One in six people with COPD with no history of depression developed it for the first time during the early stages of the pandemic, while one in two individuals with COPD and a pre-pandemic history of depression experienced a recurrence.

Older adults with COPD had a heightened risk of depression during the early stages of the COVID-19 pandemic, according to a longitudinal study published in the International Journal of Chronic Obstructive Pulmonary Disease.

Researchers examined a sample of 875 individuals with COPD from the Canadian Longitudinal Study on Aging, a national study of Canadian older adults. Using longitudinal data, researchers were able to differentiate between 369 respondents with COPD who had a pre-pandemic history of depression and 506 respondents who had never experienced depression prior to the pandemic. 

Among individuals with COPD who had no lifetime history of depression, researchers found that one in six experienced depression for the first time during the early stages of the pandemic. These findings highlight the toll that the pandemic took on many individuals who had been free from depression prior to COVID-19.

“Our findings highlight the substantial burden of COVID-19 on those who were mentally healthy prior to the pandemic,” says first author Aneisha Taunque, research assistant at the Institute for Life Course and Aging at the University of Toronto, in a release. “It is evident that the pandemic has had a detrimental impact on the mental health of many individuals, even those who had no lifetime history of depression.” 

When the analysis was restricted to those who had a history of depression prior to the pandemic, the prevalence of depression was substantially higher, with approximately one-half of these individuals experiencing a recurrence or persistence of depression during the autumn of 2020. 

“Older adults who have a history of depressive episodes are a highly vulnerable subset of the population, particularly those who faced numerous challenges with managing their chronic health conditions during the pandemic when access to regular health care was severely disrupted,” says co-author Grace Li, PhD candidate in the sociology department at the University of Victoria, in a release. 

Although there is a burgeoning body of research examining depression during the pandemic, very little research has specifically examined the vulnerabilities among those with COPD. Understanding the risk factors for depression in subpopulations of older adults can aid health professionals in more effectively targeting treatment.

The study’s researchers highlighted several risk factors for both incident and recurrent depression among those with COPD, including loneliness, family conflict, and functional limitations.

“We found that experiencing functional limitations approximately doubled the risk of depression among older adults with COPD,” says co-author Ying Jiang, MD, senior epidemiologist at the Public Health Agency of Canada, in a release. “Physical activity is integral for maintaining functional status and reducing functional limitations among COPD patients; however many individuals with COPD are hesitant to engage in physical activity. Increases in time spent sedentary during periods of lockdown may have further ramifications for this population, potentially contributing to increases in depression.”

Women with COPD also had nearly double the risk of recurrent depression when compared to their male counterparts. 

“During the pandemic, many women experienced an exacerbation of gendered roles, such as increased time spent caregiving and doing household labor, which may have contributed to declines in their mental health,” says co-author Margaret de Groh, scientific manager at the Public Health Agency of Canada, in a release.

Among individuals with no history of depression, experiencing disruptions to healthcare access was associated with approximately double the risk of incident depression.

“Many people with COPD encountered difficulties accessing pulmonary rehabilitation services during the pandemic, which are essential for supporting both the physical and mental health of COPD patients,” says co-author Andie MacNeil, research assistant at the University of Toronto’s Factor Inwentash Faculty of Social Work, in a release. “Our finding that disruptions to healthcare access were associated with incident depression highlights the reverberating consequences when healthcare is inaccessible.”

Researchers hope the study’s findings can help inform healthcare workers and social service providers about the pandemic’s impact on the mental health of people with COPD.

Photo 144062624 © Piotr Adamowicz |