Association of Global Cognitive Function With Psychological Distress and Adherence to Public Health Recommendations During the Coronavirus Disease 2019 Pandemic: The Women's Health Initiative

Aladdin H Shadyab; Joseph C Larson; Stephen R Rapp; Sally A Shumaker; Candyce H Kroenke; Jaymie Meliker; Nazmus Saquib; Farha Ikramuddin; Yvonne L Michael; Joseph S Goveas; Lorena Garcia; Jean Wactawski-Wende; Juhua Luo; Kathleen M Hayden; Jiu-Chiuan Chen; Julie Weitlauf; Laura D Baker

doi:10.1093/gerona/glac053

Association of Global Cognitive Function With Psychological Distress and Adherence to Public Health Recommendations During the Coronavirus Disease 2019 Pandemic: The Women's Health Initiative

J Gerontol A Biol Sci Med Sci. 2022 Dec 6;77(Suppl 1):S42-S50. doi: 10.1093/gerona/glac053.

Authors

Aladdin H Shadyab¹, Joseph C Larson², Stephen R Rapp³, Sally A Shumaker⁴, Candyce H Kroenke⁵, Jaymie Meliker⁶, Nazmus Saquib⁷, Farha Ikramuddin⁸, Yvonne L Michael⁹, Joseph S Goveas¹⁰, Lorena Garcia¹¹, Jean Wactawski-Wende¹², Juhua Luo¹³, Kathleen M Hayden⁴, Jiu-Chiuan Chen¹⁴, Julie Weitlauf^{15

16}, Laura D Baker¹⁷

Affiliations

¹ Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, California, USA.
² Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
³ Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
⁴ Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
⁵ Division of Research, Kaiser Permanente Northern California, Oakland, California, USA.
⁶ Program in Public Health, Department of Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, New York, USA.
⁷ College of Medicine, Sulaiman AlRajhi University, Al Buakyriyah, Saudia Arabia.
⁸ Division of Physical Medicine and Rehabilitation, Department of Rehabilitation Medicine, University of Minnesota School of Medicine, Minneapolis, Minnesota, USA.
⁹ Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania,USA.
¹⁰ Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
¹¹ Department of Public Health Sciences, School of Medicine, University of California, Davis, California, USA.
¹² Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, State University of New York (SUNY) at Buffalo, Buffalo, New York, USA.
¹³ Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, Indiana, USA.
¹⁴ Departments of Population and Public Health Sciences and Neurology, Keck School of Medicine, University of Southern California, Los Angeles, California,USA.
¹⁵ Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA.
¹⁶ Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA.
¹⁷ Department of Internal Medicine-Geriatrics, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.

Abstract

Background: The association of cognitive function with symptoms of psychological distress during the coronavirus disease 2019 (COVID-19) pandemic or adherence to COVID-19 protective health behaviors is not well-understood.

Methods: We examined 2 890 older women from the Women's Health Initiative cohort. Prepandemic (ie, within 12 months prior to pandemic onset) and peripandemic global cognitive function scores were assessed with the modified Telephone Interview for Cognitive Status (TICS-m). Anxiety, stress, and depressive symptom severity during the pandemic were assessed using validated questionnaires. We examined adherence to protective behaviors that included safe hygiene, social distancing, mask wearing, and staying home. Multivariable models were adjusted for age, race, ethnicity, education, region of residence, alcohol intake, and comorbidities.

Results: Every 5-point lower prepandemic TICS-m score was associated with 0.33-point mean higher (95% confidence interval [CI], 0.20, 0.45) perceived stress and 0.20-point mean higher (95% CI, 0.07, 0.32) depressive symptom severity during the pandemic. Higher depressive symptom severity, but not anxiety or perceived stress, was associated with a 0.69-point (95% CI, -1.13, -0.25) mean decline in TICS-m from the prepandemic to peripandemic period. Every 5-point lower peripandemic TICS-m score was associated with 12% lower odds ratio (OR, 0.88; 95% CI, 0.80, 0.97) of practicing safe hygiene.

Conclusions: Among older women, we observed that: (a) lower prepandemic global cognitive function was associated with higher stress and depressive symptom severity during the pandemic; (b) higher depressive symptom severity during the pandemic was associated with cognitive decline; and (c) lower global cognitive function during the pandemic was associated with lower odds of practicing safe hygiene.

Keywords: anxiety; depression; mental health; severe acute respiratory syndrome coronavirus 2; stress.

MeSH terms

Aged
COVID-19*
Cognition
Depression / epidemiology
Depression / psychology
Female
Humans
Pandemics / prevention & control
Psychological Distress*
Public Health
SARS-CoV-2
Stress, Psychological / epidemiology
Women's Health

Abstract

MeSH terms

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