COVID-19 and cognitive decline in older adults with high-cardiovascular risk: A post hoc analysis

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  • dc.contributor.author Shyam, Sangeetha
  • dc.contributor.author Castañer, Olga
  • dc.contributor.author Fitó Colomer, Montserrat
  • dc.contributor.author Salas-Salvadó, Jordi
  • dc.date.accessioned 2025-02-14T07:06:07Z
  • dc.date.available 2025-02-14T07:06:07Z
  • dc.date.issued 2024
  • dc.description Data de publicació electrònica: 21-07-2024
  • dc.description.abstract Cognitive decline has been reported as a short-term sequela in patients hospitalized for coronavirus disease-19 (COVID-19). Whether COVID-19 is associated with late cognitive impairment in older free-living individuals with high cardiovascular risk, a group at greater risk of cognitive decline, is unknown. We determined this association of COVID-19 through a longitudinal evaluation of post-COVID-19 cognitive performance and impairment as post hoc analysis in 5,179 older adults (48% female) with mean (SD) age 68.5 (5.0) years, body mass index 31.7 (3.7) kg/m2, harboring ≥ 3 criteria for metabolic syndrome (e.g., hypertension, hyperlipidemia, hyperglycemia etc.) enrolled in PREDIMED-Plus trial. Pre- and post-COVID-19 cognitive performance was ascertained from scheduled assessments conducted using a battery of neuropsychological tests, including 5 domains: Global Cognitive Function, General Cognitive Function, Execution Function, Verbal Fluency and Attention domains, which were standardized for the cohort. Cognitive impairment was defined as the bottom 10 percentile of the sample. Multivariable linear and logistic regression models assessed the association of COVID-19 with cognitive decline and impairment, respectively. After a mean 50-week follow-up, no significant associations were observed between COVID-19 status and post-COVID-19 scores of all tapped neuropsychological domains, except Global Cognitive Function (GCF). When fully adjusted, COVID-19 was marginally associated with higher (better) post-pandemic GCF score (βadj (95% CI): 0.06 (0.00, 0.13) p=.05). However, the odds for post-COVID-19 cognitive impairment in GCF domain were not associated with the disease (ORadj (95% CI): 0.90 (0.53, 1.51) p=.68). In the PREDIMED-Plus cohort, COVID-19 status and cognitive impairment determined 50 weeks post-infection showed no association in older adults at high cardiovascular risk. This suggests that cognitive changes observed shortly after COVID-19 revert over time. However, cautious interpretation is warranted as these data were obtained within the framework of a clinical trial encouraging a healthy lifestyle.
  • dc.description.sponsorship This work was supported by a project grant from the Fundación Francisco Soria Melguizo. The project also received support from the Community of Madrid and the European Union, through the European Regional Development Fund (ERDF)-REACT-EU resources of the Madrid Operational Program 2014-2020, in the action line of R+D+i projects in response to COVID-19, FACINGLCOVID -CM. The PREDIMED-Plus trial was supported by the official Spanish Institutions for funding scientific biomedical research, CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN) and Instituto de Salud Carlos III (ISCIII), through the Fondo de Investigación para la Salud (FIS), which is co-funded by the European Regional Development Fund (six coordinated FIS projects leaded by JS-S and JVi, including the following projects: