Interruptions in Mental Health Care,Cannabis Use,Depression, and Anxiety during the COVID-19 Pandemic: Findings from a Cohort of HIV-Positive and HIV-Negative MSM in Los Angeles,California

The objective was to examine the impact of the COVID-19 pandemic on mental health care, cannabis use, and behaviors that increase the risk of STIs among men living with or at high risk for HIV. Data were from mSTUDY — a cohort of men who have sex with men in Los Angeles, California. Participants who were 18 to 45 years and a half were HIV-positive. mSTUDY started in 2014, and at baseline and semiannual visits, information was collected on substance use, mental health, and sexual behaviors. We analyzed data from 737 study visits from March 2020 through August 2021. Compared to visits prior to the COVID-19 pandemic, there were significant increases in depressive symptomatology (CES-D ≥ 16) and anxiety (GAD-7 ≥ 10). These increases were highest immediately following the start of the pandemic and reverted to pre-pandemic levels within 17 months. Interruptions in mental health care were associated with higher substance use (especially cannabis) for managing anxiety/depression related to the pandemic (50% vs. 31%; p-value < .01). Cannabis use for managing pandemic-related anxiety/depression was higher among those reporting changes in sexual activity (53% vs. 36%; p-value = 0.01) and was independently associated with having more than one sex partner in the prior 2 weeks (adjusted OR = 1.5; 95% CI 1.0–2.4). Our findings indicate increases in substance use, in particular cannabis, linked directly to experiences resulting from the COVID-19 pandemic and the associated interruptions in mental health care. Strategies that deliver services without direct client contact are essential for populations at high risk for negative sexual and mental health outcomes.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11524-022-00607-9.     

Women's Substance Use and Mental Health During the COVID-19 Pandemic

PurposeWomen are experiencing greater unemployment and increased stress from childcare responsibilities than men during the COVID-19 pandemic. Women with these experiences may be at particular risk for mental illness and increased substance use during the COVID-19 pandemic. The purpose of the study was to assess women's substance use, mental health, and experiences of COVID-19 pandemic impacts.MethodsA national online survey was administered to adult women from September to November 2020. The survey included questionnaires assessing mental health, loneliness, intolerance for uncertainty, social support, substance use, and intimate partner violence (IPV).ResultsA total of 499 women responded; most were White, college educated, and in their mid-30s. Of the 20.24% who acknowledged at least one IPV problem, 29.7% stated that their IPV problems have gotten worse since the pandemic began, and 16.83% said that they have increased their drug or alcohol use to cope with their relationship problems. Anxiety, perceived daily impact of COVID-19, and lower self-efficacy were significant predictors of COVID-19 anxiety. Those with risky alcohol use had significantly higher anxiety (p = .028) and depression (p = .032) than those with low-risk alcohol use.ConclusionsGreater anxiety about COVID-19, greater reported changes in daily life due to the pandemic, and high-risk alcohol use are related to greater mental health–related distress among women. For some, IPV has gotten worse during the pandemic and drug or alcohol use is a coping mechanism.     

Caregiving Experiences and Health Conditions of Women Veteran and Non-Veteran Caregivers

BackgroundUnique experiences, for example, trauma, of women veteran caregivers may create differences in the caregiving experience and may be associated with health concerns. We examined caregiving factors and health concerns in women veteran caregivers compared to non-veteran women (civilian) caregivers, and identified variables associated with being a woman veteran caregiver.MethodsWe conducted secondary data analyses using data from a multistate survey to examine sociodemographics, the caregiver experience (relationship to recipient, duration as caregiver, hours of care provided, area help is needed, and greatest difficulty faced as a caregiver); emotional support; life satisfaction; lifestyle behaviors; general, physical, and mental health; and chronic conditions in women informal caregivers.FindingsOf women caregivers, more veteran caregivers provided activities of daily living (ADL) help (33%) than non-veteran caregivers (21%; p = .02). There were no differences in years as a caregiver, hours of care provided, or the relationship to the recipient. Poor sleep and poor mental health were experienced by more women veteran caregivers (vs. non-veteran), but physical health, general health, and chronic condition prevalence did not differ. Women veteran caregivers had twofold greater odds of being Black, never married, college educated, and providing ADL assistance. Odds of obesity were lower for women veteran caregivers relative to other women caregivers.ConclusionsWomen veteran caregivers experience health concerns, including sleeplessness, poor mental health, and some chronic conditions. Our cohort were young women, yet had concerns that may be exacerbated by being a veteran and assuming a caregiver role. Comprehensive services to support their needs as veteran patients and as caregivers are needed.     

