{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T01:24:04Z","timestamp":1789608244878,"version":"build-2803163510"},"reference-count":60,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,5,12]],"date-time":"2021-05-12T00:00:00Z","timestamp":1620777600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> COVID-19 not only threatened the public's physical health but also brought unbearable psychological pressure, especially for those vulnerable groups like the elderly. However, studies on the psychological status of older adults during this public health emergency remained scant. This study aims to investigate the mental health status among the elderly Chinese population during COVID-19 pandemic and determine the influencing factors of psychological symptoms.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> From February 19 to March 19, 2020, an online survey was administered to Chinese older adults using a convenience sampling method. Information on demographic data, health status and other epidemic related factors were collected. Specifically, the study defined the psychological status as five primary disorder\u2013depression, neurasthenia, fear, anxiety, and hypochondria\u2013which were assessed by the Psychological Questionnaire for Emergent Event of Public Health (PQEEPH). Standard descriptive statistics and multiple logistic regression analyses were conducted to analyze the data.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Of 1,501 participants recruited from 31 provinces in China, 1,278 were valid for further analysis. Participants' scores on each sub-scale were described in median and interquartile [M(Q)]: depression [0.00 (0.33)], neurasthenia [0.00 (0.40)], fear [1.00 (0.83)], anxiety [0.00 (0.17)], hypochondria [0.00 (0.50)]. Chronic diseases (depression <jats:italic>p<\/jats:italic> = 0.001; neurasthenia <jats:italic>p<\/jats:italic> &amp;lt; 0.001; fear <jats:italic>p<\/jats:italic> = 0.023; anxiety <jats:italic>p<\/jats:italic> &amp;lt; 0.001; hypochondria <jats:italic>p<\/jats:italic> = 0.001) and the BMI index (depression <jats:italic>p<\/jats:italic> = 0.015; neurasthenia <jats:italic>p<\/jats:italic> = 0.046; fear <jats:italic>p<\/jats:italic> = 0.016; anxiety <jats:italic>p<\/jats:italic> = 0.015; hypochondria <jats:italic>p<\/jats:italic> = 0.013) had significant impacts on all of the five sub-scales. Specifically, the rural dwellers had a higher level of neurasthenia, fear, and hypochondria. Besides, education level (<jats:italic>p<\/jats:italic> = 0.035) and outbreak risk level (<jats:italic>p<\/jats:italic> = 0.004) had significant impacts on the depression. Higher household monthly income per capita (<jats:italic>p<\/jats:italic> = 0.031), and the community-level entry\/exit control (<jats:italic>p<\/jats:italic> = 0.011) are factors against anxiety.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> Most elderly residents reported mild negative emotions during COVID-19 and more attention should be paid to the recognition and alleviation of fear. Our findings also identified factors associated with the mental health status of the elderly, which is of practical significance in the design and implementation of psychological interventions for this vulnerable population during COVID-19 and future emerging diseases.<\/jats:p>","DOI":"10.3389\/fpsyt.2021.645938","type":"journal-article","created":{"date-parts":[[2021,5,12]],"date-time":"2021-05-12T07:09:33Z","timestamp":1620803373000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":29,"title":["Mental Health Status of the Elderly Chinese Population During COVID-19: An Online Cross-Sectional Study"],"prefix":"10.3389","volume":"12","author":[{"given":"Rui","family":"Zhou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boyan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhi","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haihong","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongmei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,5,12]]},"reference":[{"key":"B1","unstructured":"2019-nCoV Outbreak is an Emergency of International Concern.2020"},{"key":"B2","unstructured":"WHO Director-General's Opening Remarks at the Media Briefing on COVID-19 - 20 March 2020.2020"},{"key":"B3","unstructured":"WHO Coronavirus Disease (COVID-19) Dashboard.2021"},{"key":"B4","unstructured":"Weekly Epidemiological Update - 2 March 2021.2021"},{"key":"B5","doi-asserted-by":"publisher","first-page":"524","DOI":"10.1016\/S0929-6646(10)60087-3","article-title":"Population-based post-crisis psychological distress: an example from the SARS outbreak in Taiwan","volume":"109","author":"Peng","year":"2010","journal-title":"J Formosan Med Assoc."