Levels and Predictors of COVID-19-Related Anxiety in Older Adults


  • Lina Mahmoud Ashour Department of Counseling Psychology, Philadelphia University, Amman, Jordan




Anxiety, Coping strategy, Coronavirus disease 2019, Depression, Older population, Stress


BACKGROUND: Prolonged quarantine during the COVID-19 outbreak is a stressful factor.

AIM: This study aims to analyze the psycho-emotional state of Jordan’s older population during the Covid-19 pandemic.

MATERIALS AND METHODS: The study on 620 older adults (mean age, 66.4±5.3 years) was conducted in 2020 in Amman (Jordan). All respondents were asked to complete an online survey on coping strategies, a HUDS questionnaire, and a specially designed questionnaire.

RESULTS: The dominant predictors of stress were uncertainty (62%) and a fear other family members getting ill (60%). Of all the respondents, 15% agreed with the necessity to prolong the quarantine period, 47% had a neutral attitude, and 38% exhibited a negative attitude. High levels of anxiety in older population were associated with the lower use of humor (H=11.498, p≤0.002). On the other hand, such respondents demonstrated the higher use of planning (H=6.227, p≤0.039), venting (H=11.087, p≤0.004), avoidance (H=7.457, p≤0.019), and active coping (H=6.043, p≤0.037).

CONCLUSIONS: Most of Covid-19 cases are registered in healthcare institutions and for that reason, there is a need to provide psychiatric care to medical workers who do not have the necessary experience in this area. This may also require the state to promote psychiatric care training.


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Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, et al. The psychological impact of quarantine and how to reduce it: Rapid review of the evidence. Lancet. 2020;395(10227):912-20. https://doi.org/10.1016/S0140-6736(20)30460-8 PMid:32112714

Everett JA, Colombatto C, Chituc V, Brady WJ, Crockett M. The Effectiveness of Moral Messages on Public Health Behavioral Intentions during the COVID-19 Pandemic. United States: World Bank; 2020. https://doi.org/10.31234/osf.io/9yqs8

Goodall J. Social rejection, exclusion, and shunning among the Gombe chimpanzees. Ethol Sociobiol. 1986;7(3-4):227-36. https://doi.org/10.1016/0162-3095(86)90050-6

Fancourt D, Bu F, WanMak H, Steptoe A. Covid-19 Social Study; 2021. Available from: https://www.marchnetwork.org/covid19study [Last accessed on 2021 Sep 25].

Manderson L, Levine S. COVID-19, risk, fear, and fall-out. Med Anthropol. 2020;39(5):367-70. https://doi.org/10.1080/01459740.2020.1746301 PMid:32212930

Brown EE, Kumar S, Rajji TK, Pollock BG, Mulsant BH. Anticipating and mitigating the impact of the COVID-19 pandemic on Alzheimer’s disease and related dementias. Am J Geriatr Psychiatry. 2020;28(7):712-21. https://doi.org/10.1016/j.jagp.2020.04.010 PMid:32331845

Wang Y, Di Y, Ye J, Wei W. Study on the public psychological states and its related factors during the outbreak of coronavirus disease 2019 (COVID-19) in some regions of China. Psychol Health Med. 2021;26(1):13-22. https://doi.org/10.1080/13548506.2020.1746817 PMid:32223317

Holmes EA, O’Connor RC, Perry VH, Tracey I, Wessely S, Arseneault L, et al. Multidisciplinary research priorities for the COVID-19 pandemic: A call for action for mental health science. Lancet Psychiatry. 2020;7(6):547-60. https://doi.org/10.1016/S2215-0366(20)30168-1 PMid:32304649

Rubin GJ, Wessely S. The psychological effects of quarantining a city. BMJ. 2020;368:313. https://doi.org/10.1136/bmj.m313 PMid:31992552

Schalle M, Murray DR. Pathogens, personality, and culture: Disease prevalence predicts worldwide variability in sociosexuality, extraversion, and openness to experience. J Pers Soc Psychol. 2008;95(1):212-21. https://doi.org/10.1037/0022-3514.95.1.212 PMid:18605861

Sorokowska A, Sorokowski P, Hilpert P, Cantarero K, Frackowiak T, Ahmadi K, et al. Preferred interpersonal distances: A global comparison. J Cross Cult Psychol. 2017;48(4):577-92. https://doi.org/10.1177%2F0022022117698039

Gunnell D, Appleby L, Arensman E, Hawton K, John A, Kapur N, et al. Suicide risk and prevention during the COVID- 19 pandemic. Lancet Psychiatry. 2020;7(6):468-71. https://doi.org/10.1016/S2215-0366(20)30171-1 PMid:32330430

