Does Experiencing the COVID-19 Pandemic Affect Death Anxiety in Iranian Older Adults? A Survey-Based Cross-sectional Study

Abstract

Background: Older Iranian adults experienced high levels of death anxiety during the COVID-19 pandemic; however, the precise nature of this relationship remains unclear. Objectives: This study aimed to investigate the association between COVID-19 infection and death anxiety among older Iranian adults during the pandemic. Methods: A cross-sectional online survey was conducted among 3,129 individuals aged 60 years and older in Iran. Data were collected via social networking platforms, including Telegram, WhatsApp, and Instagram, and were assessed using demographic variables and the Templer’s Death Anxiety Scale. Results: Death anxiety was significantly higher among women, married individuals, and those aged 60 - 64 years (P < 0.01). In addition, frequent exposure to COVID-19-related news was associated with increased death anxiety. Older adults who had lost a family member, relative, or friend to COVID-19 had significantly higher death anxiety levels (P < 0.05). However, no significant association was observed between educational attainment and death anxiety levels. Conclusions: These findings highlight the substantial psychological impact of the pandemic on older adults and underscore the urgent need for targeted psychosocial interventions to alleviate death anxiety in this population. Given the persistence of mental health challenges after the pandemic, long-term psychological outcomes among older adults should be monitored. Future research should examine post-pandemic trends in death anxiety and evaluate the effectiveness of mental health interventions in mitigating anxiety-related distress in older populations.