impact of shielding and stay-at-home orders on the mental health of older people.

Aims

To understand the extent to which shielding contributes to poorer mental health.

Method

We used longitudinal data from wave 9 (2018/2019) and two COVID-19 sub-studies (June/July 2020; November/December 2020) of the English Longitudinal Study of Ageing, and constructed logistic and linear regression models to investigate associations between patterns of shielding during the pandemic and mental health, controlling for sociodemographic characteristics, pre-pandemic physical and mental health, and social isolation measures.

Results

By December 2020, 70% of older people were still shielding or staying at home, with 5% shielding throughout the first 9 months of the pandemic. Respondents who shielded experienced worse mental health. Although prior characteristics and lack of social interactions explain some of this association, even controlling for all covariates, those shielding throughout had higher odds of reporting elevated depressive symptoms (odds ratio 1.87, 95% CI 1.22–2.87) and lower quality of life (β = −1.28, 95% CI −2.04 to −0.52) than those who neither shielded nor stayed at home. Shielding was also associated with increased anxiety.

Conclusions

Shielding seems associated with worse mental health among older people, highlighting the need for policy makers to address the mental health needs of those who shielded, both in the current pandemic and for the future.

Article activity feed

  1. Version published to 10.1192/bjp.2022.44
  2. ScreenIT

    SciScore for 10.1101/2021.12.16.21267914: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: ELSA was approved by the London Multicentre Research Ethics Committee (MREC/01/2/91), with the COVID-19 sub-study approved by the UCL REC.
    Consent: Informed consent was obtained from all participants.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Cell Line AuthenticationAuthentication: Symptoms of depression were measured by an abbreviated version of the validated Centre for Epidemiologic Studies Depression (CES-D) Scale [25].

    Table 2: Resources

    No key resources detected.

    Results from OddPub: Thank you for sharing your data.

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Our contribution, however, should be considered in light of some limitations. ELSA did not collect information about respondents’ perception on their (lack of) independence during the pandemic, exposure to COVID-19 related news, individuals’ ability to tolerate and cope with the uncertainty due to COVID-19, or personality characteristics such as degree of risk tolerance or harm avoidance. These factors might help further understand both different behaviours and choices around levels of shielding and their subsequent effect on mental health. Also, although instructions to shield were mostly targeting older people, we could not evaluate associations across the full adult-age spectrum as ELSA samples only the over-50s, and those in care homes are excluded. Also, we only had information about shielding behaviours at three points in time, mostly referring to the week prior to the interview. While we cannot construct more nuanced and continuous measures of shielding/staying at home, this is likely to be the best data obtainable at scale for behaviours among older people during the pandemic. ELSA is limited to the population of England and so it is not possible to say that this would hold in other countries, although it is plausible that it would. Finally, ELSA suffers from non-random cumulative attrition, an unavoidable problem in longitudinal studies which can only partially be corrected for by using weights in the analysis. In summary, our study provides a picture of the broader ...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2021.12.16.21267914v1 on medRxiv