Mahase Е. Covid-19: Mental health consequences of pandemic need urgent research. BMJ. 2020;369:m1515. https://doi.org/10.1136/bmj.m1515 PMid:32299806

Huang Y, Zhao N. Mental health burden for the public affected by the COVID-19 outbreak in China: Who will be the high-risk group? Psychol Health Med. 2021;26(1):23-34. https://doi.org/10.1080/13548506.2020.1754438 PMid:32286091

Huang Y, Wang Y, Wang H, Liu Z, Yu X, Yan J, et al. Prevalence of mental disorders in China: A cross-sectional epidemiological study. Lancet Psychiatry. 2019;6(3):211-24. https://doi.org/10.1016/S2215-0366(18)30511-X PMid:30792114

Rogers JP, Chesney E, Oliver D, Pollak TA, McGuire P, Fusar- Poli P, et al. Psychiatric and neuropsychiatric presentations associated with severe coronavirus infections: A systematic review and meta-analysis with comparison to the COVID-19 pandemic. Lancet Psychiatry. 2020;7(7):611-27. https://doi.org/10.1016/S2215-0366(20)30203-0 PMid:32437679

Mao L, Jin H, Wang M, Hu Y, Chen S, He Q, et al. Neurological manifestations of hospitalized patients with COVID- 19 in Wuhan, China: A retrospective case series study. JAMA Neurol. 2020;77(6):683-90. https://doi.org/10.1001/jamaneurol.2020.1127 PMid:32275288

Wighton K. Individual Response to COVID-19 “As Important” as Government Action. Imperial College London; 2020. Available from: https://www.imperial.ac.uk/news/195976/individual-response-covid-19-important-government-action [Last accessed on 2021 Sep 25].

Anderson RM, Heesterbeek H, Klinkenberg D, Hollingsworth TD. How will country-based mitigation measures influence the course of the COVID-19 epidemic? Lancet. 2020;395(10228):931-4. https://doi.org/10.1016/S0140-6736(20)30567-5 PMid:32164834

Wang J, Lloyd-Evans B, Giacco D, Forsyth R, Nebo C, Mann F, et al. Social isolation in mental health: A conceptual and methodological review. Soc Psychiatry Psychiatr Epidemiol. 2017;52(12):1451-61. https://doi.org/10.1007/s00127-017-1446-1 PMid:29080941

Khosravi M. Stress reduction model of COVID-19 pandemic. Iran J Psychiatry Behav Sci. 2020;14(2):e103865. https://doi.org/10.5812/ijpbs.103865

Khosravi M. COVID-19 quarantine: Two-way interaction between physical activity and mental health. Eur J Transl Myol. 2021;30(4):9509. https://doi.org/10.4081/ejtm.2020.9509 PMid:33520149

Yao H, Chen JH, Xu YF. Patients with mental health disorders in the COVID-19 epidemic. Lancet Psychiatry. 2020;7(4):21. https://doi.org/10.1016/S2215-0366(20)30090-0 PMid:32199510

Khosravi M. Candidate psychotropics against SARS-CoV-2: A narrative review. Pharmacopsychiatry. 2021. https://doi.org/10.1055/a-1551-3756 PMid:34399430

Mental health and COVID-19: Change the conversation. Lancet Psychiatry. 2020;7(6):463. https://doi.org/10.1016/S2215-0366(20)30194-2 PMid:32380007

Li K, Wohlford-Lenane C, Perlman S, Zhao J, Jewell AK, Reznikov LR, et al. Middle East respiratory syndrome coronavirus causes multiple organ damage and lethal disease in mice transgenic for human dipeptidyl peptidase 4. J Infect Dis. 2016;213(5):712-22. https://doi.org/10.1093/infdis/jiv499 PMid:26486634

Cheung YT, Chau PH, Yip PS. A revisit on older adults suicides and severe acute respiratory syndrome (SARS) epidemic in Hong Kong. Int J Geriatr Psychiatry. 2008;23(12):1231-8. https://doi.org/10.1002/gps.2056 PMid:18500689

Tsang HW, Scudds RJ, Chan EY. Psychosocial impact of SARS. Emerg Infect Dis. 2004;10(7):1326-7. https://doi.org/10.3201/eid1007.040090 PMid:15338536

Al Majali SA, Ashour LM. The negative consequences of poor emotion management (anger, anxiety and frustration) on the brain and body. J Talent Deve Excell. 2020;12(2s):3410-9.