Depressive Symptoms Among Older Adults Pre– and Post–COVID-19 Pandemic

ObjectivesIt is a concern that public health measures to prevent older people contracting COVID-19 could lead to a rise in mental health problems such as depression.The aim of this study therefore is to examine trends of depressive symptoms before and during the COVID-19 pandemic in a large cohort of older people.DesignObservational study with 6-year follow-up.Setting & ParticipantsMore than 3000 community-dwelling adults aged ≥60 years participating in The Irish Longitudinal Study on Ageing (TILDA).MethodsMixed effects multilevel models were used to describe trends in depressive symptoms across 3 waves of TILDA: wave 4 (2016), wave 5 (2018), and a final wave conducted July-November 2020. Depressive symptoms were measured using the 8-item Center for Epidemiologic Studies Depression Scale (CES-D), with a score ≥9 indicating clinically significant symptoms.ResultsThe prevalence of clinically significant depressive symptoms at waves 4 and 5 was 7.2% [95% confidence interval (CI) 6.5, 7.9] and 7.2% (95% CI 6.5, 8.0), respectively. This more than doubled to 19.8% (95% CI 18.5, 21.2) during the COVID-19 pandemic. There was no change in CES-D scores between waves 4 and 5 (β = 0.09, 95% CI –0.04, 0.23), but a large increase in symptoms was observed during the pandemic (β = 2.20, 95% CI 2.07, 2.33). Age ≥70 years was independently associated with depressive symptoms (β = 0.45, 95% CI 0.18, 0.72) during the pandemic but not from wave 4 to 5 (β = 0.09, 95% CI –0.18, 0.36). Living with others was associated with a lower burden of symptoms during the pandemic (β = −0.40, 95% CI –0.71, −0.09) but not between waves 4 and 5 (β = −0.40, 95% CI –0.71, −0.09).Conclusions and ImplicationsThis study demonstrates significant increases in the burden of depressive symptoms among older people during the COVID-19 pandemic, particularly those aged ≥70 years and/or living alone. Even a small increase in the incidence of late life depression can have major implications for health care systems and societies in general. Improving access to age-attuned mental health care should therefore be a priority.     

The Impact of Music and Memory on Resident Level Outcomes in California Nursing Homes

ObjectivesTo study the effects of a nonpharmacologic intervention, Music and Memory (M&M), on residents with dementia and/or behavioral problems living in nursing homes (NHs).DesignThis was a prospective, mixed-methods cohort study.Setting and ParticipantsIn total, 4107 residents in 265 California NHs and that reported data at least twice during the 3-year study period were enrolled.MeasuresWe used a quarterly rolling enrollment process; participants provided data at baseline and quarterly via an online survey that included select resident level data from the Minimum Data Set (psychotropic drug use, cognition, behaviors, mood, pain, and falls), experience with the M&M program, and resident use of music. NHs were eligible if they were Medicare- and Medicaid-certified and had 15 residents with a diagnosis of dementia or cognitive impairment or exhibited significant behavioral symptoms.ResultsM&M was associated with reductions in psychotropic medication use, reduced behaviors, and improved mood. The odds of antipsychotic use declined by about 11%, of antianxiety medications by 17%, and antidepressants by 9% per quarter. Aggressive behaviors, depressive symptoms, pain, and falls also declined significantly over time. The odds of residents exhibiting aggressive behaviors declined by 20% per quarter, depressive symptoms by 16%, reported pain by 17%, and falls by 8%.Conclusions and ImplicationsThis is the largest study of M&M to date. We found clinically and statistically significant reductions in psychotropic medications and improved behaviors in residents using M&M. Although the study showed positive results overall, the lack of a control group was a significant limitation that precluded determining how much more improvement participating residents experienced compared with nonparticipants. Future studies should include a control group so that better conclusions can be drawn regarding the effectiveness of the M&M program.     

