Loneliness Before and During the Covid-19 Pandemic: Associations with Chronic Illnesses and Relationship Quality

Abstract While self-reported loneliness generally declines after age 65, the likelihood of experiencing chronic illnesses increases. During the Covid-19 pandemic, social isolation measures have changed the social context of many people. We address three research questions: 1) What is the predictive strength of chronic illnesses, relationship quality, and their interaction on loneliness? 2) Has Covid-19 altered experienced loneliness relative to pre-pandemic? 3) Was loneliness during Covid-19 associated with the number of prior chronic illnesses in 2016? To answer these questions, we have analyzed data from participants in the Health and Retirement Study (HRS) included in the early 2020 release who also completed the 2016 wave (N = 1106). On average, in 2016, these participants were age 74.64 (SD = 6.66) and reported 2.57 (SD = 1.39) chronic illnesses. In 2016, unadjusted multiple regression models revealed that chronic illnesses (β = .38) and relationship quality (β = -.41) were associated with loneliness (R2 = .28). When covariates were added, these values were attenuated but remained statistically significant. In 2020 during the pandemic, 8% of these participants reported they often felt lonely and 26% reported feeling lonelier since the start of the Covid-19 pandemic. People who had more chronic illnesses in 2016 reported feeling lonelier in 2020 as did people whose relationships were poorer quality (p < .05). Further analyses with final data from HRS are needed to confirm these trends. These findings highlight the importance of having longitudinal information to identify individuals at high risk and most likely to benefit from interventions.

Veterans Healthcare System, North Little Rock, Arkansas, United States Background: Cognitively impaired older adults living in the community have been vulnerable to the effects of COVID-19 confinement.The current study's objectives were to examine the prevalence of loneliness in such adults along with impact of COVID-19 on neuropsychiatric symptoms and functional status.Methods: A cross-sectional study was conducted in community dwelling cognitively impaired older Veterans (N=41).Demographic data such as age, gender, race, and rurality were collected.Loneliness data were collected with the 3-item Loneliness Questionnaire.Cognition was assessed with the Tele-Montreal Cognitive Assessment (T-MoCA) and functional status of instrumental activities of daily living was assessed with the Functional Activities Questionnaire (FAQ).Neuropsychiatry symptoms including severity and distress were collected using the Neuropsychiatric Inventory (NPI), and change during COVID was also recorded for each symptom.Results: Demographic characteristics included: mean age of 71.9 (±8.6) years, 95.1% male, 46.3% rural, 75.6% Caucasian, and 19.5% African American.Loneliness was prevalent in most participants (62.5%).T-MoCA and FAQ mean scores were 15.1 (±4.5) and 10.0 (±8.6), respectively.Mean NPI total severity and total distress were 8.4 (±5.9) and 11.4 (±8.5), respectively.Irritability was most frequently reported symptom (65%), followed by agitation (57.5%), anxiety (55%), depression (50%), and night-time behavior (50%).A majority of the participants reported worsening of neuropsychiatric symptoms during COVID (71.1%).Among those that reported worsening neuropsychiatric symptoms, 70.4% noted an increase in ≥ two symptoms.Conclusion: Older adults with pre-existent cognitive impairment may be at high risk for loneliness and worsening of neuropsychiatric symptoms during the COVID pandemic.

LONELINESS BEFORE AND DURING THE COVID-19 PANDEMIC: ASSOCIATIONS WITH CHRONIC ILLNESSES AND RELATIONSHIP QUALITY
Jay Kayser, 1 and Jacqui Smith, 2 1.University of Michigan,Ann Arbor,Michigan,United States,2

. University of Michigan, University of Michigan, Michigan, United States
While self-reported loneliness generally declines after age 65, the likelihood of experiencing chronic illnesses increases.During the Covid-19 pandemic, social isolation measures have changed the social context of many people.We address three research questions: 1) What is the predictive strength of chronic illnesses, relationship quality, and their interaction on loneliness? 2) Has Covid-19 altered experienced loneliness relative to pre-pandemic?3) Was loneliness during Covid-19 associated with the number of prior chronic illnesses in 2016?To answer these questions, we have analyzed data from participants in the Health and Retirement Study (HRS) included in the early 2020 release who also completed the 2016 wave (N = 1106).On average, in 2016, these participants were age 74.64 (SD = 6.66) and reported 2.57 (SD = 1.39) chronic illnesses.In 2016, unadjusted multiple regression models revealed that chronic illnesses (β = .38)and relationship quality (β = -.41) were associated with loneliness (R2 = .28).When covariates were added, these values were attenuated but remained statistically significant.In 2020 during the pandemic, 8% of these participants reported they often felt lonely and 26% reported feeling lonelier since the start of the Covid-19 pandemic.People who had more chronic illnesses in 2016 reported feeling lonelier in 2020 as did people whose relationships were poorer quality (p < .05).Further analyses with final data from HRS are needed to confirm these trends.These findings highlight the importance of having longitudinal information to identify individuals at high risk and most likely to benefit from interventions.

LONELINESS DURING COVID-19 AND MODES OF SOCIAL CONTACT USE AMONG OLDER ADULTS
Usha Dhakal, and Athena Koumoutzis, Miami University, Oxford, Ohio, United States Due to social distancing and isolation recommendations, COVID-19 resulted in older adults' greater reliance on technology to contact friends and families.While the mental health of older adults during COVID-19 has been well explored, less is known about how changes in modes and frequency of social contact is associated with loneliness.Using the National Health and Aging Trends Study COVID-19 data, this study assessed how the frequency of varying modes of contact (e.g., phone/email/text, in-person visits, videocalls) during the pandemic was associated with feelings of loneliness during COVID-19 among community-dwelling Medicare beneficiaries (n = 2149).Participants were asked if they felt lonely "more often," "less often," or "about the same" compared to before the outbreak started.Multinomial regression analyses indicated that, compared to those who reported daily in-person visits, the odds of having more feelings of loneliness as compared to about the same as pre-COVID-19 was significantly higher among those who reported having in-person visits a few times (OR=2.17,CI=1.08-4.36),at least once (OR=2.37,CI=1.11-5.04),and never/less than once a week (OR=3.37,CI=1.59-7.16)while controlling for demographics, household, and social network size.Compared to daily use, use of phone/email/text at least once (OR=0.44,CI=0.201-0.965)or a few times (OR=0.76,CI=0.58-0.99) a week was associated with lower odds of reporting more feelings of loneliness versus about the same.Results suggest that greater use of technology that promote social engagement improves social connectedness and decreases COVID-19 related loneliness among older adults, and highlights the importance of older adults' access to technology, including reliable internet.

OLDER ADULTS' WORRY ABOUT COVID-19: ASSOCIATIONS WITH EXPERIENCES OF COVID-19 AMONG SOCIAL CONNECTIONS
Amanda Leggett, 1 Hyun Jung Koo, 2 Lindsay Kobayashi, 2 Jessica Finlay, 2 Hannah Lee, 2 and Elaina Baker, 2 1.The University of Michigan, Ypsilanti, Michigan, United States, 2. University of Michigan, Ann Arbor, Michigan, United States The COVID-19 pandemic has challenged the physical and mental health of older adults, yet it is unknown how much older adults worry about their own exposure.As older adults are at increased risk for severe complications from COVID-19, understanding patterns of worry may inform public health guidelines and interventions for this age group.We investigated older adults' worry about COVID-19 in the early months of the pandemic and associations with familial/