Perceived Stress and Loneliness During the COVID-19 Pandemic in a Cognitive Aging Cohort

Background: The COVID-19 pandemic has had disproportionate effects on the health and well-being of older adults. Little is known about the effects of isolation and social distancing measures on the mental health of older adults with cognitive impairment. Method: 194 participants from the Wake Forest Alzheimer’s Disease Research Center (ADRC) Clinical Core cohort adjudicated as cognitively normal (CN, n = 129), and mild cognitive impairment (MCI, n = 65) were given questionnaires cross-sectionally measuring loneliness, perceived stress, well-being, and coping style. We created multivariable regression models (adjusted for age, sex, race, and education) to assess relationships among dependent variables, loneliness and perceived stress, and independent variables of interest, well-being and coping style (Table 2). Result: Overall, the mean age was 72±8 years. Table 1 lists baseline demographic and study measures for CN and MCI groups. Table 2 shows associations between dependent variables (perceived stress, loneliness) and independent variables of interest. Participants with MCI had significantly higher levels of loneliness (B = 3.30; p = 0.03) than CN participants. Participants who reported lower eudaimonic and hedonic well-being had higher levels of perceived stress and loneliness (p < 0.01), and those who endorsed using self-blame and behavioral disengagement to cope with stress had higher perceived stress (B = 3.06, = < 0.01) and loneliness (B = 7.84, p < 0.01). There was no interaction by cognitive diagnosis. Conclusion: Participants with MCI had higher levels of loneliness, but not perceived stress, than those with normal cognition. We found that participants expressing high feelings of well-being had significantly lower, and participants reporting a coping style with self-blame and behavioral disengagement had significantly higher perceived stress and loneliness. Next steps involve exploring associations of neuroimaging and Alzheimer’s disease biomarkers with perceived stress and loneliness and evaluating transcriptional measures of stress measured concurrently.