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(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, Innovacion y Universidades (FPU 20/00385) . AH-C is supported by a predoctoral grant from Marti Franques-INVESTIGO research fellowship funded and supported by NextGenerationEU, Servicio Publico 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 Nutricio 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.

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COVID-19 and Cognitive Decline in Older Adults with High-Cardiovascular Risk: A Post Hoc Analysis

Publicated to:AGING AND DISEASE 16 (1): 2373-2382 - 2025-02-01 16(1), DOI: 10.14336/AD.2024.0380

Authors: Shyam, Sangeetha; Gomez-Martinez, Carlos; Ni, Jiaqi; Gaforio, Jose J; Martinez-Gonzalez, Miguel Angel; Corella, Dolores; Martinez, J Alfredo; Alonso-Gomez, Angel M; Warnberg, Julia; Vioque, Jesus; Romaguera, Dora; Lopez-Miranda, Jose; Estruch, Ramon; Tinahones, Francisco J; Lapetra, Jose; Serra-Majem, Lluis; Bueno-Cavanillas, Aurora; Tur, Josep A; Martin-Sanchez, Vicente; Pinto, Xavier; Delgado-Rodriguez, Miguel; Matia-Martin, Pilar; Vidal, Josep; Vazquez, Clotilde; Daimiel, Lidia; Ros, Emilio; Fernandez-Aranda, Fernando; Hernandez-Cacho, Adrian; Buil-Cosiales, Pilar; Sorli, Jose, V; Castaner, Olga; Garcia-Rios, Antonio; Oncina-Canovas, Alejandro; Perez-Farinos, Napoleon; Nafria, Mar; Casas, Rosa; Martinez-Diz, Silvia; Tojal-Sierra, Lucas; Gomez-Perez, A M; Toledo, Estefania; Fernandez-Carrion, Rebeca; Bayon, Alvaro Moran; Torres-Pena, Jose David; Compan-Gabucio, Laura; Vazquez-Ruiz, Zenaida; Babio, Nancy; Fito, Montserrat; Salas-Salvado, Jordi

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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/m(2,) 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 (beta adj (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.

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