Were Older Adults More Vulnerable to Generalized Anxiety Disorder during the COVID-19 Pandemic? the Role Played By the COVID-19 Vaccination

Background: Prior to the Coronavirus 2019 (COVID-19) pandemic, older adults were more susceptible to Generalized Anxiety Disorders (GAD) than their counterparts who were middle-aged and young adults. Recent literature suggests that the fear of COVID-19 itself contributed to poor mental health conditions among the U.S. adult population during the pandemic (Fitzpatrick et al., 2020). To contain the spread of COVID-19, the majority of the U.S. population has experienced stay-at-home restrictions since the outbreak of the pandemic. However, whether older adults and their counterparts exhibited different mental health outcomes as a result of these restrictions has not been investigated. As of March 2021, nearly 69 percent of older adults in the U.S. had received at least one dose of the COVID-19 vaccine and 42 percent fully vaccinated (The White House, 2021). A recent study found people who feared the COVID-19 infection were likely to receive the vaccine (Sekizawa et al., 2022). Yet, to what extent the progressive effect of COVID-19 vaccination on GAD had not been examined. We address the following two research questions:

1. Have older adults in the U.S. continued to be more susceptible to GAD than their counterparts during the pandemic?
2. Have progressive levels of COVID-19 vaccinations helped alleviate GAD in the U.S., especially among older adults?

Methods: To answer these questions, we analyzed the Household Pulse Survey data collected by the U.S. Census (N= 63,775) representing the U.S. adult population in March 2021. We first used population-weighted two-way cross tabulations with Pearson X² to examine the relative prevalence of GAD (Spitzer et al., 2007), contingent upon a series of sociodemographic characteristics, including older adults (age 65+) and different stages in the progress of receiving COVID-19 vaccine (not vaccinated, partially vaccinated, or fully vaccinated). To test the main effect of older adult status and the interaction effect of older adult status on different stages of the vaccination, we then employed two population-weighted logistic regression models to estimate the probabilities of having GAD.

Results: Older adults had a lower prevalence of GAD than their adult counterparts in age between 18 and 65 years (18% vs. 34%, p < 0.01). Compared to unvaccinated adults (35.12%), GAD was less prevalent among adults who were partially vaccinated (25.39%), and least prevalent among fully vaccinated adults (24.73%). Compared to unvaccinated older adults, the odds of having GAD were substantially reduced for older adults who were partially vaccinated [Odds ratio (OR) = 0.57, p < 0.10], and even more significantly for older adults who were fully vaccinated (OR = 0.69, p < 0.01).

Conclusions and Implications: During the pandemic, older adults were less susceptible to GAD than their counterparts. This implies that the impacts of stay-at-home restrictions on mental health conditions among U.S. adults may differ by age group. The COVID-19 vaccination is a protective factor against GAD for adults across all age ranges. Our study first provides evidence as disaster response, rapid deployment of the COVID-19 vaccines played an effective role in suppressing GAD during the pandemic, especially among older adults.