Older adults' mental health before and during the COVID-19 pandemic: Evidence paper

Endnotes

1 National Records of Scotland (2021) Mid-2020 Population Estimates Scotland

2 Scottish Government, (2010) Demographic Change in Scotland

3 UK Health Security Agency (2019) Ageing and health expenditure

4 Mental Health Foundation Promoting Mental Health And Well-being In Later Life

5 Scottish Government (2019) A Fairer Scotland for Older People: framework for action

6 Scottish Government (2020) Coronavirus (COVID-19): mental health - transition and recovery plan

7 Voluntary Health Scotland (2019) Falling Off a Cliff at 65: Key Learnings

8 Specific databases searched were: KandE, a Scottish Government search engine covering several databases; PubMed and Google Scholar; PsyArXiv and medRxiv, which host research reports that have not been peer-reviewed (i.e., have not been reviewed by other experts as a form of quality assurance); and Public Health Scotland’s Research Repository

9 The evidence review’s scope and research questions were presented to stakeholders at a virtual forum, after which they were asked to complete written feedback packs to provide or signpost to any relevant evidence. All feedback packs were reviewed to identify and assess evidence for inclusion in this report.

10 While this report defined ‘older adult’ as 65+, this definition was flexible in terms of how other research defined them (e.g., having a younger minimum age, such as 55+ or 60+)

11 Scottish Government (2022) Scottish Health Survey

12 University of Warwick (2005) The Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS)

13 Goldberg & Blackwell (1970) Psychiatric Illness in General Practice: A Detailed Study Using a New Method of Case Identification. British Medical Journal, 2(5707), 439–443

14 Lewis, Pelosi, Araya & Dunn (1992) Measuring psychiatric disorder in the community: a standardized assessment for use by lay interviewers. Psychological medicine, 22(2), 465-486

15 Differences between WEMWBS scores were assessed for statistical significance using analyses of variance. Differences between percentages were considered statistically significant if calculated confidence limits for different groups did not overlap.

16 National Records of Scotland (2021) Mid-2020 Population Estimates Scotland

17 Scottish Government (2021) Scottish Health Survey – telephone survey – August/September 2020: main report

18 Scottish Government (2022) Scottish COVID-19 (SCOVID) Mental Health Tracker Study

19 Scottish Government (2021) Coronavirus (COVID-19): wellbeing research

20 Diffley Partnership (2021) Understanding Scotland Report - Wellbeing

21 Hannaford, Moore & Macleod (2018) What a difference a year makes: comparing relationships between stressful life events, mood and life satisfaction among older adults, and their working-age counterparts. Aging & Mental Health, 22(12), 1658-1665

22 Scottish Government (2021) Scottish Health Survey – telephone survey – August/September 2020: main report

23 Brett, Dykiert, Starr & Deary (2019) Predicting change in quality of life from age 79 to 90 in the Lothian Birth Cohort 1921. Quality of Life Research, 28, 737-749

24 Age Scotland (2021) Big Survey

25 Scottish Government (2021) Coronavirus (COVID-19): wellbeing research

26 Age Scotland (2021) Big Survey

27 Healthy Ageing in Scotland (2019) HAGIS pilot study report

28 Loneliness is considered to be a subjective feeling in contrast to social isolation, which is considered more objective and refers to an individual’s contact with others.

29 Scottish Government (2022) Scottish COVID-19 (SCOVID) Mental Health Tracker Study

30 Scottish Government (2021) Coronavirus (COVID-19): impact on wellbeing research

31 Hannaford, Moore & Macleod (2018) What a difference a year makes: comparing relationships between stressful life events, mood and life satisfaction among older adults, and their working-age counterparts. Aging & Mental Health, 22(12), 1658-1665

32 Scottish Government ( 2019) Scottish household survey 2018: annual report

33 Generation Scotland (2021) CovidLife and RuralCovidLife reports

34 Scottish Government (2021) Scottish Health Survey – telephone survey – August/September 2020: main report

35 Scottish Government (2022) Scottish COVID-19 (SCOVID) Mental Health Tracker Study

36 Generation Scotland (2021) CovidLife and RuralCovidLife reports

37 Glasgow Caledonian University (2021) COVID-19 psychological wellbeing study initial results - Scotland report

38 Serrano-Alarcón, Kentikelenis, McKee & Stuckler (2021) Impact of COVID‐19 lockdowns on mental health: Evidence from a quasi‐natural experiment in England and Scotland. Health Economics, 31(2), 284-296

39 Hannaford, Moore & Macleod (2018) What a difference a year makes: comparing relationships between stressful life events, mood and life satisfaction among older adults, and their working-age counterparts. Aging & Mental Health, 22(12), 1658-1665

