A UK survey of COVID‐19 related social support closures and their effects on older people, people with dementia, and carers

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Abstract

Objectives

The aim of this national survey was to explore the impact of COVID‐19 public health measures on access to social support services and the effects of closures of services on the mental well‐being of older people and those affected by dementia.

Methods

A UK‐wide online and telephone survey was conducted with older adults, people with dementia, and carers between April and May 2020. The survey captured demographic and postcode data, social support service usage before and after COVID‐19 public health measures, current quality of life, depression, and anxiety. Multiple linear regression analysis was used to explore the relationship between social support service variations and anxiety and well‐being.

Results

Five hundred and sixty‐nine participants completed the survey (61 people with dementia, 285 unpaid carers, and 223 older adults). Paired samples t‐tests and X ²‐tests showed that the mean hour of weekly social support service usage and the number of people having accessed various services was significantly reduced post COVID‐19. Multiple regression analyses showed that higher variations in social support service hours significantly predicted increased levels of anxiety in people with dementia and older adults, and lower levels of mental well‐being in unpaid carers and older adults.

Conclusions

Being unable to access social support services due to COVID contributed to worse quality of life and anxiety in those affected by dementia and older adults across the UK. Social support services need to be enabled to continue providing support in adapted formats, especially in light of continued public health restrictions for the foreseeable future.

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Most cited references 30

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A brief measure for assessing generalized anxiety disorder: the GAD-7.

Robert L Spitzer, Kurt Kroenke, Janet B W Williams … (2006)

Generalized anxiety disorder (GAD) is one of the most common mental disorders; however, there is no brief clinical measure for assessing GAD. The objective of this study was to develop a brief self-report scale to identify probable cases of GAD and evaluate its reliability and validity. A criterion-standard study was performed in 15 primary care clinics in the United States from November 2004 through June 2005. Of a total of 2740 adult patients completing a study questionnaire, 965 patients had a telephone interview with a mental health professional within 1 week. For criterion and construct validity, GAD self-report scale diagnoses were compared with independent diagnoses made by mental health professionals; functional status measures; disability days; and health care use. A 7-item anxiety scale (GAD-7) had good reliability, as well as criterion, construct, factorial, and procedural validity. A cut point was identified that optimized sensitivity (89%) and specificity (82%). Increasing scores on the scale were strongly associated with multiple domains of functional impairment (all 6 Medical Outcomes Study Short-Form General Health Survey scales and disability days). Although GAD and depression symptoms frequently co-occurred, factor analysis confirmed them as distinct dimensions. Moreover, GAD and depression symptoms had differing but independent effects on functional impairment and disability. There was good agreement between self-report and interviewer-administered versions of the scale. The GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research.

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The PHQ-9: validity of a brief depression severity measure.

K Kroenke, R L Spitzer, J B Williams (2001)

While considerable attention has focused on improving the detection of depression, assessment of severity is also important in guiding treatment decisions. Therefore, we examined the validity of a brief, new measure of depression severity. The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. The PHQ-9 is the depression module, which scores each of the 9 DSM-IV criteria as "0" (not at all) to "3" (nearly every day). The PHQ-9 was completed by 6,000 patients in 8 primary care clinics and 7 obstetrics-gynecology clinics. Construct validity was assessed using the 20-item Short-Form General Health Survey, self-reported sick days and clinic visits, and symptom-related difficulty. Criterion validity was assessed against an independent structured mental health professional (MHP) interview in a sample of 580 patients. As PHQ-9 depression severity increased, there was a substantial decrease in functional status on all 6 SF-20 subscales. Also, symptom-related difficulty, sick days, and health care utilization increased. Using the MHP reinterview as the criterion standard, a PHQ-9 score > or =10 had a sensitivity of 88% and a specificity of 88% for major depression. PHQ-9 scores of 5, 10, 15, and 20 represented mild, moderate, moderately severe, and severe depression, respectively. Results were similar in the primary care and obstetrics-gynecology samples. In addition to making criteria-based diagnoses of depressive disorders, the PHQ-9 is also a reliable and valid measure of depression severity. These characteristics plus its brevity make the PHQ-9 a useful clinical and research tool.

