Faculty Collaboration Database

Loneliness and mental health during the COVID-19 pandemic in older breast cancer survivors and noncancer controls. Cancer 2021 Oct 01;127(19):3671-3679

Date

06/24/2021

Pubmed ID

34161601

Pubmed Central ID

PMC8419003

DOI

10.1002/cncr.33687

Scopus ID

2-s2.0-85108372778 (requires institutional sign-in at Scopus site)   44 Citations

Abstract

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has had wide-ranging health effects and increased isolation. Older with cancer patients might be especially vulnerable to loneliness and poor mental health during the pandemic.

METHODS: The authors included active participants enrolled in the longitudinal Thinking and Living With Cancer study of nonmetastatic breast cancer survivors aged 60 to 89 years (n = 262) and matched controls (n = 165) from 5 US regions. Participants completed questionnaires at parent study enrollment and then annually, including a web-based or telephone COVID-19 survey, between May 27 and September 11, 2020. Mixed-effects models were used to examine changes in loneliness (a single item on the Center for Epidemiologic Studies-Depression [CES-D] scale) from before to during the pandemic in survivors versus controls and to test survivor-control differences in the associations between changes in loneliness and changes in mental health, including depression (CES-D, excluding the loneliness item), anxiety (the State-Trait Anxiety Inventory), and perceived stress (the Perceived Stress Scale). Models were adjusted for age, race, county COVID-19 death rates, and time between assessments.

RESULTS: Loneliness increased from before to during the pandemic (0.211; P = .001), with no survivor-control differences. Increased loneliness was associated with worsening depression (3.958; P < .001) and anxiety (3.242; P < .001) symptoms and higher stress (1.172; P < .001) during the pandemic, also with no survivor-control differences.

CONCLUSIONS: Cancer survivors reported changes in loneliness and mental health similar to those reported by women without cancer. However, both groups reported increased loneliness from before to during the pandemic that was related to worsening mental health, suggesting that screening for loneliness during medical care interactions will be important for identifying all older women at risk for adverse mental health effects of the pandemic.

Author List

Rentscher KE, Zhou X, Small BJ, Cohen HJ, Dilawari AA, Patel SK, Bethea TN, Van Dyk KM, Nakamura ZM, Ahn J, Zhai W, Ahles TA, Jim HSL, McDonald BC, Saykin AJ, Root JC, Graham DMA, Carroll JE, Mandelblatt JS

Author

Kelly E. Rentscher PhD Assistant Professor in the Psychiatry and Behavioral Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Aged, 80 and over
Anxiety
Breast Neoplasms
Cancer Survivors
Female
Humans
Loneliness
Mental Health
Middle Aged
Pandemics
Surveys and Questionnaires