Volume 16, Issue 1 (Spring (COVID-19 and Older Adults) 2021)                   Salmand: Iranian Journal of Ageing 2021, 16(1): 62-73 | Back to browse issues page

XML Persian Abstract Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Olyani S, Peyman N. Assessment of the Subjective Wellbeing of the Elderly During the COVID-19 Disease Pandemic in Mashhad. Salmand: Iranian Journal of Ageing. 2021; 16 (1) :62-73
URL: http://salmandj.uswr.ac.ir/article-1-2140-en.html
1- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.
2- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. , peymann@mums.ac.ir
Full-Text [PDF 5514 kb]   (439 Downloads)     |   Abstract (HTML)  (1908 Views)
Full-Text:   (354 Views)

Extended Abstract

1. Introduction

The Coronavirus Disease 2019 (COVID-19) pandemic can be considered a stressful and uncontrollable public health crisis. Due to its ease of transmission and potential ability to cause death in the elderly, this disease can increase the risk of mental health problems or aggravate the symptoms of existing mental disorders; accordingly, by reducing mental health in the elderly, it can potentially affect their mental wellbeing [1]. Therefore, maintaining and improving the psychological wellbeing of the elderly is important as a positive socioeconomic and cultural measure. This study aimed to evaluate the psychological wellbeing of the elderly and its related factors during the COVID-19 pandemic in Mashhad City, Iran. In this study, the relationship between some factors affecting mental wellbeing in the elderly, such as family structure, chronic illnesses, staying at home, and physical activity, and the mental wellbeing of the elderly was investigated.

2. Methods and Materials 

In this cross-sectional study, 400 individuals aged >60 years were studied from April 16, 2020, to June 31, 2020, in Mashhad City, Iran. Sampling was performed in several stages. First, 5 healthcare networks in Mashhad were considered as 5 clusters. Next, among the comprehensive healthcare centers covered by each of these clusters, a comprehensive healthcare center was randomly selected and considered as a cluster. Then, to reach the desired number of samples from each of the 5 comprehensive centers of healthcare, 80 samples were randomly selected and entered into the study. Due to the COVID-19 pandemic and the lack of face-to-face visits of the elderly to healthcare centers, the researcher, after obtaining permission to enter the comprehensive centers of healthcare services from the Vice Chancellor for Research of Mashhad University of Medical Sciences, referred to the healthcare services; after obtaining permission from the center officials, the researcher collected the telephone numbers of the elderly from their records. Subsequently, the demographic information and questionnaire used in the study were completed by telephone. The questionnaires were completed in June 2020 and 20 elderly were examined daily; thus, except for the 10 days off in June, the questionnaires were completed in the remaining 20 days of this month.
In this study, the Persian version of the Mental Welfare Index was used [2]. A score of ≥50 indicates adequate mental wellbeing and a score <50 reflects insufficient mental wellbeing [3]. The obtained data were analyzed in SPSS using descriptive and analytical statistics at a significance level of 0.05. The relevant code of ethics was obtained for this study (Code: IR.MUMS.REC.1399.158).