},{"key":"B6","doi-asserted-by":"publisher","first-page":"210","DOI":"10.2471\/BLT.15.158543","article-title":"Psychosocial effects of an Ebola outbreak at individual, community and international levels","volume":"94","author":"Van Bortel","year":"2016","journal-title":"Bull World Health Organ."},{"key":"B7","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1186\/1471-2458-11-2","article-title":"Perceived risk, anxiety, and behavioural responses of the general public during the early phase of the Influenza A (H1N1) pandemic in the Netherlands: results of three consecutive online surveys","volume":"11","author":"Bults","year":"2011","journal-title":"BMC Public Health."},{"key":"B8","doi-asserted-by":"publisher","first-page":"915","DOI":"10.1016\/j.cjca.2020.04.010","article-title":"Management and treatment of COVID-19: the Chinese experience","volume":"36","author":"Peng","year":"2020","journal-title":"Can J Cardiol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"113045","DOI":"10.1016\/j.psychres.2020.113045","article-title":"How an epidemic outbreak impacts happiness: factors that Worsen (vs. protect) emotional well-being during the Coronavirus Pandemic","volume":"289","author":"Yang","year":"2020","journal-title":"Psychiatry Res."},{"key":"B10","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1186\/s12992-020-00654-4","article-title":"Mental health consequences of COVID-19 media coverage: the need for effective crisis communication practices","volume":"17","author":"Su","year":"2021","journal-title":"Glob Health."},{"key":"B11","doi-asserted-by":"publisher","first-page":"e10","DOI":"10.1093\/geronb\/gbaa048","article-title":"\u201cWe're staying at home\u201d. Association of self-perceptions of aging, personal and family resources and loneliness with psychological distress during the lock-down period of COVID-19","volume":"76","author":"Losada-Baltar","year":"2021","journal-title":"J Gerontol B Psychol Sci Soc Sci."},{"key":"B12","doi-asserted-by":"publisher","first-page":"1054","DOI":"10.1016\/S0140-6736(20)30566-3","article-title":"Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study","volume":"395","author":"Zhou","year":"2020","journal-title":"Lancet."},{"key":"B13","doi-asserted-by":"publisher","first-page":"1061","DOI":"10.1001\/jama.2020.1585","article-title":"Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China","volume":"323","author":"Wang","year":"2020","journal-title":"JAMA."},{"key":"B14","doi-asserted-by":"publisher","first-page":"105924","DOI":"10.1016\/j.ijantimicag.2020.105924","article-title":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): the epidemic and the challenges","volume":"55","author":"Lai","year":"2020","journal-title":"Int J Antimicrob Agents."},{"key":"B15","doi-asserted-by":"publisher","first-page":"102154","DOI":"10.1016\/j.ajp.2020.102154","article-title":"'Age and ageism in COVID-19': Elderly mental health-care vulnerabilities and needs","volume":"51","author":"Banerjee","year":"2020","journal-title":"Asian J Psychiatr."},{"key":"B16","doi-asserted-by":"publisher","first-page":"e100213","DOI":"10.1136\/gpsych-2020-100213","article-title":"A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: implications and policy recommendations","volume":"33","author":"Qiu","year":"2020","journal-title":"Gen Psychiatr."},{"key":"B17","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s11469-020-00305-0","article-title":"Intolerance of uncertainty and mental wellbeing: serial mediation by rumination and fear of COVID-19","author":"Satici","year":"2020","journal-title":"Int J Ment Health Addict."},{"key":"B18","doi-asserted-by":"publisher","first-page":"749","DOI":"10.1007\/s00787-020-01541-4","article-title":"Prevalence and socio-demographic correlates of psychological health problems in Chinese adolescents during the outbreak of COVID-19","volume":"29","author":"Zhou","year":"2020","journal-title":"Eur Child Adolesc Psychiatry."