Caring for a Relative With Dementia in Long-Term Care During COVID-19

ObjectivesThe COVID-19 pandemic created unique stressors for caregivers of persons with dementia living in long-term care (LTC) facilities. The purpose of this qualitative study was to identify the challenges associated with caring for a relative with dementia in LTC during the pandemic, as well as resources, strategies, and practices caregivers found helpful in coping with COVID-19.DesignThis study was conducted within the context of an ongoing randomized controlled trial of a psychosocial intervention to support caregivers. Open-ended survey responses (n = 125) and semistructured interviews with a subset of the sample (n = 20) collected between June 2020 and June 2021 explored caregivers' experiences during COVID-19.Setting and ParticipantsParticipants included 125 family caregivers of persons with dementia living in residential LTC.MethodsThematic analysis was used to identify themes capturing caregivers' experiences.ResultsIn addition to concerns about COVID-19 infection, participants reported key challenges such as the difficulty of maintaining contact with relatives because of visiting restrictions, lack of information about relatives' health and well-being, worries about overburdened LTC staff, impossibility of returning relatives home from the LTC facility, and fears about relatives dying alone. Participants also identified resources, strategies, and practices that they perceived as helpful, including effective infection prevention within the LTC facility, good communication with LTC staff, and creative strategies for connecting with their relatives.Conclusions and ImplicationsThis qualitative analysis informs recommendations for practice within LTC facilities, as well as supports that may help caregivers manage stressful situations in the context of COVID-19. Vaccination and testing protocols should be implemented to maximize family caregivers' opportunities for in-person contact with relatives in LTC, as alternative visiting modalities were often unsatisfactory or unfeasible. Informing caregivers regularly about individual residents' needs and status is crucial. Supports for bereaved caregivers should address complicated grief and feelings of loss.     

Investigating the early impacts of the COVID-19 pandemic on modifiable risk factors for cancer and chronic disease: a repeated cross-sectional study in Alberta,Canada

ObjectivesThis study contributes to empirical evidence by examining the impact of the first and second waves of the COVID-19 pandemic on modifiable risk factors (MRF) and whether these patterns differ according to level of material deprivation among people living in Alberta.MethodsUsing data from a repeated cross-sectional provincial health survey (Alberta Community Health Survey (ACHS): 2018–2021), we conducted logistic regression analyses examining the impacts of the COVID-19 pandemic on meeting national guidelines on four MRFs (tobacco use, physical activity, fruit and vegetable consumption, alcohol use) (n=11,249). We compared population-level changes in MRFs from one year before the COVID-19 pandemic (March 2019–February 2020) to one year during the pandemic (March 2020–February 2021) in Alberta. We also assessed whether these trends differed by a measure of material deprivation.ResultsCompared to the pre-COVID-19 period, the fully adjusted odds of meeting recommended guidelines for fruit and vegetable consumption (OR=0.42) decreased during the pandemic. Individuals experiencing high material deprivation had lower odds of meeting recommended guidelines for physical activity (OR=0.65) and higher odds of not being current tobacco users (OR=1.36) during the pandemic versus during the pre-pandemic period.ConclusionAt a population level, analyses from the ACHS showed minimal impacts of the first year of the COVID-19 pandemic on MRFs, besides fruit and vegetable consumption. Yet, stratifying results showed statistically significant differences in pandemic impacts on MRFs by level of material deprivation. Therefore, understanding the influence of material deprivation on MRFs during the pandemic is key to tailoring future public health interventions promoting health and preventing cancer and chronic disease.     

