Stress Related to COVID-19, Anxiety and Resilience Among Middle-Aged and Older Adults

Background and Purpose

Many people have suffered from stress, loneliness, and anxiety caused by the COVID-19 pandemic (Havnen et al., 2020; Luchetti et al., 2020). However, previous studies have shown that resilience may help people move forward despite distressful situations (PeConga et al., 2020). The current study investigated stress related to COVID-19, loneliness, and anxiety among middle-aged and older adults in the areas of South Korea with the largest COVID-19 outbreaks. Perceived physical health (hereafter referred to as health), marital status, income, and family cohesion were also investigated, focusing on moderating effects of resilience. The research aimed to investigate (1) factors affecting the association between stress related to COVID-19 (hereafter, stress) and anxiety and (2) the moderating effects of resilience on this association.

Methods

Data was collected from 667 middle-aged and older adults (ages 40 through 76) living in the largest COVID-19 outbreak areas in South Korea at the time of this survey. The dependent variable, anxiety (α = .922) was measured by the GAD-7 (Spitzer et al., 2006). Loneliness (α = .855) was measured by three items (Hughes et al., 2004), resilience (α=.837) was measured using the Brief Resilience Scale (Smith et al., 2008), and family cohesion (α=.894) was measured using four items based on the Brief Family Relationship Scale (Timg Fok et al., 2014). Stress related to COVID-19 (α=.877) was measured using seven items based on the survey questionnaire from Mohanty and colleagues (2020). Health, marital status, and income were also investigated. A multi-group path analysis using Amos 25 was employed and maximum likelihood (ML) estimation was used. Measurement invariance was examined by comparing unconstrained and fully constrained models. Both models fit.

Results

Stress related to COVID-19 and loneliness were positively associated with anxiety among people with both higher and lower levels of resilience. However, the impact of stress on anxiety was significantly stronger for people with lower levels of resilience than for people with higher levels of resilience. Health was negatively associated with anxiety only for people with lower levels of resilience, whereas family cohesion was negatively associated with anxiety only for people with higher levels of resilience. Family cohesion and being married were negatively associated with loneliness in both groups. Health and income were negatively associated with loneliness only for people with lower levels of resilience. Stress was positively associated with loneliness solely for those with lower levels of resilience. Moreover, stress was negatively associated with family cohesion for people with higher levels of resilience, whereas stress was positively associated with family cohesion for people with lower levels of resilience.

Conclusions and Implications

The study found that the moderating effects of resilience existed for stress related to COVID-19 and anxiety among the sample populations. Healthcare providers should develop client-oriented programs and services to boost resilience to reduce and prevent negative consequences of poor mental health among middle-aged and older adults and their family members during the pandemic.