Objective  To analyze the knowledge about coronavirus disease 2019 (COVID-19) and its influence on anxiety symptoms among Chinese community elderly and to provide evidences for developing health education programs during public health emergencies.

  Methods  From 188 407 community residents aged 65 years and above, who completed a psychological assessment in the National Psychological Care Project for the Elderly conducted in 818 communities across China in 2019, we selected 6 467 participants with convenient sampling for a face-to-face survey carried out during April – May 2020. The information on participants′ knowledge about COVID-19 was collected using a self-designed questionnaire and the Generalized Anxiety Disorder-2 (GAD-2) was adopted to evaluated participants′ anxiety symptoms during the epidemic period.

  Results  Of all the participants, 6 270 (97.0%) reported the awareness on COVID-19 epidemic. There were 76.9% of the participants reporting the acquirement of COVID-19 related knowledge from TV/newspapers and 9.3%, 6.4%, 6.4% reporting from friends or family members, community workers/medical staff, online media. The main difficulties in daily life during the epidemic period reported by participants included being hard to purchase masks and other personal protective equipment (by 31.4% of the participants), inconvenience when purchasing foodstuff and daily supplies (21.8%), being unable to meet children or friends (12.7%), and inconvenience in seeking medication when suffering from chronic disease or other illness (9.3%). Among the 6 147 participants without history of anxiety symptoms before the epidemic, 576 (9.4%) were identified having anxiety symptoms during the epidemic. After adjusting for potential confounders as gender, age, education, marital status, residence, relationship with children, relationship with friends, number of hobbies, number of chronic diseases, attitude towards aging, psychological resilience and life satisfaction, the results of unconditional multivariate logistic regression analysis showed that two groups of the participants were at an increased risk of having anxiety symptoms during the epidemic: the participants obtaining COVID-19 related information from friends or family members (odds ratio OR = 1.50, 95% confidence interval 95% CI: 1.14 – 1.98, P = 0.004) as compared to those getting the information from TV/newspapers and the participants reporting difficulties in daily life (OR = 3.72, 95% CI: 3.07 – 4.51, P < 0.001) in comparison with those without the reporting.

  Conclusion  Among community-dwelling elderly residents in China, the awareness on COVID-19 prevention was at a high level; but the prevalence of anxiety symptoms was also relatively high during the epidemic and the elderly obtaining COVID-19 related information from friends or family members and those reporting difficulties in daily life were at an increased risk of having anxiety symptoms.