40 Hubbard, den Daas, Johnston & Dixen (2021) Sociodemographic and Psychological Risk Factors for Anxiety and Depression: Findings from the Covid-19 Health and Adherence Research in Scotland on Mental Health (CHARIS-MH) Cross-sectional Survey. International Journal of Behavioural Medicine, 28(6), 788-800

41 Support in Mind Scotland (2018) Well connected communities report

42 Scottish Government (2021) Scottish Health Survey – telephone survey – August/September 2020: main report

43 Brett, Dykiert, Starr & Deary (2019) Predicting change in quality of life from age 79 to 90 in the Lothian Birth Cohort 1921. Quality of Life Research, 28, 737-749

44 Generation Scotland (2021) CovidLife and RuralCovidLife reports

45 Scottish Government (2021) Coronavirus (COVID-19) - impact on wellbeing: survey summary

46 National Records of Scotland (2022) Probable Suicides: Deaths which are the Result of Intentional Self-harm or Events of Undetermined Intent

47 Scottish Government (2022) Scottish COVID-19 (SCOVID) Mental Health Tracker Study

48 Scottish Government (2022) COVID-19 in Scotland

49 Taylor, Page, Okely, Corley, Welstead, Skarabela et al. (2021) Impact of COVID-19 lockdown on psychosocial factors, health, and lifestyle in Scottish octogenarians: The Lothian Birth Cohort 1936 study. PLoS ONE, 16(6) and Okely, Corley, Welstead, Taylor, Page, Skarabela et al. (2021) Change in Physical Activity, Sleep Quality, and Psychosocial Variables during COVID-19 Lockdown: Evidence from the Lothian Birth Cohort 1936. International Journal of Environmental Research and Public Health 18(1), 210; Studies comprise a cohort of participants born in 1936, who completed a survey before the pandemic (at a point between 2014 and 2019) and early during the pandemic (May to June 2020), when they were, on average, 84 years old. Please note that the results from this study were not intended to be representative of the Scottish population.

50 Serrano-Alarcón, Kentikelenis, McKee & Stuckler (2021) Impact of COVID‐19 lockdowns on mental health: Evidence from a quasi‐natural experiment in England and Scotland. Health Economics, 31(2), 284-296; sample comprises 286 older adults in Scotland (scores weighted to be representative of the Scottish population), who completed questions at two points before the pandemic (once between 2017 and 2019, and once between 2018 and 2020) and at four points during the start of the pandemic (April, May, June and July 2020)

51 Tomaz, Coffee, Ryde, Swales, Neely, Connelly et al. (2021) Loneliness, Wellbeing, and Social Activity in Scottish Older Adults Resulting from Social Distancing during the COVID-19 Pandemic. International Journal of Environmental Research and Public Health, 18(9), 4517 (May to July 2020, 84% of the sample were 60 years old or over)

52 Age Scotland (2021) Big Survey (February to March 2021; 87% of the sample were 65+)

53 Generation Scotland (2021) CovidLife and RuralCovidLife reports (April to May 2020)

54 Scottish Government (2020) Coronavirus (COVID-19): mental health tracker study - wave 1 report (May to June 2020)

55 Alliance (2021) Older people and mental health: Consultation event report

56 Chief Scientist Office (2021) Looking after the elderly during the COVID-19 pandemic: a focus on addressing physical activity, loneliness, and help-seeking behaviour (sample were between 58 and 90 years old, mean age 72; rates of loneliness - June 30%, July 23%, August, 23%; rates of probable or possible depression – June 20%, July 20%, August 16%).

57 Serrano-Alarcón, Kentikelenis, McKee & Stuckler (2021) Impact of COVID‐19 lockdowns on mental health: Evidence from a quasi‐natural experiment in England and Scotland

58 Scottish Government (2021) Coronavirus (COVID-19): mental health tracker study - wave 1 report (May to June 2020, July to August 2020, October to November 2020, February to March 2021).

59 Alliance (2021) Older people and mental health: Consultation event report

60 National Records of Scotland (2021) Mid-2020 Population Estimates Scotland

61 Scottish Government (2021) Scottish Health Survey – telephone survey – August/September 2020: main report

62 Scottish Government (2022) Scottish COVID-19 (SCOVID) Mental Health Tracker Study

63 National Records of Scotland (2022) Probable Suicides: Deaths which are the Result of Intentional Self-harm or Events of Undetermined Intent