3. Results 

The Mean±SD age of the study participants was 66.7±5.8 years. Among all study participants, 224(56%) were females and 176(44%) were males. Most of the research subjects had high school education (61.5%), lived alone (49%), and had at least one chronic illness (73.8%). Moreover, most of the study participants were completely quarantined at home (91%) and had no physical activity (93.8%) during the study period.
Furthermore, the Mean±SD score of psychological wellbeing in the explored elderly was 44.8±24.7. According to the collected results, the psychological wellbeing score in 285(71.2%) subjects was below 50. Therefore, considering that a score of 50 and above indicates adequate mental wellbeing and a score less than 50 reflects insufficient mental wellbeing, most examined elderly had insufficient mental wellbeing. There was a significant relationship between family structure (P<0.001), chronic illness (P<0.001), staying at home (P<0.001), and physical activity (P<0.001), and psychological wellbeing in the study subjects. To determine the effects of the contextual variables on the psychological wellbeing of the tested elderly, a multiple logistic regression model was used. The relevant results demonstrated that having at least one chronic disease was the most effective variable for inadequate mental wellbeing in the elderly.
Thus, the elderly with chronic diseases presented a 23.77 times higher odds of inadequate mental wellbeing than those without the chronic disease (OR=23.7, 95%CI: 42.08-13.42) (P<0.001). Moreover, among the factors affecting the psychological wellbeing of the elderly in the COVID-19 pandemic, loneliness was the second most important characteristic after chronic disease. In other words, the elderly who lived alone presented an 8.28 times higher odds of inadequate mental wellbeing, compared to those who did not live alone (OR=8.28, 95%CI: 4.79-14.31) (P<0.001).
Furthermore, living with a spouse had a protective effect and prevented a decrease in psychological wellbeing in the examined elderly (OR=0.107, 95%CI: 0.065-0.175) (P<0.001); thus, living with a spouse reduced the odds of declined mental wellbeing in the tested elderly. The elderly who stayed at home during the study period had an 8.03-fold lower chance of poor mental wellbeing than others (OR=8.03, 95%CI: 3.72-17.30) (P<0.001).
Finally, the elderly who had no physical activity during the study period had a 7.37 times higher chance of inadequate mental wellbeing than the other elderly (OR=7.37, 95%CI: 2.98-18.18) (P<0.001).

4. Discussion and Conclusion

According to the current research results, most of the studied elderly had inadequate mental wellbeing. The elderly have a vulnerable immune system and often suffer from chronic diseases; thus, infectious diseases are more severe and more dangerous than other populations in them. Consequently, the elderly are more prone to death, especially those with chronic illnesses. Therefore, encountering situations, such as the COVID-19 pandemic crisis can increase fear and stress among the elderly. During the COVID-19 pandemic, older people not only have to cope with the potential side effects of a weakened immune system but also have to overcome numerous problems caused by the psychological aspects of such a crisis. Therefore, it seems necessary to pay attention to the mental health of the elderly and adopt adaptive strategies to maintain and improve the mental wellbeing of the elderly in crises, like the COVID-19 pandemic.

Ethical Considerations

Compliance with ethical guidelines
This study was approved by the Ethics Committee of the University of Mashhad University of Medical Sciences (Code: IR.MUMS.REC.1399.158).


This research was supported by by the Mashhad University of Medical Sciences.

Authors' contributions

Drafting, introduction and methodology: Nooshin Peyman; Editing and finalizing the article,analysing and writing finding, discussion and conclusion: Samira Olyani.

Conflicts of interest

The authors declared no conflict of interest.


Authors appreciate from Vice-Chancellor of Mashhad University of Medical Sciences.


