Physical and mental health of 40,000 older women in England during the COVID-19 pandemic (2020–2021)

Abstract

Background To assess factors associated with perceived changes in physical and mental health and with delays in seeking healthcare during the second and third COVID-19 lockdowns in England (2020–2021). Methods An online survey of Million Women Study participants collected data on 44,523 women, mean age 76 (SD = 4), October 2020—May 2021. These data were linked to data collected prospectively on Million Women Study participants at recruitment in median year 1998 and at re-surveys in 2011–2013, as well as to hospital admission data from 2017–2019. Results Of 40,821 participants with complete data on the outcomes of interest, 28% reported worse physical health and 26% worse mental health. After adjustment for age, region, education and survey period, poor/fair self-rated health (adjusted OR 2.71, 95% CI 2.52–2.91), having been told to shield (1.92, 1.79–2.05), obesity (2.17, 2.04–2.31) and other measures of poor health prior to the outbreak were all strongly related to worse physical health, as was being an informal carer (1.47, 1.38–1.56) and having a COVID-19 infection (1.64, 1.53–1.77). Depression (2.31, 2.06–2.58), poor/fair self-rated health (1.98, 1.84–2.13) and being an informal carer (1.69, 95% CI 1.58–1.80) were the factors most strongly related to worse mental health. Having poor/fair self-rated health (2.22, 2.05–2.40), obesity (1.58, 1.47–1.70) and being an informal carer (1.45, 1.34–1.56) were all strongly related to delaying seeking medical care. These associations remained essentially unchanged after exclusion of participants who had a COVID-19 infection. Conclusions In a large sample of older women in England, just over a quarter reported a deterioration in their physical and mental health during the national lockdowns. In addition to the expected effect of a COVID-19 infection on physical health, the groups who were most likely to report such a deterioration were those with pre-existing morbidity and those who were caring for others as informal carers.