Professor Daniel Lai is Chair Professor and Dean of Faculty of Social Sciences in the Hong Kong Baptist University. He was the former Director of Institute of Active Ageing and Head of Department of Applied Social Sciences in The Hong Kong Polytechnic University. Before returning to Hong Kong in 2015, he was Professor and Associate Dean (Research & Partnerships) in the Faculty of Social Work of The University of Calgary in Canada. Professor Lai’s research expertise includes health and wellness, aging, culture and immigration, community mental health, and outcome evaluation. Professor Lai serves on the Board of Directors of the American Society on Aging. He is Vice-President of the Hong Kong Association of Gerontology. He also sits on the Training, Research & Development Committee of the New Life Psychiatric Rehabilitation Association.
Impacts of COVID-19 and challenges on mental health of older Chinese in Hong Kong: A city-wide survey study
Daniel WL Lai, Hong Kong Baptist University, China
COVID-19 has infected over 170 million people and caused the lives of close to 4 million. Older people are at a greater risk of requiring hospitalization and death when infected. Thus, the impact of COVID-19 on older people should be examined, not just in terms of physical but mental health. This study examined the factors affecting mental wellbeing of older people and the moderating role of coping strategies and resilience in the pandemic.
A random sample of 1200 older Chinese aged 60 or above in Hong Kong were invited to take part in a structured telephone survey. The questionnaire measured different types of impacts of COVID-19, challenges encountered by older people, strategies of coping, and resilience. The mental health variables included post-traumatic stress disorder (PTSD), depression, anxiety, and self-rated mental health. Hierarchal linear regression was used to test the associations between the various impacts of COVID-19 and challenges faced by older people during the pandemic on the mental health variables. The effects of coping strategies and resilience on their mental health were also examined.
In terms of challenges encountered in the COVID-19 pandemic, having more information about the pandemic (β=-0.07; β=-0.05), being more optimistic about the pandemic (β=-0.09; β=-0.03), and a higher level of resilience (β=-0.07; β=-0.08) were associated with fewer symptoms of PTSD and depression. Being more optimistic about the pandemic (β=-0.08), adopting more positive coping styles (β=-0.02) and a higher level of resilience (β=-0.07) tended to be associated with fewer symptoms of anxiety. Participants who received more information about the pandemic (β=0.05), being more optimistic towards the pandemic (β=0.12), adopted more positive coping styles (β=0.08), and having a higher level of resilience (β=0.1) were more inclined to rate higher in their self-rated mental health.
The older Chinese in Hong Kong were also more likely to report symptoms of PTSD when they were more negatively impacted in their finance and routine (β=0.06), and interpersonal relationships (β=0.18) and when they adopted more positive (β=0.05) and negative coping strategies (β=0.17). Their depressive symptoms increased when they were more negatively impacted in areas of social activities (β=0.06), finance and routine (β=0.16), interpersonal relationships (β=0.08), and used excessive negative coping measures (β=0.16). However, older people with a higher level resilience were less likely to suffer from anxiety symptoms (β=-0.10). On the other hand, those who adopted more positive coping measures (β=0.09) and reported a higher level of resilience (β=0.15) were also in a better state of self-rated mental health.
The challenges and daily disturbances faced by older people in the pandemic are strongly associated with mental health factors. Interventions should focus on easing the negative impacts related to finance and routine of older people and their interpersonal relationships. Strategies to facilitate older people to understand and process the negative news about the pandemic and instill optimistic attitude should be developed. Intervention can also be focused on educating older people on the proper use of coping strategies to deal with the challenges and negative impacts during the pandemic.