  1. Yang Y, Li W, Zhang Q, Zhang L, Cheung T, Xiang YT. Mental health services for older adults in China during the COVID-19 outbreak. The Lancet Psychiatry. 2020; 7(4):e19. [DOI:10.1016/S2215-0366(20)30079-1]
  2. Dehshiri G, Mousavi SF. [An investigation into psychometric properties of persian version of World Health Organization Five Well-Being Index (Persian)]. Journal of Clinical Psychology. 2016; 8(2):1-7. http://ensani.ir/file/download/article/20160822133857-9528-160.pdf
  3. Topp CW, Østergaard SD, Søndergaard S, Bech P. The WHO-5 Well-Being Index: A systematic review of the literature. Psychotherapy and Psychosomatics. 2015; 84(3):167-76. [DOI:10.1159/000376585] [PMID]
  4. Tajvar M, Grundy E, Fletcher A. Social support and mental health status of older people: A population-based study in Iran-Tehran. Aging & Mental Health. 2018; 22(3):344-53. [DOI:10.1080/13607863.2016.1261800] [PMID]
  5. Mohammadi T, Yazdani Charati G, Mousavinasab SN. [Indentification of factors affecting the aging of the Iranian population in 2016 (Persian)]. Journal of Mazandaran University of Medical Sciences. 2017; 27(155):71-8. http://jmums.mazums.ac.ir/article-1-10604-en.html
  6. Moradi S. [Study of the relationship between social participation and quality of life of ageing centers of Tehran (Persian)]. [MS. Thesis]. Tehran: University of Welfare and Rehabilitation Sciences; 2012.
  7. Heravi Karimloo M, Anoosheh M, Foroughan M, Sheykhi M T, Hajizade E, Seyed Bagher Maddah MS, et al. [Loneliness from the perspectives of elderly people: A phenomenological study (Persian)]. Salmand: Iranian Journal of Ageing. 2008; 2(4):410-20. http://salmandj.uswr.ac.ir/article-1-53-fa.html
  8. Lemon BW, Bengtson VL, Peterson JA. An exploration of the activity theory of aging: Activity types and life satisfaction among in-movers to a retirement community. Journal of Gerontology. 1972; 27(4):511-23. [DOI:10.1093/geronj/27.4.511] [PMID]
  9. Longino Jr CF, Kart CS. Explicating activity theory: A formal replication. Journal of Gerontology. 1982; 37(6):713-22. [DOI:10.1093/geronj/37.6.713] [PMID]
  10. Adams KB, Leibbrandt S, Moon H. A critical review of the literature on social and leisure activity and wellbeing in later life. Ageing & Society. 2011; 31(4):683-712. [DOI:10.1017/S0144686X10001091]
  11. Hogan M. Physical and cognitive activity and exercise for older adults: A review. The International Journal of Aging and Human Development. 2005; 60(2):95-126. [DOI:10.2190/PTG9-XDVM-YETA-MKXA] [PMID]
  12. Lazarus RS, Folkman S. Stress, appraisal, and coping. Amsterdam: Springer; 1984.
  13. Organization Health Organization. Neuroscience of psychoactive substance use and dependence. Geneva: World Health Organization; 2004.
  14. Takeuchi T, Takenoshita S, Taka F, Nakao M, Nomura K. The relationship between psychotropic drug use and suicidal behavior in Japan: Japanese adverse drug event report. Pharmacopsychiatry. 2017; 50(02):69-73. [DOI:10.1055/s-0042-113468] [PMID]
  15. Rothan HA, Byrareddy SN. The epidemiology and pathogenesis of Coronavirus Disease (COVID-19) outbreak. Journal of Autoimmunity. 2020; 109:102433. [DOI:10.1016/j.jaut.2020.102433] [PMID] [PMCID]
  16. Wu Z, McGoogan JM. Characteristics of and important lessons from the Coronavirus Disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020; 323(13):1239-42. [DOI:10.1001/jama.2020.2648] [PMID]
  17. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet. 2020; 395(10223):497-506. [DOI:10.1016/S0140-6736(20)30183-5]
  18. Landi F, Barillaro C, Bellieni A, Brandi V, Carfì A, D’Angelo M, et al. The new challenge of geriatrics: Saving frail older people from the SARS-COV-2 pandemic infection. The Journal of Nutrition, Health & Aging. 2020; 24(5):466-70. [DOI:10.1007/s12603-020-1356-x] [PMID] [PMCID]