Carver CS, Scheier MF, Weintraub JK. Assessing coping strategies: A theoretically based approach. J Pers Soc Psychol. 1989;56(2):267-83. https://doi.org/10.1037/0022-3514.56.2.267 PMid:2926629

Snaith RP. The hospital anxiety and depression scale. Health Qual Life Outcomes. 2003;1:29. https://doi.org/10.1186/1477-7525-1-29 PMid:12914662

Kawohl W, Nord C. COVID-19, unemployment, and suicide. Lancet Psychiatry. 2020;7(5):389-90. https://doi.org/10.1016/S2215-0366(20)30141-3 PMid:32353269

Sherman AL. Coronavirus anxiety scale: A brief mental health screener for COVID-19 related anxiety. Death Stud. 2020;44(7):393-401. https://doi.org/10.1080/07481187.2020.17 48481 PMid:32299304

Khosravi M. Worden’s task-based model for treating persistent complex bereavement disorder during the coronavirus disease-19 pandemic: A narrative review. Open Access Maced J Med Sci. 2020;8(1):553-9. https://doi.org/10.3889/oamjms.2020.5502

Khosravi M. Worden’s task-based approach for supporting people bereaved by COVID-19. Curr Psychol. 2021;40:5735-6. https://doi.org/10.1007/s12144-020-01292-0 PMid:33424200

Garfin DR, Silver RC, Holman EA. The novel coronavirus (COVID-2019) outbreak: Amplification of public health consequences by media exposure. Health Psychol. 2020;39(5):355-7. https://doi.org/10.1037/hea0000875 PMid:32202824

Chen L, Alston M, Guo W. The influence of social support on loneliness and depression among older elderly people in China: Coping styles as mediators. J Community Psychol. 2019;47(5):1235-45. https://doi.org/10.1002/jcop.22185 PMid:30912159

Duan L, Zhu G. Psychological interventions for people affected by the COVID-19 epidemic. Lancet Psychiatry. 2020;7(4):300-2. https://doi.org/10.1016/S2215-0366(20)30073-0 PMid:32085840

Turecki G, Brent DA, Gunnell D, O’Connor RC, Oquendo MA, Pirkis J, et al. Suicide and suicide risk. Nat Rev Dis Primers. 2019;5(1):74. https://doi.org/10.1038/s41572-019-0121-0 PMid:31649257

Khosravi M, Ghiasi Z, Ganjali A. A narrative review of research on healthcare staff’s burnout during the COVID-19 pandemic. Proc Singapore Healthc. 2021. https://doi.org/10.1177/20101058211040575

John A, Glendenning AC, Marchant A, Montgomery P, Stewart A, Wood S, et al. Self-harm, suicidal behaviours, and cyberbullying in children and young people: Systematic review. J Med Internet Res. 2018;20(4):e129. https://doi.org/10.2196/jmir.9044 PMid:29674305

Pfefferbaum B, North CS. Mental health and the Covid-19 pandemic. N Engl J Med. 2020;383(6):510-2. https://doi.org/10.1056/NEJMp2008017 PMid:32283003

D’Agostino A, Demartini B, Cavallotti S, Gambini O. Mental health services in Italy during the COVID-19 outbreak. Lancet Psychiatry. 2020;7(5):385-7. https://doi.org/10.1016/S2215-0366(20)30133-4 PMid:32353266

Klomek AB. Suicide prevention during the COVID-19 outbreak. Lancet Psychiatry. 2020;7(5):390. https://doi.org/10.1016/S2215-0366(20)30142-5 PMid:32353271

Olaimat AN, Aolymat I, Elsahoryi N, Shahbaz HM, Holley RA. Attitudes, anxiety, and behavioral practices regarding COVID-19 among university students in Jordan: A cross-sectional study. Am J Trop Med Hyg. 2020;103(3):1177-83. https://doi.org/10.4269/ajtmh.20-0418 PMid:32662398

Alnazly E, Khraisat OM, Al-Bashaireh AM, Bryant CL. Anxiety, depression, stress, fear and social support during COVID- 19 pandemic among Jordanian healthcare workers. PLoS One. 2021;16(3):e0247679. https://doi.org/10.1371/journal.pone.0247679 PMid:33711026




How to Cite

Ashour LM. Levels and Predictors of COVID-19-Related Anxiety in Older Adults. Open Access Maced J Med Sci [Internet]. 2022 Jan. 1 [cited 2022 Jan. 27];10(B):18-25. Available from: https://oamjms.eu/index.php/mjms/article/view/7724