64 Scottish Government (2022) Scottish COVID-19 (SCOVID) Mental Health Tracker Study

65 NHS Highland (2016) Annual report of the director of public health 2016: loneliness and health

66 Age Scotland (2021) Big Survey (February to March 2021; 87% of the sample were 65+)

67 Tomaz, Coffee, Ryde, Swales, Neely, Connelly et al. (2021) Loneliness, Wellbeing, and Social Activity in Scottish Older Adults Resulting from Social Distancing during the COVID-19 Pandemic. International Journal of Environmental Research and Public Health, 18(9), 4517 (May to July 2020, 84% of the sample were 60 years old or over)

68 Scottish Women’s Convention (2021) Consultation report on older women's mental health

69 Participating stakeholder organisations including the Equality Network, Scottish Trans and Age Scotland

70 Scottish Mental Health Co-operative Age in mind: mental health in later life

71 Scottish Government (2020) Scottish Health Survey 2019 - volume 1: main report

72 Scottish Parliament (2021) Report on the impact of the COVID-19 pandemic on equalities and human rights

73 Hubbard, den Daas, Johnston & Dixen (2021) Sociodemographic and Psychological Risk Factors for Anxiety and Depression: Findings from the Covid-19 Health and Adherence Research in Scotland on Mental Health (CHARIS-MH) Cross-sectional Survey. International Journal of Behavioural Medicine, 28(6), 788-800

74 ‘Poor’ general health concerns participants who rated their general health as ‘fair’, ‘bad’ or ‘very bad’. ‘Good’ mental health concerns participants who rated their general health as ‘good’ or ‘very good’.

75 Okely, Corley, Welstead, Taylor, Page, Skarabela et al. (2021) Change in Physical Activity, Sleep Quality, and Psychosocial Variables during COVID-19 Lockdown: Evidence from the Lothian Birth Cohort 1936. International Journal of Environmental Research and Public Health 18(1), 210

76 Taylor, Page, Okely, Corley, Welstead, Skarabela et al. (2021) Impact of COVID-19 lockdown on psychosocial factors, health, and lifestyle in Scottish octogenarians: The Lothian Birth Cohort 1936 study. PLoS ONE, 16(6)

77 Scottish Women’s Convention (2021) Consultation report on older women's mental health

78 NHS Highland (2016) Annual report of the director of public health 2016: loneliness and health

79 Taylor, Page, Okely, Corley, Welstead, Skarabela et al. (2021) Impact of COVID-19 lockdown on psychosocial factors, health, and lifestyle in Scottish octogenarians: The Lothian Birth Cohort 1936 study. PLoS ONE, 16(6)

80 Graham, Burke & Holman (2020) Covid-19 Lockdown Affects Hearing Disability and Handicap in Diverse Ways: A Rapid Online Survey Study. Ear and Hearing, 41(6), 1442-1449 (mean age 64.4 years)

81 Court, McLean, Guthrie, Mercer & Smith (2014) Visual impairment is associated with physical and mental comorbidities in older adults: a cross-sectional study. BMC Medicine, 12(181)

82 NHS Highland (2016) Annual report of the director of public health 2016: loneliness and health

83 See Me & Scottish Mental Health Co-operative Press release: Older people can be left isolated if they experience mental health problems

84 NHS Highland (2016) Annual report of the director of public health 2016: loneliness and health

85 Age Scotland (2021) Big Survey

86 Age Scotland (2021) Big Survey

87 Age Scotland (2021) Big Survey

88 Equality and Human Rights Commission (2020) Equality in residential care in Scotland during coronavirus (COVID-19)

89 Mental Health Foundation (2022) Loneliness and mental health report - UK

90 Tomaz, Coffee, Ryde, Swales, Neely, Connelly et al. (2021) Loneliness, Wellbeing, and Social Activity in Scottish Older Adults Resulting from Social Distancing during the COVID-19 Pandemic. International Journal of Environmental Research and Public Health, 18(9), 4517 (May to July 2020, 84% of the sample were 60 years old or over)

91 NHS Highland (2016) Annual report of the director of public health 2016: loneliness and health

92 Age Scotland (2021) Big Survey

93 Taylor, Page, Okely, Corley, Welstead, Skarabela et al. (2021) Impact of COVID-19 lockdown on psychosocial factors, health, and lifestyle in Scottish octogenarians: The Lothian Birth Cohort 1936 study. PLoS ONE, 16(6)

94 Taylor, Page, Okely, Corley, Welstead, Skarabela et al. (2021) Impact of COVID-19 lockdown on psychosocial factors, health, and lifestyle in Scottish octogenarians: The Lothian Birth Cohort 1936 study. PLoS ONE, 16(6)

95 Taylor, Page, Okely, Corley, Welstead, Skarabela et al. (2021) Impact of COVID-19 lockdown on psychosocial factors, health, and lifestyle in Scottish octogenarians: The Lothian Birth Cohort 1936 study. PLoS ONE, 16(6)

