Impacto da infecção pelo vírus SARS-COV-2 na cognição de idosos

Abstract

INTRODUCTION: SARS-CoV-2 infection leads to a range of sequelae, notably affecting mental health in the medium and long term. Between 30% and 80% of patients report cognitive difficulties shortly after COVID-19, and about one-third still complains two years later. Post-COVID cognitive dysfunctions, such as declines in attention, executive functions, memory, and processing speed, are well-documented, though primarily in younger populations. Understanding the neuropsychological profile of post-COVID cognitive dysfunction in older adults, who are more susceptible to cognitive decline, is essential, especially considering the pandemic's global impact. METHODOLOGY: This quantitative, observational, prospective cohort study was conducted from 2021 to 2023 with older participants aged 60 to 80 in Natal, RN, who had no previous history of cognitive decline. The study involved two groups: 70 individuals exposed to SARS-CoV-2 before vaccination (COVID group) and 153 in a control group. Exclusion criteria were education ≤ 4 years, prior cognitive decline, unstable psychiatric conditions, and significant cerebrovascular or cardiovascular events in 2020. Participants underwent three serial assessments of cognitive functions, functional capacity, mood, and sleep quality at six-month intervals, up to 20 months post-infection. Statistical analysis used linear mixed models regression, excluding those with less than high school education for sample homogeneity. A subsequent regression evaluated prognostic factors influencing cognitive outcomes. RESULTS: The average participant age was 66.97±4.64 years. Significant differences in executive functioning trajectories were observed between the COVID and control groups (Frontal Assessment Battery, p-interaction=0.051), with poorer performance in inhibitory control, cognitive flexibility, and working memory in the COVID group showing. Being married (p-interaction=0.065) and engaged in mentally stimulating activities (p-interaction=0.069) provided protection against executive decline. Conversely, overweight/obesity, anxiety, and arthralgia adversely affected cognitive outcomes. CONCLUSION: SARS-CoV-2 has long-term cognitive impacts on older adults, particularly affecting executive functions, regardless of initial infection severity. Enhancing cognitive reserve appears to offer resilience against these effects. Given the critical role of executive functioning in maintaining autonomy and independence along aging, implementing targeted cognitive rehabilitation strategies for older adults is imperative.