Fear of COVID-19 and Adverse Psychological Health Outcomes Among Chinese Elderly: a Serial Mediation Model of Social Participation and Loneliness

This cross-sectional study examined fear of COVID-19, social participation, loneliness, and adverse psychological health outcomes among Chinese older adults after the pandemic control measures were relaxed. We also tested the correlations among these variables and examined the serial-mediating effects of social participation and loneliness on the relationship between fear of COVID-19 and adverse psychological health outcomes. Participants were 508 Chinese elderly individuals (Mage = 70.53 ± 7.90 years; 56.5% women). We used Pearson correlation analyses and Hayes’ PROCESS macro analysis (Model 6). Respondents had a relatively higher level of fear of COVID-19 compared to the general population. Their levels of loneliness, anxiety, and depression were higher than those of Chinese older adults who were surveyed before the restriction policy changed in previous research. The correlations among fear of COVID-19, social participation, loneliness, and adverse psychological health outcomes were significant, supporting the serial-mediating effects of social participation and loneliness on the relationship between fear of COVID-19 and adverse psychological health outcomes. Attention should be paid to the mental health issues of Chinese older adults, and the impacts of fear of COVID-19 and social participation on their mental health should be emphasized. Future researchers should use random systematic sampling methods, conduct longitudinal tracking and perform intervention studies.