Cognitive consequences of COVID-19: results of a cohort study from South America.

BACKGROUND: Neurological and psychiatric manifestations associated with SARS-CoV-2 infection have been reported throughout the scientific literature. However, studies on post-COVID cognitive impairment in people with no previous cognitive complaint are scarce. OBJECTIVE: We aim to investigate the impact of COVID-19 on cognitive functions in adults without cognitive complaints before infection and to study cognitive dysfunction according to disease severity and cognitive risk factors. METHODS: Forty-five post-COVID-19 patients and forty-five controls underwent extensive neuropsychological evaluation, which assessed cognitive domains such as memory, language, attention, executive functions, and visuospatial skills, including psychiatric symptomatology scales. Data were collected on the severity of infection, premorbid medical conditions, and functionality for activities of daily living before and after COVID-19. RESULTS: Significant differences between groups were found in cognitive composites of memory (p=0.016, Cohen's d= 0.73), attention (p<0.001, Cohen's d=1.2), executive functions (p<0.001, Cohen's d=1.4), and language (p=0.002, Cohen's d=0.87). The change from premorbid to post-infection functioning was significantly different between severity groups (WHODAS, p=0.037). Self-reported anxiety was associated with the presence of cognitive dysfunction in COVID-19 subjects (p=0.043). CONCLUSION: Our results suggest that the presence of cognitive symptoms in post-COVID-19 patients may persist for months after disease remission and argue for the inclusion of cognitive assessment as a protocolized stage of the post-COVID examination. Screening measures may not be sufficient to detect cognitive dysfunction in post-COVID-19 patients.

Psychological distress and mental health trajectories during the COVID-19 pandemic in Argentina: a longitudinal study.

Psychological-distress increased at the onset of the COVID-19 pandemic in Argentina. Longitudinal studies in developing countries are scarce. Particularly, Argentina had one of the longest lockdowns. Differences in preventive measures against the virus spread between countries may differentially affect the mental health of the populations. Here we aimed to characterize distinct psychological-distress and related-symptoms trajectories associated with the pandemic and explore risk/protective factors. In this longitudinal study, data from 832 Argentineans were collected every 3-5 months, between April 2020-August 2021. Mean psychological-distress levels and related-symptoms tended to increase over time. However, latent-class analysis identified four distinct psychological-distress trajectories. Most individuals had consistently good mental health (Resilient). Two classes showed psychological-distress worsening during the initial phase of the pandemic and recovered at different time points (Fast Recovery; Slow Recovery). The remaining class maintained a mild -level of psychological-distress and began to deteriorate in March 2021 (Deteriorating) continuously. Individuals who are younger, female, have pre-existing psychiatric diagnoses, or have high neuroticism or lower resilience were more likely to experiencing fluctuations in psychological-distress. The mental health trajectory during the pandemic had a complex dynamic. Although most participants remained resilient, a vulnerable group was detected, which deteriorated over time and should be considered by health-services.

Covid-19 and Children's Social Development Changes in cognitive functioning after COVID-19: A systematic review and meta-analysis

Summary In this chapter, the authors focus on disruptions to children's lives at home and at school (including early childhood care and education programs [ECCE] and primary schooling) as critical settings for healthy development. The Covid-19 pandemic has upended children's lives in myriad ways, including disruptions in the family system due to illness or death, financial instability tied to job loss, and educational disruptions as a result of closures of child care facilities and schools. In considering how the Covid-19 pandemic is shaping children's social development, the authors attend to how interactions with others and socialization processes within families and schools may buffer or exacerbate the pandemic's negative impact. Developmental scientists are well positioned to research how macro-level shocks such as the coronavirus pandemic affect children's developmental trajectories, and the life-course perspective can guide and inform that investigation. Introduction We conducted a systematic review and meta-analysis of the cognitive effects of coronavirus disease 2019 (COVID-19) in adults with no prior history of cognitive impairment. Methods Searches in Medline/Web of Science/Embase from January 1, 2020, to December 13, 2021, were performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.  A meta-analysis of the Montreal Cognitive Assessment (MoCA) total score comparing recovered COVID-19 and healthy controls was performed. Results Oof 6202 articles, 27 studies with 2049 individuals were included (mean age = 56.05 years, evaluation time ranged from the acute phase to 7 months post-infection). Impairment in executive functions, attention, and memory were found in post-COVID-19 patients.  The meta-analysis was performed with a subgroup of 290 individuals and showed a difference in MoCA score between post-COVID-19 patients versus controls (mean difference = ?0.94, 95% confidence interval [CI] ?1.59, ?0.29;P = .0049). Discussion Patients recovered from COVID-19 have lower general cognition compared to healthy controls up to 7 months post-infection.

Changes in cognitive functioning after COVID-19: A systematic review and meta-analysis.