},{"key":"B19","doi-asserted-by":"publisher","first-page":"112983","DOI":"10.1016\/j.psychres.2020.112983","article-title":"Analyze the psychological impact of COVID-19 among the elderly population in China and make corresponding suggestions","volume":"289","author":"Meng","year":"2020","journal-title":"Psychiatry Res."},{"key":"B20","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1080\/13607860600638545","article-title":"Ageing and psychological response during the post-SARS period","volume":"10","author":"Lee","year":"2006","journal-title":"Aging Ment Health."},{"key":"B21","doi-asserted-by":"publisher","first-page":"746","DOI":"10.1080\/13607860802380607","article-title":"The SARS (Severe Acute Respiratory Syndrome) pandemic in Hong Kong: effects on the subjective wellbeing of elderly and younger people","volume":"12","author":"Lau","year":"2008","journal-title":"Aging Ment Health."},{"key":"B22","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1027\/0227-5910\/a000015","article-title":"The impact of epidemic outbreak the case of severe acute respiratory syndrome (SARS) and suicide among older adults in Hong Kong","volume":"31","author":"Yip","year":"2010","journal-title":"Crisis."},{"key":"B23","volume-title":"China's Aging Population: From a Global Perspective","author":"Liu","year":"2019"},{"key":"B24","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.archger.2013.07.016","article-title":"A meta-analysis of the prevalence of depressive symptoms in Chinese older adults","volume":"58","author":"Li","year":"2014","journal-title":"Arch Gerontol Geriatr."},{"key":"B25","doi-asserted-by":"publisher","first-page":"631","DOI":"10.16168\/j.cnki.issn.1002-9982.2014.07.026","article-title":"Progress on collective behavior in emergency pubfic health events","volume":"30","author":"Li","year":"2014","journal-title":"J Chin J Health Educ."},{"key":"B26","unstructured":"Notice on the Issuance of Guidelines for Emergency Psychological Crisis Intervention in the Pneumonia Epidemic of New Coronavirus Infection.2020"},{"key":"B27","unstructured":"Notice on the Issuance of Guidelines for the Psychological Assistance Hotline During the Prevention and Control of the New Coronavirus Pneumonia Epidemic.2020"},{"key":"B28","doi-asserted-by":"publisher","first-page":"e19","DOI":"10.1016\/S2215-0366(20)30079-1","article-title":"Mental health services for older adults in China during the COVID-19 outbreak","volume":"7","author":"Yang","year":"2020","journal-title":"Lancet Psychiatry."},{"key":"B29","doi-asserted-by":"publisher","first-page":"112954","DOI":"10.1016\/j.psychres.2020.112954","article-title":"Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 outbreak in China: a web-based cross-sectional survey","volume":"288","author":"Huang","year":"2020","journal-title":"Psychiatry Res."},{"key":"B30","doi-asserted-by":"publisher","first-page":"e924085","DOI":"10.12659\/MSMBR.924085","article-title":"Analysis of psychological and sleep status and exercise rehabilitation of front-line clinical staff in the fight against COVID-19 in China","volume":"26","author":"Wu","year":"2020","journal-title":"Med Sci Monit Basic Res."},{"key":"B31","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1631\/jzus.B2010013","article-title":"Efficacy of internet-based integrated intervention on depression and anxiety symptoms in patients with COVID-19","volume":"21","author":"Wei","year":"2020","journal-title":"J Zhejiang Univ Sci B."},{"key":"B32","doi-asserted-by":"publisher","first-page":"6","DOI":"10.3389\/fpsyt.2020.00459","article-title":"Online mental health survey in a Medical College in China during the COVID-19 outbreak","volume":"11","author":"Liu","year":"2020","journal-title":"Front Psychiatry."},{"key":"B33","doi-asserted-by":"publisher","first-page":"559951","DOI":"10.3389\/fpsyg.2020.559951","article-title":"Adolescents in quarantine during COVID-19 pandemic in Italy: perceived health risk, beliefs, psychological experiences and expectations for the future","volume":"11","author":"Commodari","year":"2020","journal-title":"Front Psychol."