Cognitive decline among older adults with heart diseases before and during the COVID-19 pandemic: A longitudinal cohort study

Rong Hua; Chenglong Li; Darui Gao; Fanfan Zheng; Wuxiang Xie

doi:10.3389/fcvm.2022.1077800

Cognitive decline among older adults with heart diseases before and during the COVID-19 pandemic: A longitudinal cohort study

Front Cardiovasc Med. 2023 Jan 26:9:1077800. doi: 10.3389/fcvm.2022.1077800. eCollection 2022.

Authors

Rong Hua^{1

2}, Chenglong Li^{1

2}, Darui Gao^{1

2}, Fanfan Zheng³, Wuxiang Xie^{1

2}

Affiliations

¹ Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China.
² Peking University Clinical Research Institute Heart and Vascular Health Research Center at Peking University Shougang Hospital, Beijing, China.
³ School of Nursing, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.

Abstract

Background: Little is known about the impact induced by the COVID-19 pandemic on the cognitive function of older adults with heart diseases. This study aimed to examine whether older adults with heart diseases suffered larger cognitive deterioration during the COVID-19 pandemic.

Methods: This study leveraged longitudinal data from the Health and Retirement Study (HRS), a nationally representative U.S. aging cohort with objective cognitive assessments measured before and during the pandemic. The interval from HRS waves 13 to 14 (April 2016 to June 2019) was defined as the pre-pandemic period to control the pre-existed cognitive difference between participants with and without heart diseases, and the interval from waves 14 to 15 (June 2019 to June 2021) was defined as the pandemic period. The HRS wave 14 survey was considered the baseline. The heart disease status was defined by a self-reported diagnosis. Linear mixed models were performed to evaluate and compare the cognitive differences during different periods.

Results: A total of 9,304 participants (women: 5,655, 60.8%; mean age: 65.8 ± 10.8 years) were included, and 2,119 (22.8%) had heart diseases. During the pre-pandemic period, there was no significant difference (-0.03, 95% CI: -0.22 to 0.15, P = 0.716) in the changes in global cognitive scores between participants with and without heart disease. During the pandemic period, a larger decreased change in the global cognitive score was observed in the heart disease group compared with the non-heart disease group (-0.37, 95% CI: -0.55 to -0.19, P < 0.001). An enlarged difference in global cognitive score was observed during the pandemic period (-0.33, 95% CI: -0.65 to -0.02, P = 0.036).

Conclusion: The findings demonstrated that the population with heart diseases suffered more cognitive decline related to the pandemic, underscoring the necessity to provide immediate cognitive monitoring and interventions for the population with heart diseases.

Keywords: COVID-19 pandemic; cognitive decline; dementia; heart diseases; older adult.

Grants and funding

This study was supported by the National Natural Science Foundation of China (81974490), the Non-profit Central Research Institute Fund of the Chinese Academy of Medical Sciences (2021-RC330-001), and the 2019 Irma and Paul Milstein Program for Senior Health Research Project. The funding sources had no role in the design and conduct of the study, collection, management, analysis, and interpretation of the data, preparation, review, or approval of the manuscript, and decision to submit the manuscript for publication.