Complicated grief and its relationship with anxiety, depression, and risk suicide in older adults in the context of the COVID-19 pandemic in Peru: a cross-sectional analysis

Abstract

Background Complicated grief (CG) resulting from poor adaptation to the death of a close person may have predisposed the presence of other mental health problems in older adults in Peru during the COVID-19 pandemic. The aim of our study was to assess the association between CG and the presence of anxiety, depression, and suicidal risk in older adults in Peru in the context of COVID-19 pandemic. Methods We conducted a cross-sectional analysis using data from the "Socioemotional evaluation form" applied in 2020 to assess the presence of mental health problems in older adults being attended in the Peruvian Social Security (EsSalud). For our study we included older adults who reported the death of a close person during the last 6 months when this assessment was performed. CG, depression, anxiety, and risk of suicide was originally evaluated using validated questionnaires. The association between CG and the presence of mental health problems was calculated through multivariate analysis where prevalence ratios (PR) were estimated with 95% confidence intervals (CI). Results Of the 249 older adults included, 175 (70.3%) were female with a median age of 71 years (interquartile range: 9) and 35 (14.1%) reported the presence of CG. It was found that CG in this population was associated with the presence of anxiety (PR: 1.35, 95% CI: 0.98 to 1.85), depression (PR: 1.44, 95% CI: 1.06 to 1.95), and suicidal risk (PR: 2.84, 95% CI: 1.06 to 7.59). Conclusions CG predisposes the presence of mental health problems in older adults in Peru. It is important to implement measures that facilitate its prevention and proper management of this condition in this population, especially in context of high population mortality such as the COVID-19 pandemic.