• Christina Reppas-Rindlisbacher, Jessica M Finlay, Alyson L Mahar, Shailee Siddhpuria, Julie Hallet, Paula A Rochon, and Lindsay C Kobayashi.
• Division of Geriatric Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
• J Am Geriatr Soc. 2021 May 1; 69 (5): 1147-1154.

Background/ObjectivesDifferences in older adults' worry, attitudes, and mental health between high-income countries with diverging pandemic responses are largely unknown. We compared COVID-19 worry, attitudes towards governmental responses, and self-reported mental health symptoms among adults aged ≥55 in the United States and Canada early in the COVID-19 pandemic.DesignOnline cross-sectional survey administered between April 2nd and May 31st in the United States and between May 1st and June 30th, 2020 in Canada.SettingNationally in the United States and Canada.ParticipantsConvenience sample of older adults aged ≥55.MeasurementsLikert-type scales measured COVID-19 worry and attitudes towards government support. Three standardized scales assessed mental health symptoms: the eight-item Center for Epidemiological Studies Depression Scale, the five-item Beck Anxiety Inventory, and the three-item UCLA loneliness scale.ResultsThere were 4453 U.S. respondents (71.7% women; mean age 67.5) and 1549 Canadian (67.6% women; mean age 69.3). More U.S. respondents (71%) were moderately or extremely worried about the pandemic, compared to 52% in Canada. Just 20% of U.S. respondents agreed or strongly agreed that the federal government cared about older adults in their COVID-19 pandemic response, compared to nearly two-thirds of Canadians (63%). U.S. respondents were more likely to report elevated depressive and anxiety symptoms compared to Canadians; 34.2% (32.8-35.6) versus 25.6% (23.3-27.8) for depressive and 30.8% (29.5-32.2) versus 23.7% (21.6-25.9) for anxiety symptoms. The proportion of United States and Canadian respondents who reported loneliness was similar. A greater proportion of women compared to men reported symptoms of depression and anxiety across all age groups in both countries.ConclusionU.S. older adults felt less supported by their federal government and had elevated depressive and anxiety symptoms compared to older adults in Canada during early months of the COVID-19 pandemic. Public health messaging from governments should be clear, consistent, and incorporate support for mental health.© 2021 The American Geriatrics Society.

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