Examining the Links Between Asthma, Depression During the Pandemic in Canada

Older adults with asthma had a higher risk of depression during the COVID-19 pandemic, according to a study published this month.

Writing in Respiratory Medicine, researchers said they conducted a prospective study using data from the Canadian Longitudinal Study on Aging (CLSA), with a goal of finding out 2 things: to see which factors were linked with developing depression in adults with asthma without a history of the disease and to identify which factors were associated with recurrent depression during the pandemic in adults with both conditions.

The study included data from 4 waves of the CLSA, which is ongoing: baseline (2011-2015), follow-up (2015-2018), COVID spring 2020, and COVID autumn 2020. The CLSA is a research platform of community-dwelling adults aged 45 to 85 living in 7 provinces.

The sample in the study included 2017 respondents who answered yes to a question in either the baseline or first follow-up period as to whether they had asthma. Of those, 770 had a prepandemic history of depression and 1247 had never experienced depression before the pandemic.

Depression was measured by the Centre for Epidemiologic Studies–Depression (CES-D-10) scale. The researchers also collected information on demographics, socioeconomic status, loneliness, religiosity, functional status, and other health indicators, including whether the respondents had a history of adverse childhood experiences.

Results showed some striking differences.

The return of depressive symptoms during fall 2020 was significantly higher (P < 0.01) for those with asthma (48%; 95% CI, 45%, 52%) when there was a history of depression compared with those who did not have asthma (43%; 95% CI = 41%, 44%).

For individuals without a history of depression, the prevalence of depressive symptoms during that fall was not statistically significantly different (P = 0.14) between those who had asthma (14%; 95% CI, 12%-15%) compared with those without (12%; 95% CI, 11%-13%).

In addition, about 1 in 7 (13.4%) older adults with asthma with no history of depression developed depressive symptoms during the COVID-19 pandemic.

A sensitivity analysis showed that among adults who had not been depressed during the baseline and follow-up periods, but had a diagnosis of depression in previous decades, the prevalence of recurrent depression 30%.

Factors that were associated with a higher risk of depression included:

• Disruptions to health care access
• An increase in family conflict during the pandemic
• Loss of income
• Food insecurity or inability to obtain other necessary supplies

While the knowledge that many were depressed during the pandemic is not new, the authors said few prior studies have focused specifically on the impact of those with asthma.

The authors said there were a few limitations. Depression was measured by self-report, and while the instrument used is considered reliable and valid, a clinical assessment would have been preferable. In addition the data did not have any information on asthma severity.

Reference

MacNeil A, Li G, Jiang Y, de Groh M, Fuller Thompson E. Incident and recurrent depression among older adults with asthma during the COVID-19 pandemic: findings from the Canadian Longitudinal Study on Aging. Respir Med. Published online January 12, 2023. doi:10.1016/j.rmed.2022.107003