INTRODUCTION: We conducted a systematic review and meta-analysis of the cognitive effects of coronavirus disease 2019 (COVID-19) in adults with no prior history of cognitive impairment. METHODS: Searches in Medline/Web of Science/Embase from January 1, 2020, to December 13, 2021, were performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.  A meta-analysis of the Montreal Cognitive Assessment (MoCA) total score comparing recovered COVID-19 and healthy controls was performed. RESULTS: Oof 6202 articles, 27 studies with 2049 individuals were included (mean age = 56.05 years, evaluation time ranged from the acute phase to 7 months post-infection). Impairment in executive functions, attention, and memory were found in post-COVID-19 patients.  The meta-analysis was performed with a subgroup of 290 individuals and showed a difference in MoCA score between post-COVID-19 patients versus controls (mean difference = -0.94, 95% confidence interval [CI] -1.59, -0.29; P = .0049). DISCUSSION: Patients recovered from COVID-19 have lower general cognition compared to healthy controls up to 7 months post-infection.

Impact of social isolation on people with dementia and their family caregivers

Background: People with dementia and their family caregivers may face a great burden through social isolation due to the COVID-19 pandemic, which can be manifested as various behavioral and clinical symptoms. Objective: To investigate the impacts of social isolation due to the COVID-19 pandemic on individuals with dementia and their family caregivers. Methods: Two semi-structured questionnaires were applied via telephone to family caregivers of people diagnosed with dementia in three cities in Argentina, Brazil, and Chile, in order to assess clinical and behavioral changes in people with dementia and in their caregivers. Results: In general, 321 interviews were conducted. A significant decline in memory function has been reported among 53.0% of people with dementia. In addition, 31.2% of individuals with dementia felt sadder and 37.4% had increased anxiety symptoms. These symptoms of anxiety were greater in individuals with mild to moderate dementia, while symptoms of agitation were greater in individuals with severe dementia. Moreover, compulsive-obsessive behavior, hallucinations, increased forgetfulness, altered appetite, and increased difficulty in activities of daily living were reported more frequently among individuals with moderate to severe dementia. Caregivers reported feeling more tired and overwhelmed during this period and these symptoms were also influenced by the severity of dementia. Conclusion: Social isolation during the COVID-19 pandemic triggered a series of negative behavioral repercussions, both for people with dementia and for their family caregivers in these three South American countries. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Addressing the disparities in dementia risk, early detection and care in Latino populations: Highlights from the second Latinos & Alzheimer's Symposium.

The Alzheimer's Association hosted the second Latinos & Alzheimer's Symposium in May 2021. Due to the COVID-19 pandemic, the meeting was held online over 2 days, with virtual presentations, discussions, mentoring sessions, and posters. The Latino population in the United States is projected to have the steepest increase in Alzheimer's disease (AD) in the next 40 years, compared to other ethnic groups. Latinos have increased risk for AD and other dementias, limited access to quality care, and are severely underrepresented in AD and dementia research and clinical trials. The symposium highlighted developments in AD research with Latino populations, including advances in AD biomarkers, and novel cognitive assessments for Spanish-speaking populations, as well as the need to effectively recruit and retain Latinos in clinical research, and how best to deliver health-care services and to aid caregivers of Latinos living with AD.

Impact of an intergenerational training program in the use of information and communication technologies for older adults who receive cognitive intervention in the context of a Covid-19 pandemic: Preliminary results

Background Worldwide, the Covid-19 pandemic impacted on professionals and patients receiving cognitive rehabilitation (CR) forcing them to instrument assistance programs through tele-neuropsychology. Many of those who receive CR are older adults who lack the necessary technological knowledge to carry out CR through teleneuropsychology. The present study aims to evaluate the impact of a training program on technological tools, carried out by high school students, for older adults who received CR through teleneuropsychology. Method Design: Pre-post, longitudinal intervention study. Participants: Older adults (n=13) (73.34 +/- 5.07 years old) and Students (n=20) (16.14 +/-1.33 years old). The intervention consisted of a 4 week program for technological training. Participants were assessed at the beginning and the end of the program which consists in two training sessions of 45 minutes each. Instruments: Older adults were assessed with: Questionnaire of Social Demographic Data and Use of Technology (built ad. Hoc.), Functional Assessment Questionnaire, MOS Scale of Social Support, Try Your Memory Test (TYM). Students were assessed with: Basic data questionnaire and Negative stereotypes questionnaire towards old age (CENVE). Result When comparing pre and post-tests, statistically significant differences were found in the assessed variables. In the older adult group, a significant difference was found in the use of zoom platform (z= -2.97, p= .003). In the student group, a statistically significant difference was found regarding the beliefs about aging (z=-2,53 p= .01). Conclusion These results add evidence regarding the importance of applying technology training programs for older adults. Intergenerational programs are a promising alternative where both parts can benefit: older adults through the incorporation of meaningful technological tools for their daily lives, and young participants taking the opportunity to provide community service and to deconstruct negative prejudices and beliefs towards old age and its consequences.