},{"key":"B34","doi-asserted-by":"publisher","first-page":"60","DOI":"10.3969\/j.issn.1001-8565.2004.02.028","article-title":"Discussion on the coping style of undergraduates and the correlative factors during the epidemic period of SARS","volume":"17","author":"Gao","year":"2004","journal-title":"Chin Med Ethics."},{"key":"B35","doi-asserted-by":"publisher","first-page":"658","DOI":"10.3760\/cma.j.issn.1674-6554.2004.06.029","article-title":"Research on the status of emotion response in college students during the epidemic period of SARS","volume":"13","author":"Gao","year":"2004","journal-title":"Chin J Behav Med Sci."},{"key":"B36","doi-asserted-by":"publisher","first-page":"1073","DOI":"10.3760\/cma.j.issn.0253-9624.2015.12.011","article-title":"The negative psychology for the public in Zhejiang province during the epidemic of human H7N9 avian influenza","volume":"49","author":"Zhang","year":"2015","journal-title":"Chin J Prev Med."},{"key":"B37","doi-asserted-by":"publisher","first-page":"15","DOI":"10.19504\/j.cnki.issn1671-5365.2020.04.004","article-title":"Survey and analysis of public mentality in COVID-19 epidemic","volume":"20","author":"Wang","year":"2020","journal-title":"J Yibin Univ."},{"key":"B38","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1016\/S0140-6736(20)30211-7","article-title":"Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study","volume":"395","author":"Chen","year":"2020","journal-title":"Lancet."},{"key":"B39","doi-asserted-by":"publisher","first-page":"2231","DOI":"10.1017\/S0033291713002833","article-title":"Association between body mass index and mental health among Scottish adult population: a cross-sectional study of 37,272 participants","volume":"44","author":"Ul-Haq","year":"2014","journal-title":"Psychol Med."},{"key":"B40","doi-asserted-by":"publisher","first-page":"3919","DOI":"10.3390\/ijerph16203919","article-title":"Social and psychological predictors of body mass index among South Africans 15 years and older: SANHANES-1","volume":"16","author":"McHiza","year":"2019","journal-title":"Int J Environ Res Public Health."},{"key":"B41","doi-asserted-by":"publisher","first-page":"e008720","DOI":"10.1136\/bmjopen-2015-008720","article-title":"High prevalence of underweight and undernutrition in Japanese inpatients with schizophrenia: a nationwide survey","volume":"5","author":"Sugai","year":"2015","journal-title":"BMJ Open."},{"key":"B42","doi-asserted-by":"publisher","first-page":"104853","DOI":"10.1016\/j.appet.2020.104853","article-title":"Obesity, eating behavior and physical activity during COVID-19 lockdown: a study of UK adults","volume":"156","author":"Robinson","year":"2021","journal-title":"Appetite."},{"key":"B43","doi-asserted-by":"publisher","first-page":"369","DOI":"10.32394\/rpzh.2018.0042","article-title":"The level of physical activity in elderly persons with overweight and obesity","volume":"69","author":"Zbronska","year":"2018","journal-title":"Roczniki Panstwowego Zakladu Higieny."},{"key":"B44","doi-asserted-by":"publisher","first-page":"336","DOI":"10.1055\/s-0033-1347219","article-title":"Health awareness as dominating impact factor on the development of overweight - a health questionnaire among the rural population of Austria","volume":"76","author":"Schoberberger","year":"2014","journal-title":"Gesundheitswesen."},{"key":"B45","doi-asserted-by":"publisher","first-page":"112934","DOI":"10.1016\/j.psychres.2020.112934","article-title":"The psychological impact of the COVID-19 epidemic on college students in China","volume":"287","author":"Cao","year":"2020","journal-title":"Psychiatry Res."},{"key":"B46","doi-asserted-by":"publisher","first-page":"248","DOI":"10.1016\/j.idm.2020.02.001","article-title":"An updated estimation of the risk of transmission of the novel coronavirus (2019-nCov)","volume":"5","author":"Tang","year":"2020","journal-title":"Infect Dis Model."},{"key":"B47","doi-asserted-by":"publisher","first-page":"1729","DOI":"10.3390\/ijerph17051729","article-title":"Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China","volume":"17","author":"Wang","year":"2020","journal-title":"Int J Environ Res Public Health."},{"key":"B48","doi-asserted-by":"publisher","first-page":"159","DOI":"10.16809\/j.cnki.2096-3653.2020022401","article-title":"Investigation on novel coronavirus pneumonia knowledge and attitude among some urban and rural residents in Guangdong","volume":"36","author":"Luo","year":"2020","journal-title":"J Guangdong Pharm Univ."