96 Scottish Government (2020) Scottish Surveys Core Questions (SSCQ)

97 Scottish Government (2021) Rural Scotland Key Facts 2021

98 NHS Highland (2016) Annual report of the director of public health 2016: loneliness and health

99 Scottish Government (2020) Scottish Surveys Core Questions (SSCQ)

100 NHS Highland (2016) Annual report of the director of public health 2016: loneliness and health

101 Alliance (2021) Older people and mental health - informing national policy implementation

102 Tomaz, Coffee, Ryde, Swales, Neely, Connelly et al. (2021) Loneliness, Wellbeing, and Social Activity in Scottish Older Adults Resulting from Social Distancing during the COVID-19 Pandemic. International Journal of Environmental Research and Public Health, 18(9), 4517 (May to July 2020, 84% of the sample were 60 years old or over)

103 Alliance (2021) Older people and mental health: Consultation event report; Scottish Women’s Convention (2021) Consultation report on older women's mental health

104 NHS Highland (2016) Annual report of the director of public health 2016: loneliness and health

105 Organisations including Age Scotland, Support in Mind Scotland and Alliance Scotland

106 Scottish Government (2020) Coronavirus (COVID-19): supporting people at higher risk - qualitative research

107 Mental Welfare Commission (2020) Older people's functional mental health wards in hospitals

108 Scottish Mental Health Co-operative Age in mind: mental health in later life An action research project: October 2017. Focus groups conducted with adults 50 years old and over, unpaid carers, professional staff and public, private and third-sector service providers.

109 Alliance (2021) Older people and mental health: Consultation event report

110 Voluntary Health Scotland (2019) Falling Off a Cliff at 65: Key Learnings

111 Scottish Care (2017) Fragile foundations: exploring the mental health of the social care workforce and the people they support

112 Voluntary Health Scotland (2021) Falling Off a Cliff at 65: February and March round tables; Alliance (2021) Older people and mental health: Consultation event report

113 Public Health Scotland (2022) All releases of psychological therapies waiting times

114 Public Health Scotland (2021) Mental health inpatient activity

115 Public Health Scotland (2021) Mental health inpatient activity

116 Voluntary Health Scotland (2019) Falling Off a Cliff at 65: Key Learnings

117 Mental Welfare Commission (2020) Older people's functional mental health wards in hospitals

118 Alliance (2021) Older people and mental health: Consultation event report

119 Participating stakeholder organisations including Age Scotland and the Scottish Women’s Convention

120 Voluntary Health Scotland (2019) Falling Off a Cliff at 65: Key Learnings

121 Scottish Mental Health Co-operative Age in mind: mental health in later life

122 Public Health Scotland (2021) Mental health inpatient activity

123 Issues highlighted by Engender and the Scottish Women’s Convention

124 Issues highlighted by Equality Network, Scottish Trans and Age Scotland

125 Please note that the terminology ‘Black, Asian and Minority Ethnic (BAME) groups’ is used to be consistent with the data source.

126 Mental Welfare Commission (2021) Racial inequality and mental health in Scotland

127 Issues highlighted by BEMIS, Alliance and the Scottish Women’s Convention

128 Scottish Mental Health Co-operative Age in mind: mental health in later life

129 Scottish Care (2017) Fragile foundations: exploring the mental health of the social care workforce and the people they support

130 Alliance (2021) Older people and mental health: Consultation event report

131 Covid-19 Lockdown Affects Hearing Disability and Handicap in... : Ear and Hearing (lww.com) (mean age 64.4 years)

132 Support in Mind Scotland (2018) Well connected communities report

133 Issues highlighted by Alliance, Support in Mind Scotland and the Scottish Women’s Convention

134 Support in Mind Scotland (2021) Marginalised Communities in rural areas during COVID-19

135 Scottish Care (2017) Fragile foundations: exploring the mental health of the social care workforce and the people they support

136 Voluntary Health Scotland (2019) Falling Off a Cliff at 65: Key Learnings; Taylor, Page, Okely, Corley, Welstead, Skarabela et al. (2021) Impact of COVID-19 lockdown on psychosocial factors, health, and lifestyle in Scottish octogenarians: The Lothian Birth Cohort 1936 study. PLoS ONE, 16(6)

137 In Age Scotland’s Big Survey (Age Scotland (2021) Big Survey), younger respondents (e.g., in their 50s and 60s) were more likely to have the right technology or expertise to use online communications than older respondents (e.g., in their 80s and 90s).

138 Scottish Government (2014) Attitudes to Mental Health in Scotland: Scottish Social Attitudes Survey 2013 people 55+ were less likely than other age groups to say they had experienced a mental health problem

139 Voluntary Health Scotland (2019) Falling Off a Cliff at 65: Key Learnings