Working Group Recommendations for the Practice of Teleneuropsychology in Latin America.

OBJECTIVE: Teleneuropsychology (teleNP) could potentially expand access to services for patients who are confined, have limited personal access to healthcare, or live in remote areas. The emergence of the COVID-19 pandemic has significantly increased the use of teleNP for cognitive assessments. The main objective of these recommendations is to identify which procedures can be potentially best adapted to the practice of teleNP in Latin America, and thereby facilitate professional decision-making in the region. METHOD: Steps taken to develop these recommendations included (1) formation of an international working group with representatives from 12 Latin American countries; (2) assessment of rationale, scope, and objectives; (3) formulation of clinical questions; (4) evidence search and selection; (5) evaluation of existing evidence and summary; and (6) formulation of recommendations. Levels of evidence were graded following the Oxford Centre for Evidence-Based Medicine system. Databases examined included PubMed, WHO-IRIS, WHO and PAHO-IRIS, Índice Bibliográfico Español en Ciencias de la Salud (IBCS), and LILACS. RESULTS: Working group members reviewed 18,400 titles and 422 abstracts and identified 19 articles meeting the criteria for level of evidence, categorization, and elaboration of recommendations. The vast majority of the literature included teleNP tests in the English language. The working group proposed a series of recommendations that can be potentially best adapted to the practice of teleNP in Latin America. CONCLUSIONS: There is currently sufficient evidence to support the use of videoconferencing technology for remote neuropsychological assessments. These recommendations will likely contribute to the advancement of teleNP research and practice in the region.

Impact of Social Isolation on People with Dementia and Their Family Caregivers.

BACKGROUND: People with dementia and their family caregivers may face a great burden through social isolation due to the COVID-19 pandemic, which can be manifested as various behavioral and clinical symptoms. OBJECTIVE: To investigate the impacts of social isolation due to the COVID-19 pandemic on individuals with dementia and their family caregivers. METHODS: Two semi-structured questionnaires were applied via telephone to family caregivers of people diagnosed with dementia in three cities in Argentina, Brazil, and Chile, in order to assess clinical and behavioral changes in people with dementia and in their caregivers. RESULTS: In general, 321 interviews were conducted. A significant decline in memory function has been reported among 53.0%of people with dementia. In addition, 31.2%of individuals with dementia felt sadder and 37.4%had increased anxiety symptoms. These symptoms of anxiety were greater in individuals with mild to moderate dementia, while symptoms of agitation were greater in individuals with severe dementia. Moreover, compulsive-obsessive behavior, hallucinations, increased forgetfulness, altered appetite, and increased difficulty in activities of daily living were reported more frequently among individuals with moderate to severe dementia. Caregivers reported feeling more tired and overwhelmed during this period and these symptoms were also influenced by the severity of dementia. CONCLUSION: Social isolation during the COVID-19 pandemic triggered a series of negative behavioral repercussions, both for people with dementia and for their family caregivers in these three South American countries.

Psychological distress associated with COVID-19 quarantine: Latent profile analysis, outcome prediction and mediation analysis.

BACKGROUND: Mental health of the population during COVID-19 quarantine could be at risk. Previous studies in short quarantines, found mood-related and anxiety symptomatology. Here we aimed to characterize the subtypes of psychological distress associated with quarantine, assess its prevalence, explore risk/protective factors, and possible mechanisms. METHODS: Online cross-sectional data (n = 4408) was collected during the Argentine quarantine, between 1st-17th April 2020 along a small replication study (n = 644). Psychological distress clusters were determined using latent profile analysis on a wide-range of symptoms using the complete Brief-Symptom Inventory-53. Multinomial and Elastic-net regression were performed to identify risk/protective factors among trait-measures (Personality and Resilience) and state-measures (COVID-19 related fear and coping-skills). RESULTS: Three latent-classes defined by symptom severity level were identified. The majority of individuals were classified in the mild (40.9%) and severe classes (41.0%). Participants reported elevated symptoms of Phobic-Anxiety (41.3%), Anxiety (31.8%), Depression (27.5%), General-Distress (27.1%), Obsession-Compulsion (25.1%) and Hostility (13.7%). Logistic-regressions analyses mainly revealed that women, young individuals, having a previous psychiatric diagnosis or trauma, having high levels of trait-neuroticism and COVID-related fear, were those at greater risk of psychological distress. In contrast, adults, being married, exercising, having upper-class income, having high levels of trait-resilience and coping-skills, were the most protected. Mediation analysis, showed that state-measures mediated the association between trait-measures and class-membership. CONCLUSIONS: Quarantine was associated intense psychological distress. Attention should be given to COVID-19-related fear and coping-skills as they act as potential mediators in emotional suffering during quarantine.