PI13/00673, PI13/00492, PI13/00272, PI13/01123, PI13/00462, PI13/00233, PI13/02184, PI13/00728, PI13/01090, PI13/01056, PI14/01722, PI14/00636, PI14/00618, PI14/00696, PI14/01206, PI14/01919, PI14/00853, PI14/01374, PI14/00972, PI14/00728, PI14/01471, PI16/00473, PI16/00662, PI16/01873, PI16/01094, PI16/00501, PI16/00533, PI16/00381, PI16/00366, PI16/01522, PI16/01120, PI17/00764, PI17/01183, PI17/00855, PI17/01347, PI17/00525, PI17/01827, PI17/00532, PI17/00215, PI17/01441, PI17/00508, PI17/01732, PI17/00926, PI19/00957, PI19/00386, PI19/00309, PI19/01032, PI19/00576, PI19/00017, PI19/01226, PI19/00781, PI19/01560, PI19/01332, PI20/01802, PI20/00138, PI20/01532, PI20/00456, PI20/00339, PI20/00557, PI20/00886, PI20/01158, PI21/01617, PI21/01214, PI21/00767, PI21/00465, PI17/00214, PI20/00012, CP21/00097); the Especial Action Project entitled: Implementación y evaluación de una intervención intensiva sobre la actividad física Cohorte PREDIMED-Plus grant to JS-S; the European Research Council (Advanced Research Grant 2014-2019; agreement #340918) granted to MÁM-G.; the Recercaixa (number 2013ACUP00194) grant to JS-S; grants from the Consejería de Salud de la Junta de Andalucía (PI0458/2013, PS0358/2016, PI0137/2018); the PROMETEO/2017/017, PROMETEO 21/2021 and the AICO/2021/347 grants from the Generalitat Valenciana; the SEMERGEN grant. This research was also partially funded by EU-H2020 Grants (Eat2beNICE/H2020-SFS-2016-2; and the Horizon 2020 PRIME study (Prevention and Remediation of Insulin Multimorbidity in Europe; grant agreement #847879). S.G.S is a recipient of the Maria Zambrano Fellowship with funding support from the Ministry of Universities and the Recovery, Transformation and Resilience Plan, Spain. The Fellowship is “Funded by the European Union - NextGenerationEU”. CG-M receives a predoctoral scholarship (2020PMF-PIPF-37) from URV. JN is supported by a predoctoral grant from Ministerio de Ciencia, Innovación y Universidades (FPU 20/00385). AH-C is supported by a predoctoral grant from Martí Franquès - INVESTIGO research fellowship funded and supported by NextGenerationEU, Servicio Público de Empleo Estatal and Universitat Rovira i Virgili (2022PMF-INV-01). JS-S was partially supported by ICREA under the ICREA Academia program. We thank the CERCA Programme/Generalitat de Catalunya for institutional support. The Institut de Recerca en Nutrició i Seguretat Alimentaria (INSA-UB). The University of Barcelona, Barcelona, Spain, is recognized as a Maria de Maeztu Unit of Excellence grant CEX2021-001234-M) funded by MICIN/AEI/FEDER, UE.
  • dc.format.mimetype application/pdf
  • dc.identifier.citation Shyam S, Gómez-Martínez C, Ni J, Gaforio JJ, Martínez-González MÁ, Corella D, et al. COVID-19 and cognitive decline in older adults with high-cardiovascular risk: A post hoc analysis. Aging Dis. 2024 Jul 21. DOI: 10.14336/AD.2024.0380
  • dc.identifier.doi http://dx.doi.org/10.14336/AD.2024.0380
  • dc.identifier.issn 2152-5250
  • dc.identifier.uri http://hdl.handle.net/10230/69605
  • dc.language.iso eng
  • dc.publisher JKL International
  • dc.relation.ispartof Aging Dis. 2024 Jul 21
  • dc.relation.projectID info:eu-repo/grantAgreement/EC/FP7/340918
  • dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/847879
  • dc.relation.projectID info:eu-repo/grantAgreement/ES/3PE/CEX2021-001234-M
  • dc.rights © 2024 Shyam et al. This is an open access article distributed under the terms of the creative commons attribution license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium provided that the original work is properly attributed.
  • dc.rights.accessRights info:eu-repo/semantics/openAccess
  • dc.rights.uri http://creativecommons.org/licenses/by/4.0/
  • dc.subject.keyword COVID-19
  • dc.subject.keyword Cognition
  • dc.subject.keyword Older adults
  • dc.subject.keyword PREDIMED-Plus
  • dc.title COVID-19 and cognitive decline in older adults with high-cardiovascular risk: A post hoc analysis
  • dc.type info:eu-repo/semantics/article
  • dc.type.version info:eu-repo/semantics/publishedVersion

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