Background: The COVID-19 pandemic, due to its disproportionated higher morbidity and mortality rates in the older age, has been considered to be a``geropandemic ."Several studies, however, have found that older age is associated with lower psychological distress in relation to the COVID-19 outbreak and related lockdown measures . Aim: To explore the role of Resilience as a mediator between stressful COVID-19 related life events and depressive and, anxiety symptoms and perceived stress, and to ascertain the role of age as a moderator of the mediator's effect .
Methods: An on-line survey was spread through social networks during the first lockdown in Italy . Depressive and anxiety symptoms and perceived stress were measured using the Italian version of the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder Questionnaire-7 (GAD-7) and the Perceived Stress Scale (PSS). Resilience was measured using the Italian version of the Resilience Scale for Adults (RSA). Stressful COVID-19 related life events were explored using a checklist of events derived from the International Adjustment Disorder Questionnaire (IADQ). After a preliminary panel of linear regressions, mediation was tested using Structural Equation Modeling and inspecting the bootstrapped indirect effects . Afterwards, age was introduced as a mediator of the indirect effect in a moderated mediation analysis .
Results: Twenty one thousand three hundred and thirty four subjects completed the questionnaire , 17,178 (80.52 %) were female , 748 (3.5 %) were> 60 years old . In the whole sample, the presence of any stressful event was associated with depressive and anxiety symptoms and perceived stress . Resilience mediated the effects of stressful COVID-19-related events on depressive and anxiety symptoms and perceived stress . The moderated mediation analysis revealed that age moderated the mediation effect of Resilience between the presence of a stressful event and the selected outcomes . Conclusion: Taken together, our results show that age moderates the mediating effect of Resilience in the relationship between COVID-19-related stressful events and depressive and anxiety symptoms and perceived stress . Older adults' Resilience was less influenced by stressful events, and this could be one of the reasons accounting for the better mental health outcomes observed in the older age.
Index: COVID-19, mental health, old age, resilience, stress