The COVID-19 pandemic has made mental health a bigger issue for older adults, according to a national study.

Even before the pandemic, U.S. seniors were facing increased emotional-health challenges involving drug deaths, suicide, and frequent mental distress. The problems have been exacerbated by COVID-19. A recent survey by the AARP Foundation found the pandemic undermined healthy routines by isolating people and causing higher levels of anxiety and depression.

Similar findings emerged in the latest America’s Health Rankings Senior Report. The report, now in its ninth year and developed by the United Health Foundation in partnership with the Gerontological Advanced Practice Nurses Association (GAPNA), revealed that seniors across the country experienced some improvements in access to quality healthcare and preventive services. However, disparities by geography, race/ethnicity, and other factors persist. Health improvements for older adults weren’t experienced equally across the country, with populations in rural states and certain racial and ethnic populations facing greater challenges.

The report “shows meaningful progress, including an increase in flu vaccinations and number of geriatric professionals, on key measures of senior health in the period immediately preceding the COVID-19 pandemic,” said Dr. Rhonda Randall, executive vice president and chief medical officer of United Healthcare. “However, the pandemic has underscored the challenges and disparities that impair healthy living and longevity for older adults.”

The number of Americans 65 and over is estimated to be 85 million by 2050, roughly 20 percent of the country’s population. The analysis of seniors’ health from the 2021 Senior Report can help with planning for public health needs now and into the future, said GAPNA president Sherry Greenberg.

In Washington alone, the report noted that frequent mental distress increased 35 percent between 2018 and 2019 among adults over 65. There was good news on other fronts for the state: The number of geriatric providers increased to 26 per 100,000 adults ages 65-plus, and falls among that age group decreased 17 percent between 2016 and 2018. Numbers for more recent years weren’t available.

Frequent mental distress, an indicator of health-related quality of life and the burden of mental illness in a population, is characterized by 14 or more days of self-reported poor mental health in a given month. A strong relationship has been demonstrated between the 14-day minimum period and clinically diagnosed mental disorders, such as depression and anxiety, according to the report.

Frequent mental distress is associated with health conditions, including diabetes, hypertension, smoking, obesity, physical inactivity, and insufficient sleep.

The prevalence of frequent mental distress among older adults is higher among females, multiracial older adults compared, persons with less than a high school education, older adults with an annual household income below $25,000, and older adults who are limited physically or emotionally.