Changes in Satisfaction with Meaningful Activities and Onset of Depressive Symptoms among Community-Dwelling Japanese Older Adults: A Population-Based Study Before and During the COVID-19 Pandemic

ObjectivesThis study aimed to clarify the association between changes in satisfaction with meaningful activities and the occurrence of depressive symptoms before and during the coronavirus disease 2019 (COVID-19) pandemic.DesignA population-based prospective cohort study (Tarumizu Study).Setting and ParticipantsA total of 231 community-dwelling older adults aged ≥65 years without depressive symptoms at baseline.MethodsThe participants completed baseline (June to December 2018, before the COVID-19 pandemic) and follow-up (September to December 2021, during the COVID-19 pandemic) assessments. Depressive symptoms were assessed using the 15-item Geriatric Depression Scale (GDS-15) and defined by a GDS-15 score of ≥5. Participants selected meaningful activities from the 95 activities included in the Aid for Decision-Making in Occupation Choice, and their satisfaction levels were evaluated. Satisfaction with the most meaningful activities was assessed as to whether it was maintained/improved or decreased at follow-up.ResultsIn the follow-up survey, 31 (14.3%) participants reported the occurrence of depressive symptoms. Compared with before the COVID-19 pandemic, the rates of meaningful activities during the COVID-19 pandemic decreased for interpersonal interaction and social life and increased for leisure, sports, self-care, and domestic life. Logistic regression analysis revealed that changes in satisfaction with meaningful activity were associated with the occurrence of depressive symptoms after adjusting for demographic variables, baseline GDS scores, cognitive and physical status, and instrumental activities of daily living (odds ratio, 2.78; 95% confidence interval, 1.17–6.59, P = .020).Conclusions and ImplicationsTo avoid decreasing satisfaction with meaningful activities, supporting older adults may be protective against the occurrence of depressive symptoms. Our findings highlight the need for health care professionals to not only encourage older adults to participate in activities for their mental health but also consider whether the activities are meaningful or satisfying for them.     

Training Needs Among Family Caregivers Assisting During Home Health,as Identified by Home Health Clinicians

ObjectivesTo estimate the proportion of family caregivers assisting older adults during Medicare home health who have an identified need for activity-specific training and identify characteristics associated with caregiver training needs.DesignNationally representative retrospective cohort study.Setting and Participants1758 (weighted n = 8,477,990) Medicare beneficiaries who participated in the National Health and Aging Trends Study (NHATS) and received Medicare-funded home health care between 2011 and 2016.MeasuresOlder adult and caregiving network characteristics before home health (sociodemographic factors, caregiver assistance, older adult health and function) were drawn from NHATS; characteristics during home health (family caregiver training needs, older adult health and function) were drawn from home health patient assessments. Weighted proportions of family caregivers with an identified need for activity-specific training were estimated. Weighted, multivariable logistic regressions modeled associations between older adult/caregiving network characteristics and family caregivers’ identified activity-specific training needs during home health.ResultsMore than 1 in 3 (35.7%) family caregivers assisting older adults during Medicare home health had an identified training need with at least 1 caregiving activity. Rates of need for training varied widely, from 8.6% among caregivers helping with advocacy to 48.2% among caregivers helping with medical procedures. In weighted analyses that adjusted for older adults’ health and function, family caregivers were less likely to have identified training needs when assisting older adults with ongoing disability or who received caregiver assistance before home health admission.Conclusions and ImplicationsFindings highlight the pervasiveness of family caregivers' training needs, particularly with medically oriented activities, and indicate that escalations in older adults’ care needs are linked to caregiver training needs. Therefore, transitions of care may present critical opportunities to connect family caregivers with training resources.     

