Pandemic increases depression risk for older adults living with migraine

A recent longitudinal study from the University of Toronto reveals the mental health consequences of the COVID-19 pandemic on older adults living with migraine.

Using a sample of more than 2,000 older adults with migraine from the Canadian Longitudinal Study on Aging, researchers examined changes in depression status among this population during the pandemic. More than 1 in 7 older adults with migraine experienced depression for the first time during the COVID-19 pandemic, while approximately 1 in 2 with a previous history of depression experienced a recurrence during this period.

People living with migraine are already known to be highly vulnerable to adverse mental health outcomes, such as depression. Considering the increases in stressors during the pandemic, such as disruptions to medication and healthcare access, we wanted to understand how this may have impacted the mental health of those with migraine."

Esme Fuller-Thomson, senior author, professor at the University of Toronto's Factor-Inwentash Faculty of Social Work (FIFSW) and director of the Institute for Life Course & Aging (ILCA)

The researchers looked at risk factors for depression to better understand the subpopulations of people with migraine that had the highest risk of pandemic-related depression.

Increased family conflict during the pandemic was associated with a five-fold risk of incident depression and a three-fold risk of recurrent depression.

"Many families experienced increased discord and conflict during periods of lockdown, which were coupled by declines in access to important coping mechanisms that can mitigate family stress, such as physical activity outside and time spent socializing with friends. This likely impacted the mental health challenges observed during the pandemic," said co-author Andie MacNeil, PhD student at FIFSW.

Other pandemic-related stressors that were associated with incident depression among older adults with migraine included experiencing difficulty accessing healthcare.

"Access to comprehensive healthcare was already recognized as a major challenge for people with migraine prior to the pandemic," said co-author Aneisha Taunque, a research assistant at the Institute for Life Course and Aging. "We know access to healthcare worsened during the pandemic, which may have exacerbated mental health challenges among this population."

Increased time spent caregiving and/or challenges linked to caregiving were also associated with incident depression, which, like difficulties in accessing health care, approximately doubled the risk of incident depression.

"Caregiving responsibilities can be extremely challenging for people living with debilitating pain, such as that caused by migraine -- and many people reported increases in their caregiving responsibilities during the pandemic," said co-author Ying Jiang, Senior Epidemiologist at the Public Health Agency of Canada.

Other contributors to the study include Sarah Leo, a recent MSW graduate from FIFSW, Dr. Grace Li, who was a research associate with ILCA, and Margaret de Groh, a retired Scientific Manager at the Public Health Agency of Canada.

The authors emphasized the importance of ongoing research to examine depression among people with migraine.

"It will be important to identify if the observed increases were a temporary occurrence due to pandemic-related stressors, or if these trends have persisted after the pandemic," said Fuller-Thomson. "This knowledge can help inform targeted screening and intervention for people with migraine."