Trajectories of depression and anxiety during the COVID-19 pandemic in a population-based sample of middle-aged and older adults

The COVID-19 pandemic and the related governmental restrictions have greatly impacted the lives of people worldwide and have been suggested to negatively impact mental health. We describe the trajectories of depressive and anxiety symptoms during the pandemic and their determinants in a large population-based sample of middle-aged and older adults. From April to June 2020, participants of the Rotterdam Study were asked to complete questionnaires including questions on depressive symptoms (Center of Epidemiological Studies Depression Scale, 10 item version) and anxiety symptoms (Hospital Anxiety and Depression Scale, anxiety subscale). We compared depressive and anxiety symptom scores to those before the pandemic and described its trajectories during the pandemic by demographic variables, chronic disease status and pre-pandemic clinically relevant depressive or anxiety symptoms. In total, 6241 participants responded to the questionnaires (mean age [standard deviation] 70.1 years [11.6]; 58% women). Participants more often reported clinically relevant depressive symptoms during than before the pandemic (19% vs. 12%, P < .001), which was similar for clinically relevant anxiety symptoms (17% vs. 12%, P < .001). During the pandemic, depressive symptoms persisted over time while anxiety symptoms improved. Depressive and anxiety symptoms were more common among women, persons living alone, with chronic diseases and with pre-pandemic clinically relevant symptoms, although the trajectories of these symptoms over time were broadly similar for the subgroups. Together, these results suggest that it is important to be aware of long-term depressive symptoms following the COVID-19 pandemic in the general population.