The impact of mental health outcomes on cognition during the COVID‐19 pandemic in older adults with remitted depression, mild cognitive impairment, or normal cognition

Abstract

AbstractBackgroundOlder adults may be vulnerable to worsening cognition during pandemics because of public health restrictions that increase social isolation and negatively impact mental health. In the current study, we assessed mental health outcomes during the COVID‐19 pandemic and their relationship with cognitive status at 6 months in older adults with remitted major depressive disorder (rMDD), mild cognitive impairment (MCI), or normal cognition (NC).MethodThe sample consisted of 108 older adults enrolled from ongoing studies [37M, mean age = 70.6 (SD = ±5.75)], including 71 NC, 21 rMDD, and 16 MCI]. Participants completed self‐report measures including the Patient Health Questionnaire‐9 to assess depression, Patient Reported Outcomes Measurement Information System to assess anxiety, Perceived Stress Scale to assess general stress, Impact of Events Scale‐Revised to assess post‐traumatic stress, and the Clinical Dementia Rating Scale (CDR) at baseline, 3 and 6 months. Repeated measures ANCOVA of mood and cognitive measures with time as a within‐subject factor and covariates of parent study and mood/memory diagnosis assessed change over time in mental health and cognition. Regression modelling of CDR Sum of Boxes (CDR‐SB) score at 6 months with baseline mood and anxiety scores as predictors and age, gender, parent study, and mood/memory diagnosis as covariates were used to assess the association between mental health and future cognition.ResultMood and cognition did not significantly vary over the three time‐points. Depression and general stress at baseline were predictive of CDR‐SB at 6‐month follow‐up, accounting for 14% of its variance (F(6,55) = 2.69, p = .023, B = .28, p = .038; F(6,72) = 3.16, p = .008, B = .21, p = .088, respectively). Neither anxiety nor post‐traumatic stress symptom severity predicted CDR‐SB.ConclusionThese findings are consistent with epidemiological studies supporting associations between depression or stress and risk of dementia (Byers & Yaffe, 2011; Stuart & Padgett, 2020). Limitations of the study include non‐random sampling and small rMDD and MCI samples. Nevertheless, these preliminary findings suggest the need to address adverse mental health outcomes in seniors during the COVID‐19 pandemic to potentially reduce risk of future cognitive decline.