The impact of changes to work circumstances enforced by COVID-19 on anxiety: a systematic review.

Background: The COVID-19 pandemic enforced changes on employment circumstances for all workers but older workers experiencing job loss are less likely to return to work than younger individuals. Under normal circumstances, job loss is a well-recognised risk factor for poor mental health, while it is unclear whether working from home is beneficial or harmful to mental health. We systematically reviewed the literature to explore the association between enforced changes in employment (job loss, working from home or being furloughed) and anxiety in the adult population, with a particular focus on older workers.

Methods: The protocol was registered in June 2021 in the International Prospective Register of Systematic Reviews database. We searched Medline, Embase, PsycInfo and CINAHL (January 2020-July 2023) databases for studies including older adults (some of the study sample were workers aged over 50 years). Results were presented by narrative review, complemented by a vote-counting technique and effect direction plots to summarise the relationship between exposures and anxiety.

Results: Forty-eight studies from several countries met the inclusion criteria, including 39 cross-sectional and nine longitudinal studies. The prevalence of anxiety varied between studies due to different tools and cut-offs chosen, reaching as high as 63% in one study. The vote-counting method showed convincing evidence that job loss since lockdown negatively impacted anxiety overall and among people aged 50 and over. Inconsistent results were observed across studies investigating the effect of working from home or furlough on anxiety.

Conclusion: Disruption of employment during the pandemic and related lockdowns has increased anxiety levels in the adult population and among older workers. More research is needed to know how persistent these effects are and to identify strategies to support those most affected.

Systematic review registration: The protocol of the systematic review was registered in June 2021 in the International Prospective Register of Systematic Reviews database (PROSPERO: CRD42021260499), and it is provided as supporting information (Additional File 1).