The role of resilience and coping among Italian healthcare workers during the COVID-19 pandemic

Objective:To evaluate the psychological state of healthcare workers (HCWs) in the field of rehabilitation during the COVID-19 pandemic.Methods:Cross-sectional observational study. Sample of 334 HCWs including: nurses, medical doctors, therapists, scientists, and clerical workers working at the IRCCS San Raffaele Roma rehabilitation hospital during the second wave of the COVID-19 pandemic. Anonymous web-based questionnaire included 14-item Resilience Scale, Brief-COPE, Hospital Anxiety Depression Scale, Fear of COVID-19 Scale. Occupational and sociodemographic characteristics.Results:High levels of resilience, low levels of anxiety, depression, and fear were observed in the study population; the most frequently used coping strategies in the Brief-COPE were acceptance, planning, and active coping. Specifically, 87% of the participants reported a moderate to high level of resilience, with the highest level observed in nurses while physicians show the lowest level. HCWs showed symptoms of anxiety (29%), depressive symptoms (10%), and fear caused by the COVID-19 pandemic (44%). Statistically significant differences were observed between different occupations for fear (p <0.05) and resilience (p <0.01). Levels of anxiety and fear appeared to be higher in female and younger workers. The latter group - who also reported higher levels of depression - showed lower levels of resilience.Conclusions:In our study hospital and non-hospital workers show different emotional, cognitive, and behavioural resources when facing stressful situations, like in the case of the SARS-CoV-2 pandemics. Our results support the role of resilience and the proper use of problem-focused and emotion-focused coping strategies as protective factors from psychological distress.     

COVID-19-related music-video-watching among the Vietnamese population: lessons on health education

BackgroundHealth education through music video plays a vital role in raising a person''s knowledge, attitudes, and behaviors positively connected to health during COVID-19 pandemic.ObjectiveThis study aimed to estimate the prevalence of COVID-19-related music-video-watching and examine associated factors among the Vietnamese population.MethodsA cross-sectional study in Vietnam was conducted in February 2021 via the Internet.ResultsAmong 658 participants, the prevalence of COVID-19-related music-video-watching was 89.1% among people. In the multivariable regression models, significant factors for COVID-19-related music-video-watching were living area, types of housemate, age groups, and current occupation.ConclusionsLessons on health education to fight against the COVID-19 pandemic in Vietnam could be useful for similar settings in the world.     

Who Is Caring for the Caregiver? The Role of Cybercoping for Dementia Caregivers

ABSTRACT

The purpose of this study is to investigate the relationship between dementia caregivers’ communication behaviors (information seeking and forwarding) and their outcomes (coping outcomes: e.g., dealing better with negative feelings or improved medical outcomes). A survey data set of dementia patients’ caregivers substantiates the effects of communication behaviors about dementia illness on coping outcomes, as well as the mediating role of emotion-focused and problem-focused coping processes. Using structural equation modeling (SEM), this study found positive effects of communication behaviors on outcomes through coping processes. Further, the results indicate that communication behaviors in cyberspace are crucial for caregivers to cope with dementia, both affectively (improvement of caregivers’ emotional control) and physically (health improvement of patients). The implications for the improvement of public health through online health communication behaviors are discussed.     

Psychological and behavioral responses during the COVID-19 pandemic among individuals with mobility and/or self-care disabilities

BackgroundThe lockdowns during the COVID-19 pandemic created major obstacles for individuals with disabilities to obtain support in their daily living.ObjectivesThis study was to examine the psychological and behavioral responses of US individuals with mobility and/or self-care disabilities during the pandemic.MethodsFrom a nationally representative longitudinal survey (n = 6403) administered during the pandemic, individuals were classified at baseline as having no mobility/self-care disability (ADL = 0, n = 4975), mobility or self-care disability (ADL = 1, n = 1061), and both mobility and self-care disabilities (ADL = 2, n = 367). Weighted mean of baseline mental distress scores (PHQ4), psychological risk factors (loneliness, stress, perceived COVID risk), resilience, and coping were compared among these groups. Random effects models were employed to assess the effects of disability and disability-moderated effects of risk factors on mental distress.ResultsAt baseline, mental distress increased with greater ADL disabilities (Mean[95%CI] = 1.88[1.77, 1.98], 2.54[2.29, 2.79], and 3.55[3.01, 4.08] for ADL = 0, 1, and 2, respectively, p < .0001). Loneliness, stress, and perceived risk increased with ADL disabilities, but resilience and social coping decreased with it (p's < 0.0001). In the random-effects models, greater ADL disabilities, higher psychological risks, and use of cannabis and other recreational drugs were associated with greater mental distress. Greater ADL disabilities augmented the detrimental effects of risk factors on mental health, but resilience protected mental health both independently and through a buffering effect on its risk factors across all groups.ConclusionIndividuals with mobility and/or self-care disability tend to have poorer mental health and are differentially more affected by its risk factors. Mental health professionals should address these modifiable factors in interventions.     

