Exploring the COVID-19 pandemic's impact on mood, anxiety, and neurocognitive disorders in older adults: sex, geographic context, and healthcare setting considerations.

Introduction: Older adults face unique risk factors for psychiatric illness, including comorbid medical concerns, loss, and loneliness. With the older adult population expected to triple in the next two decades, understanding patterns of prevalent psychiatric disorders, including anxiety, mood, and neurocognitive disorders is crucial for treatment and policy planning.

Methods: This longitudinal cohort design examined anxiety, mood, and neurocognitive disorders among older adults in Alberta, utilizing physician billing data from 2017 to 2022. Rates of presentations were compared before, during, and after the COVID-19 pandemic. The study assessed the influence of sex, geographic location (urban, rural) and healthcare setting (outpatient, emergency department, inpatient). Descriptive statistics, ANOVA, and regression analyses were performed to assess the impact of these factors on presentations.

Results: Alberta's older adults had 1,365,423 presentations for mood, anxiety, and neurocognitive disorders from 2017 to 2022 with outpatient services comprising the majority, increased 28.18% during the pandemic. Anxiety was the most common (45.47%), followed by mood (34.76%) and neurocognitive disorders (18.77%). ANOVA showed no significant differences across pandemic phases for mood, anxiety or neurocognitive disorders. Regression analyses identified sex, geographic locations, and healthcare setting as significant predictors, with healthcare setting having the strongest effect. Interactions between sex, geographic location, and healthcare setting were significant for mood and anxiety disorders.

Conclusion: Psychiatric presentations varied by disorder, influenced by demographic and contextual factors. Healthcare setting was a significant predictor across all disorders. The lack of pandemic-related effects suggests a consistent impact across phases, highlighting the need for ongoing evaluation on the pandemic's long-term effects.