A-20: COVID-19 Illness Characteristics and Cognitive Performance in Older Adults: A Pilot Analysis
Abstract
Objective: COVID-19 has been associated with cognitive changes in older adults, but the illness characteristics linked to later cognitive performance remain unclear. We examined whether selected COVID-19 illness characteristics were associated with cognitive outcomes in older adults with prior COVID-19 infection. Method/Data Selection: 100 English-speaking adults aged 55 years and older with documented prior COVID-19 were evaluated at the Icahn School of Medicine at Mount Sinai. Participants completed a neuropsychological battery and COVID-19 symptom questionnaire. COVID-19 illness characteristics included self- reported cognitive changes, highest level of medical care, brain fog, smell/taste change, and number of prior infections. Cognitive outcomes included Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) total score, recognition, and delayed recall; Montreal Cognitive Assessment (MoCA) score; letter fluency; and Oral Trail Making Test (O-TMT) Parts A and B. Significant associations were further examined in unadjusted and adjusted linear regression models controlling for age, sex, education, race/ethnicity, and depressive symptoms. Results/Data Synthesis: Several COVID-19 illness characteristics were associated with cognitive outcomes in unadjusted analyses, but many associations weakened after covariate adjustment. In adjusted models, self-reported cognitive change score was associated with lower CERAD total (estimate = -0.31, SE = 0.09, p < 0.001), lower CERAD recognition (estimate = -0.08, SE = 0.03, p = 0.02), and worse O-TMT Part A (estimate = 0.23, SE = 0.07, p < 0.001). Other indicators showed less consistent associations. Conclusions: Among older adults with prior COVID-19 infection, selected illness characteristics showed varying associations with later cognitive performance, supporting further study of which aspects of COVID-19 are most relevant to post-COVID cognitive outcomes.