Psychopathology Symptoms are Associated with Prenatal Health Practices in Pregnant Women with Heavy Smoking Levels

Purpose

Smoking during pregnancy may be linked to other problematic prenatal health behaviors in women. We examined interrelationships among prenatal smoking, prenatal health behaviors and mental health. The objective of this study was to examine factors that may contribute to variations in prenatal health practices among women who smoke during pregnancy.

Methods

Birth mothers from an adoption study (N?=?912) were interviewed about prenatal smoking, health behaviors, and mental health symptoms at 5 months postpartum.

Results

One-quarter of participants (N?=?222) reported smoking 6 or more cigarettes daily for at least 1 trimester. For mothers who smoked more than 6 cigarettes daily, higher levels of antisocial behaviors (β?=????.14, p?=?.03) and depressive symptoms (β?=????.17, p?=?.03) were associated with less frequent prenatal folate use; antisocial behaviors and depressive symptoms were not associated for prenatal folate use among women who did not smoke more than 6 cigarettes daily. For mothers who did not smoke more than 6 cigarettes daily, more depressive symptoms were associated with fewer prenatal care visits (β?=?.12, p?=?.01). Antisocial behaviors and anxiety symptoms were not associated with prenatal care visits in either group of mothers.

Conclusions for Practice

Maternal antisocial behaviors and depressive symptoms during pregnancy may be markers for poorer adherence to recommendations for folate supplementation among women who smoke 6 or more cigarettes daily during pregnancy, independent of adequacy of prenatal care.

     

Living Alone and Depressive Symptoms among Older Adults in the COVID-19 Pandemic: Role of Non–Face-to-Face Social Interactions

ObjectiveThis study examined the association of living alone with changes in depressive symptom status and the moderating effect of non–face-to-face social interactions among older adults during the coronavirus disease (COVID-19) pandemic.DesignA longitudinal study.Setting and ParticipantsThis study recruited individuals aged ≥ 65 years without long-term care in one semi-urban city in Japan, who completed mailed questionnaires in March (baseline) and October 2020 (follow-up).MethodsBased on depressive symptoms assessed by the Two-Question Screening at baseline and follow-up, participants were classified as: “non-case,” “onset,” “remission,” and “persistence.” Non–face-to-face social interactions during the pandemic, including phone calls or emails with separated families or friends, were dichotomized as “less than weekly interactions” and “weekly interactions.” A multinomial logistic regression analysis was conducted to examine the association of living arrangement (living alone or together) with changes in depressive symptoms status.ResultsData of 1001 participants were analyzed (mean age = 79.9 years). Of them, 13.8% lived alone. Overall, 40.6% participants were grouped as “non-case,” 11.7% as “onset,” 11.0% as “remission,” and 27.1% as “persistence.” Living alone was significantly associated with depressive symptom onset (odds ratio: 1.92; 95% CI: 1.03–3.56; P = .039), and a negative interaction (protective effect) was found between living alone and weekly non–face-to-face social interactions for depressive symptom onset.Conclusion and ImplicationsDuring the pandemic, older adults living alone had a higher depressive symptom risk, but non–face-to-face social interactions may have buffered this risk. Our findings suggest the importance of supporting older adults living alone in times of social restrictions such as the pandemic, and furthermore, maintaining social connections, including non–face-to-face relationships, is necessary to protect their mental health.     

Spouse and Adult-Child Dementia Caregivers in Chinese American Families: Who Are More Stressed Out?