},{"key":"B49","doi-asserted-by":"publisher","first-page":"12","DOI":"10.2196\/18718","article-title":"Measures undertaken in China to avoid COVID-19 infection: internet-based, cross-sectional survey study","volume":"22","author":"Huang","year":"2020","journal-title":"J Med Internet Res."},{"key":"B50","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1016\/j.japwor.2011.06.001","article-title":"Working in old age and health outcomes in Japan","volume":"23","author":"Kajitani","year":"2011","journal-title":"Japan World Econ."},{"key":"B51","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1037\/1076-8998.12.3.193","article-title":"Transformational leadership and psychological well-being: the mediating role of meaningful work","volume":"12","author":"Arnold","year":"2007","journal-title":"J Occup Health Psychol."},{"key":"B52","doi-asserted-by":"publisher","first-page":"e924609","DOI":"10.12659\/MSM.924609","article-title":"Comparison of prevalence and associated factors of anxiety and depression among people affected by versus people unaffected by quarantine during the COVID-19 epidemic in Southwestern China","volume":"26","author":"Lei","year":"2020","journal-title":"Med Sci Monit."},{"key":"B53","doi-asserted-by":"publisher","first-page":"841","DOI":"10.3389\/fpsyt.2020.00841","article-title":"Impacts of the SARS-CoV-2 pandemic on the mental health of the elderly","volume":"11","author":"Fontes","year":"2020","journal-title":"Front Psychiatry."},{"key":"B54","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1111\/j.1440-1819.2006.01522.x","article-title":"Psychosocial impact among the public of the severe acute respiratory syndrome epidemic in Taiwan","volume":"60","author":"Ko","year":"2006","journal-title":"Psychiatry Clin Neurosci."},{"key":"B55","doi-asserted-by":"publisher","first-page":"e256","DOI":"10.1016\/S2468-2667(20)30061-X","article-title":"COVID-19 and the consequences of isolating the elderly","volume":"5","author":"Armitage","year":"2020","journal-title":"Lancet Public Health."},{"key":"B56","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1002\/wps.20193","article-title":"Prevalence of psychiatric disorders in US older adults: findings from a nationally representative survey","volume":"14","author":"Reynolds","year":"2015","journal-title":"World Psychiatry."},{"key":"B57","doi-asserted-by":"publisher","first-page":"708","DOI":"10.1057\/ejis.2013.19","article-title":"Internet adoption by the elderly: employing IS technology acceptance theories for understanding the age-related digital divide","volume":"23","author":"Niehaves","year":"2014","journal-title":"Eur J Inform Syst."},{"key":"B58","doi-asserted-by":"publisher","first-page":"m313","DOI":"10.1136\/bmj.m313","article-title":"The psychological effects of quarantining a city","volume":"368","author":"Rubin","year":"2020","journal-title":"BMJ."},{"key":"B59","doi-asserted-by":"publisher","first-page":"1091","DOI":"10.1080\/13669877.2011.571790","article-title":"The \u2018Typhoon Eye Effect\u2019: determinants of distress during the SARS epidemic","volume":"14","author":"Xie","year":"2011","journal-title":"J Risk Res."},{"key":"B60","doi-asserted-by":"publisher","first-page":"441","DOI":"10.16719\/j.cnki.1671-6981.2011.02.045","article-title":"The features of significant others' social support and its relationship with the attitudes toward aging among older adults","volume":"34","author":"Zhang","year":"2011","journal-title":"Psychol Sci."}],"container-title":["Frontiers in Psychiatry"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2021.645938\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,12]],"date-time":"2021-05-12T07:09:48Z","timestamp":1620803388000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2021.645938\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,12]]},"references-count":60,"alternative-id":["10.3389\/fpsyt.2021.645938"],"URL":"https:\/\/doi.org\/10.3389\/fpsyt.2021.645938","relation":{},"ISSN":["1664-0640"],"issn-type":[{"value":"1664-0640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,12]]},"article-number":"645938"}}