Death anxiety among the oldest old in Germany. Evidence from the nationally representative 'Old Age in Germany (D80+)'.

Background: There is a lack of studies investigating death anxiety among the oldest old based on a large, nationally representative sample during the pandemic. Thus, our aim was to investigate the prevalence and determinants of death anxiety among the oldest old in Germany during the Covid-19 pandemic.

Methods: Cross-sectional data were taken from the 'Old Age in Germany' (D80+) study. This is a large, nationwide representative study including individuals 80 years and over living at home and individuals in institutionalised settings (N = 9542 individuals in the analytic sample).

Results: Overall, 30% of the respondents reported the absence of death anxiety, 45.5% reported a rather not strong death anxiety, 20.2% reported a rather strong death anxiety, and 4.3% reported a very strong death anxiety. Linear regressions revealed that higher death anxiety was significantly associated with being female (β = 0.21, P < 0.01), younger age (β = -0.02, P < 0.001), being married (β = 0.09, P < 0.001), high education (compared to low education, β = 0.07, P < 0.05), the presence of meaning in life (β = 0.13, P < 0.001), higher loneliness levels (β = 0.18, P < 0.001), the presence of multimorbidity (β = 0.07, P < 0.05), and poorer self-rated health (β = -0.07, P < 0.001). A further analysis showed that probable depression (β = 0.31, P < 0.001) is also associated with higher death anxiety.

Conclusion: About one in four individuals had a strong or very strong fear of death during the pandemic. Several sociodemographic, psychosocial, and health-related factors are associated with higher death anxiety. This better understanding of the determinants of death anxiety can be relevant for, among others, the affected individuals, informal and professional carers, as well as friends and relatives.