ObjectivesThough many studies have explored differences between spouses and adult children in dementia care, empirical evidence is lacking on racial- and ethnic-minority populations. To fill this research gap, this study examined care tasks, caregiver burden, and depressive symptoms of Chinese spouse and adult-child caregivers in dementia care. Guided by the stress process model, this study asked 3 questions: Do spouse and adult-child caregivers take up different care tasks and experience different levels of caregiver burden and depressive symptoms? Does gender moderate the differences between spouse and adult-child caregivers? Whether care tasks and burden mediate the association between being a spouse/adult-child caregiver and depressive symptoms?Setting and ParticipantsData were collected from a questionnaire-based survey of Chinese Americans who provided care for their family members with dementia in New York City. The analytical sample included 126 Chinese spouse or adult-child caregivers.MethodsCare tasks was indicated by intensity of 8 types of care tasks. Caregiver burden and depressive symptoms were measured by Zarit's Burden Interview and the 10-item Center for Epidemiologic Studies Depression Scale. Linear regression, interaction term (spouse/adult-child caregiver by gender), and path analysis were conducted to address the 3 questions.ResultsThe results of linear regression show no significant difference in care tasks between the 2 groups, but spouse caregivers had significantly higher levels of caregiver burden and depressive symptoms than adult children. Wives had higher levels of caregiver burden and depressive symptoms than husbands, daughters, and sons. Caregiver burden mediated the association between being a spouse caregiver and higher depressive symptoms, whereas care tasks did not shape such association.Conclusions and ImplicationsThis study highlighted the emotional stress of Chinese American older adults in providing care for their spouses. The findings indicate the necessity of developing culturally meaningful activities to support Chinese American spouse caregivers.     

Food-Seeking Behaviors and Food Insecurity Risk During the Coronavirus Disease 2019 Pandemic

ObjectiveFood insecurity risk increases among disaster-struck individuals. The authors employed the social determinants of health framework to (1) describe the characteristics and food-seeking behaviors of individuals coping with the coronavirus disease 2019 pandemic and (2) evaluate the relationship between these factors and food insecurity risk.DesignA cross-sectional Qualtrics survey was administered May 14–June 8, 2020.ParticipantsAdults living in New York were recruited online (n = 410).Main Outcome MeasureFood insecurity risk.AnalysisLogistic regression analyses were conducted using a model-building approach.ResultsA total of 38.5% of the sample was considered food insecure after the coronavirus disease 2019 outbreak. The final model revealed that not knowing where to find help to acquire food, reporting that more food assistance program benefits would be helpful, being an essential worker, having general anxiety, and being a college student were risk factors for food insecurity regardless of demographic characteristics.Conclusions and ImplicationsWith more individuals experiencing food insecurity for the first time, there is a need for enhanced outreach and support. The findings complement emerging research on food insecurity risk during and after the pandemic and can help to inform food assistance programs and policies.     

Patient-Related Factors Associated With Depressive State in Caregivers of Patients With Dementia at Home

ObjectvesTo identify patient-related factors associated with depressive state in caregivers of patients with dementia, we investigated the caregivers' and patients' characteristics in relation to the depressive state in their caregivers.DesignProspective hospital-based cohort study.SettingTwo memory clinics in Japan.ParticipantsOutpatients with dementia (n = 135) and their caregivers at home.MeasurementsThe outpatients and their caregivers were divided into 2 groups according to the Center for Epidemiologic Studies Depression Scale for caregivers. To identify the patient-related factors that cause depressive state in caregivers, Mini-Mental State Examination (MMSE), the Physical Self-Maintenance Scale for fundamental activities of daily living (ADL), and the instrumental ADL scale (IADL) scores for instrumental ADL and the neuropsychiatric inventory (NPI) subscale score for behavioral and psychological symptoms of dementia were compared between the 2 groups. We used logistic regression to determine the independent predictors of caregiver depressive state.ResultsThere was no significant difference in MMSE score between the 2 groups. Logistic regression analysis revealed that the depressive state in caregivers was related with IADL score and delusion in NPI subscale of patients.ConclusionsDepressive state in caregivers was independent of the decline in cognitive function in patients with dementia but was associated with decline in instrumental ADL and severity of delusion.