Differences in the associations between mental health, wellness, and age during the first wave of the COVID-19 pandemic in a multi-country survey

Moréniké Oluwátóyìn Folayan^1*Roberto Ariel Abeldaño Zuñiga²Nourhan M. Aly³Passent Ellakany⁴Oliver Chukwujekwu Ezechi⁵Balgis Gaffar⁴Olanrewaju Ibikunle Ibigbami¹Ifeoma Eugenia Idigbe⁶Anthonia Omotola Ishabiyi⁷Yousef Khader⁸Folake Lawal⁹Joanne Lusher¹⁰Kessketlen Miranda¹¹Nicaise Ndembi¹²Bamidele Olubukola Popoola⁹Mir Faeq Ali Quadri¹³Jorma I Virtanen¹⁴Maha El Tantawi³Annie L Nguyen¹⁵

• ¹Obafemi Awolowo University, Ife, Osun, Nigeria
• ²University of Sierra Sur,, Oaxaca,, Mexico
• ³Alexandria University, Alexandria, Alexandria, Egypt
• ⁴Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
• ⁵Department of Clinical Sciences, Nigerian Institute of Medical Research (NIMR), Lagos, Lagos, Nigeria
• ⁶Nigerian Institute of Medical Research (NIMR), Lagos, Nigeria
• ⁷University of Cincinnati, Cincinnati, Ohio, United States
• ⁸Jordan University of Science and Technology, Irbid, Irbid, Jordan
• ⁹University of Ibadan, Ibadan, Oyo, Nigeria
• ¹⁰Regent's University London, London, United Kingdom
• ¹¹University of Porto, Porto, Portugal
• ¹²School of Medicine, University of Maryland, Baltimore, Maryland, United States
• ¹³University of Washington, Seattle, Washington, United States
• ¹⁴University of Bergen, Bergen, Hordaland, Norway
• ¹⁵University of California, San Diego, La Jolla, California, United States

Background: The COVID-19 pandemic substantially impacted mental health. This study explored age-related differences in the mental health and well-being of participants during the initial wave of the COVID-19 pandemic.Methods: Secondary analyses of data from 21,106 participants collected between July and December 2020 across 152 countries was conducted. Multivariable logistic regression models were used to determine the relationship between the dependent variables and age after accounting for potential confounders. The dependent variables examined were emotional distress, social isolation, sleep pattern changes, sexual activity changes, financial security, housing and food insecurity, changes in family relationships, memory complaints, and posttraumatic stress syndrome (PTSS). Age groups were considered: young adults (18-24), adults (25-49), and older individuals (>50). The confounding variables were sociodemographic variables namely: sex (male or female), marital status (single or has had a relationship), employment status (employed, unemployed, student, or retiree), educational status (none, primary, secondary, or college/university), country of residence income (low-income countries, lower-middle-income countries, upper-middle-income countries, and high-income countries) and pandemic stringency index indicating the comprehensiveness of pandemic policies adopted at country level.Results: Of the 21,106 participants, 12,807 (60.7%) were aged 25-49. Compared to those over 50, 18-24-year-olds had significantly higher odds of increased sexual activity (AOR: 4.41), housing insecurity (AOR: 1.73), and PTSD (AOR: 3.22), but lower odds of social isolation (AOR: 0.66), food insecurity (AOR: 0.85), and memory complaints (AOR: 0.53). Similarly, 25-49-year-olds had higher odds of increased sexual activity (AOR: 2.65), housing insecurity (AOR: 2.28), food insecurity (AOR: 1.14), worsened family relationships (AOR: 1.15), and PTSD (AOR: 2.24), but lower odds of social isolation (AOR: 0.84), sleep disturbances (AOR: 0.82), and memory complaints (AOR: 0.81). Emotional distress and financial insecurity did not differ significantly across age groups.The study highlights age-specific variations in mental health challenges during the pandemic. The nuanced impact of age on mental well-being emphasizes the need for targeted interventions. Future research should explore the interplay between age, pandemic-related factors, and specific mental health outcomes to inform tailored support mechanisms for diverse age groups.