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The PHQ-9

Kurt Kroenke, Robert L Spitzer, Janet B W Williams (2001)

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Author and article information

Contributors

Clarissa Giebel:

ORCID: https://orcid.org/0000-0002-0746-0566

Clarissa.giebel@liverpool.ac.uk

Journal

Journal ID (nlm-ta): Int J Geriatr Psychiatry

Journal ID (iso-abbrev): Int J Geriatr Psychiatry

Journal ID (doi): 10.1002/(ISSN)1099-1166

Journal ID (publisher-id): GPS

Title: International Journal of Geriatric Psychiatry

Publisher: John Wiley and Sons Inc. (Hoboken )

ISSN (Print): 0885-6230

ISSN (Electronic): 1099-1166

Publication date (Electronic): 25 September 2020

Electronic Location Identifier: 10.1002/gps.5434

Affiliations

[ ¹ ] Department of Primary Care and Mental Health University of Liverpool Liverpool UK

[ ² ] NIHR ARC NWC Liverpool UK

[ ³ ] Centre for Applied Dementia Studies University of Bradford Bradford UK

[ ⁴ ] Division of Psychiatry University College London London UK

[ ⁵ ] Camden and Islington NHS Foundation Trust London UK

[ ⁶ ] Sefton Older People's Forum Sefton UK

[ ⁷ ] Lewy Body Society Wigan UK

[ ⁸ ] Lancashire Care NHS Foundation Trust Preston UK

[ ⁹ ] Department of Modern Languages and Cultures University of Liverpool Liverpool UK

[ ¹⁰ ] Together in Dementia Everyday (TIDE) Liverpool UK

[ ¹¹ ] SURF Liverpool Liverpool UK

[ ¹² ] Mersey Care NHS Foundation Trust Prescot UK

[ ¹³ ] EQE Health Liverpool UK

[ ¹⁴ ] Me2U Day Care Centre Liverpool UK

[ ¹⁵ ] National Museums Liverpool Liverpool UK

[ ¹⁶ ] North West Boroughs NHS Trust Warrington UK

[ ¹⁷ ] Liverpool Dementia Action Alliance Liverpool UK

[ ¹⁸ ] Faculty of Health and Wellbeing UCLAN Preston UK

[ ¹⁹ ] Department of Health Research Lancaster University Lancaster UK

[ ²⁰ ] The Brain Charity Liverpool UK

[ ²¹ ] School of Psychology University of Liverpool Liverpool UK

Author notes

[*] [* ] Correspondence

Clarissa Giebel, University of Liverpool, Waterhouse Building 2nd Floor, 1‐5 Brownlow St, Liverpool L69 3GL, UK.

Email: Clarissa.giebel@ 123456liverpool.ac.uk

Author information

Clarissa Giebel https://orcid.org/0000-0002-0746-0566

Claudia Cooper https://orcid.org/0000-0002-2777-7616

Article

Publisher ID: GPS5434

DOI: 10.1002/gps.5434

PMC ID: 7536967

PubMed ID: 32946619

SO-VID: 3f25e032-ef5b-4cdd-9fdd-cd199b04ef7b

License:

This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

History

Date received : 29 June 2020

Date accepted : 16 September 2020

Page count

Figures: 2, Tables: 3, Pages: 10, Words: 0

Funding

Funded by: National Institute for Health Research , open-funder-registry 10.13039/501100000272;

Award ID: ARC NWC

Funded by: University of Liverpool , open-funder-registry 10.13039/501100000836;

Award ID: COVID‐19 Strategic Research Fund

Custom metadata

source-schema-version-number 2.0

edited-state corrected-proof

details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:5.9.2 mode:remove_FC converted:06.10.2020

ScienceOpen disciplines: Geriatric medicine

Keywords: caring,covid‐19,dementia,quality of life,social care,well‐being

Data availability:

ScienceOpen disciplines: Geriatric medicine

Keywords: caring, covid‐19, dementia, quality of life, social care, well‐being

A UK survey of COVID‐19 related social support closures and their effects on older people, people with dementia, and carers

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UCL: Covid-19 Research

Most cited references 30

A brief measure for assessing generalized anxiety disorder: the GAD-7.

The PHQ-9: validity of a brief depression severity measure.

The PHQ-9

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