  19. Meng H, Xu Y, Dai J, Zhang Y, Liu B, Yang H. The psychological effect of COVID-19 on the elderly in China. Psychiatry Research. 2020:112983. [DOI:10.1016/j.psychres.2020.112983] [PMCID]
  20. Forlenza OV, Stella F. Impact of SARS-CoV-2 pandemic on mental health in the elderly: Perspective from a psychogeriatric clinic at a tertiary hospital in São Paulo, Brazil. International psychogeriatrics. 2020; 32(10):1147-51. [DOI:10.1017/S1041610220001180] [PMID] [PMCID]
  21. Armitage R, Nellums LB. COVID-19 and the consequences of isolating the elderly. The Lancet Public Health. 2020; 5(5):e256. [DOI:10.1016/S2468-2667(20)30061-X]
  22. Cheung Y, Chau PH, Yip PS. A revisit on older adults suicides and Severe Acute Respiratory Syndrome (SARS) epidemic in Hong Kong. International Journal of Geriatric Psychiatry: A Journal of the Psychiatry of Late Life and Allied Sciences. 2008; 23(12):1231-8. [DOI:10.1002/gps.2056] [PMID]
  23. Lau AL, Chi I, Cummins RA, Lee TM, Chou KL, Chung LW. The SARS (Severe Acute Respiratory Syndrome) pandemic in Hong Kong: Effects on the subjective wellbeing of elderly and younger people. Aging and Mental Health. 2008; 12(6):746-60. [DOI:10.1080/13607860802380607] [PMID]
  24. Zandifar A, Badrfam R. Iranian mental health during the COVID-19 epidemic. Asian Journal of Psychiatry. 2020; 51:101990. [DOI:10.1016/j.ajp.2020.101990] [PMID] [PMCID]
  25. Caciula I, Boscaiu V, Cooper C. Prevalence and correlates of well-being in a cross-sectional survey of older people in Romania attending community day facilities. The European Journal of Psychiatry. 2019; 33(3):129-34. [DOI:10.1016/j.ejpsy.2019.06.002]
  26. Gao J, Zheng P, Jia Y, Chen H, Mao Y, Chen S, et al. Mental health problems and social media exposure during COVID-19 outbreak. Plos One. 2020; 15(4):e0231924. [DOI:10.1371/journal.pone.0231924] [PMID] [PMCID]
  27. Qiu J, Shen B, Zhao M, Wang Z, Xie B, Xu Y. A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: Implications and policy recommendations. General Psychiatry. 2020; 33(2):e100213.. [DOI:10.1136/gpsych-2020-100213] [PMID] [PMCID]
  28. Goudarz M, Foroughan M, Makarem A, Rashedi V. [Relationship between social support and subjective well-being in older adults (Persian)]. Iranian Journal of Ageing. 2015;10(3):110-9. http://salmandj.uswr.ac.ir/article-1-953-en.html
  29. Alipour F, Sajadi H, Forouzan A, Nabavi H, E K. [The role of social support in the anxiety and depression of elderly (Persian)]. Iranian Journal of Ageing. 2009; 4(11):53-61. http://salmandj.uswr.ac.ir/article-1-333-en.pdf
  30. Bonanno GA, Galea S, Bucciarelli A, Vlahov D. Psychological resilience after disaster: New York City in the aftermath of the September 11th terrorist attack. Psychological Science. 2006; 17(3):181-6. [DOI:10.1111/j.1467-9280.2006.01682.x] [PMID]
  31. Hasanpoor Dehkordi A, Masoodi R, Naderipoor A, Poor Mir Reza Kalhori R. [The effect of exercise program on the quality of life in shahrekord elderly people (Persian)]. Salmand: Iranian Journal of Ageing. 2008; 2(4):437-444. http://salmandj.uswr.ac.ir/article-1-58-en.html
  32. Kord B. The prediction of subjective well-being based on meaning of life and mindfulness among cardiovascular patients. Iranian Journal of Psychiatric Nursing. 2018; 5(6):16-23. [DOI:10.21859/ijpn-05063]
Type of Study: Research | Subject: Psychology
Received: 2020/11/14 | Accepted: 2021/01/11 | Published: 2011/04/01

Add your comments about this article : Your username or Email:

Send email to the article author

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2021 CC BY-NC 4.0 | Iranian Journal of Ageing

Designed & Developed by : Yektaweb