Post-COVID cognitive dysfunction in socioeconomically-vulnerable older adults: findings from a Brazilian cohort

Background  Cognitive impairment is increasingly recognized as a long-term consequence of coronavirus disease 2019 (COVID-19), but most evidence comes from high-income settings. Little is known about its impact in socioeconomically-vulnerable populations.

Objective  The current study investigated long-term cognitive effects in 133 individuals older than 50 years of age with low level of schooling and low socioeconomic status who were hospitalized for COVID-19.

Methods  The participants were assessed 12 to 18 months after hospitalization using the Modified Telephone Interview for Cognitive Status (TICS-M). A subset of 65 participants underwent further cognitive and neuropsychiatric evaluations. Cognitive impairment was defined as scores ≤ −1.5 standard deviations from age- and education-adjusted Brazilian norms. During the acute phase of the disease, sociodemographic, clinical, and laboratory data were evaluated to identify potential risk factors.

Results  The mean age of the subjects (n = 65) was of 65.3 years, and the sample was composed of 69.2% of women, 57.1% of pardo individuals, 47.7% of subjects with ≤ 4 years of schooling, and 83.6% of participants with monthly family income ≤ 3 minimum wages. Hospitalization averaged 16.1 days, and 55.4% required intensive care. Cognitive impairment affected 70.8% of the participants. Higher age, female sex, and hyposmia were associated with cognitive impairment.

Conclusion  Cognitive impairment was frequent in this socioeconomically-vulnerable sample, a group still underrepresented in existing research.

Keywords
COVID-19; Post-Acute COVID-19 Syndrome; Cognitive Dysfunction