A-16: Psychosocial Factors as Potential Mediators of the Association Between Post-COVID-19 Self-Reported Cognitive Change and Cognitive Performance in Older Adults: A Pilot Analysis

Abstract

Objective: Persistent cognitive concerns after COVID-19 are common in older adults, and psychosocial factors may influence outcomes. We examined whether selected psychosocial characteristics mediated the association between post-COVID-19 self-reported cognitive changes and objective cognitive performance. Method/Data Selection: Participants were 100 English-speaking adults aged 55 years and older, with documented prior COVID-19. They were not selected based on prior cognitive diagnosis and were recruited through Mount Sinai Data Warehouse MyChart, the Mount Sinai COVID-19 Biobank, and referrals/flyers. All participants were evaluated remotely at Mount Sinai. Quasi-Bayesian mediation analyses tested whether self-reported pre-COVID psychosocial factors, including anxiety, depression, mood disorder (e.g., bipolar disorder), and chronic stress during infection, mediated associations between post-COVID-19 self-reported cognitive changes and cognitive outcomes, including Montreal Cognitive Assessment (MoCA) and Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) scores. Results/Data Synthesis: Pre-COVID anxiety partially mediated the association between post-COVID-19 self-reported cognitive change and CERAD total score. The indirect effect was significant (ACME = 0.10, SE = 0.04, p < 0.001; 95% CI [0.04, 0.18]), indicating that pre-COVID anxiety accounted for a small portion of the association, while the direct effect remained significant (ADE = -0.39, SE = 0.07, p < 0.001; 95% CI [-0.53, -0.24]). No significant indirect effects were observed for pre-COVID mood disorder, depression, or chronic stress, and pre-COVID anxiety did not significantly mediate the association with MoCA. Conclusions: Pre-COVID anxiety modestly mediated the association between post-COVID-19 self-reported cognitive change and CERAD total performance, suggesting that psychosocial vulnerability may contribute to post-COVID cognitive outcomes. These preliminary findings warrant replication.