Abstract
The COVID-19 pandemic is a health issue leading older adults to an increased vulnerability to unfavorable outcomes. Indeed, the presence of physical frailty has recently led to higher mortality due to SARS-CoV-2 infection. However, no longitudinal studies have investigated the role of neuropsychogeriatric factors associated with lockdown fatigue in healthy cognitive aging. Eighty-one healthy older adults were evaluated for their neuropsychological characteristics, including physical frailty, before the pandemic (T0). Subsequently, 50 of them agreed to be interviewed and neuropsychologically re-assessed during the lockdown (T1) and immediately after it (T2). Moreover, during another home confinement, they performed a psychological screening (T3) to evaluate possible mood changes and fatigue. According to Fried's frailty criteria, at T0, 63% of the sample was robust, 34.5% pre-frail, and only 2.5% frail. Significantly, these subjects presented a decrease in handgrip strength and walking speed (29.6 and 6.1%, respectively). Results from Principal Component Analyses and multiple regression models highlighted the contribution of “cognitive” and “psychological” factors (i.e., attentive-executive performance and mood deflections) in explaining handgrip strength and gait speed. At T3, lockdown fatigue was explained by higher scores on the Beck Depression Inventory and lower scores on the Trail Making Test part A. Results from a moderated-mediation model showed that the effect of psychomotor speed on lockdown fatigue was mediated by depression, with a moderating effect of gait speed. Our findings highlight the complex interrelationship between cognitive, psychological, and physical factors in the emergence of pandemic fatigue in a carefully selected older population.
Highlights
The presence of a state of frailty, characterized by a clinical history of polypathology, has recently led to higher mortality due to the SARS-CoV-2 pandemic among the older population (Onder et al, 2020)
We investigated the relationships between pandemic lockdown fatigue, physical-cognitive functions, and mood changes in 50 older adults−60 years and older (World Health Organization, 2021)—engaged as volunteers, suffering from two or more age-related diseases and receiving subsequent pharmacotherapy (Masnoon et al, 2017)
Even if the MMSE scores did not suggest the presence of Mild Cognitive Impairment (MCI) (i.e., O’Bryant et al, 2008) and the participants did not report subjective cognitive decline, their performance was below the reference cut-off value on some tests
Summary
The presence of a state of frailty, characterized by a clinical history of polypathology, has recently led to higher mortality due to the SARS-CoV-2 pandemic among the older population (Onder et al, 2020). Polypathological subjects suffer from two or more chronic diseases, which could lead to disability and higher mortality rates (Gómez-Salgado et al, 2019). Lockdown measures play a major role in the containment of SARS-CoV-2 infection. Isolation and social distancing are associated with cognitive decline, depression, and anxiety in the older population (Santini et al, 2020). Social isolation is an important public health issue that can lead to higher probabilities of cognitive and mental problems (Gerst-Emerson and Jayawardhana, 2015)
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