TY - JOUR
T1 - COVID-19 and Cognitive Change in a Community-Based Cohort
AU - Demmer, Ryan T.
AU - Cornelius, Talea
AU - Kraal, Zarina
AU - Pike, James R.
AU - Sun, Yifei
AU - Balte, Pallavi
AU - Wu, Chaoqi
AU - Allen, Norrina B.
AU - Cushman, Mary
AU - Suchy-Dicey, Astrid M.
AU - Elkind, Mitchell S.V.
AU - Howard, Virginia
AU - Kucharska-Newton, Anna
AU - Levine, Deb
AU - Lutsey, Pamela L.
AU - Manly, Jennifer
AU - Mosley, Thomas H.
AU - Palta, Priya
AU - Power, Melinda C.
AU - Seshadri, Sudha
AU - Tracy, Russell P.
AU - Walker, Keenan
AU - Coresh, Josef
AU - Oelsner, Elizabeth C.
N1 - Publisher Copyright:
© 2025 Demmer RT et al.
PY - 2025/6
Y1 - 2025/6
N2 - IMPORTANCE SARS-CoV-2 infection has been linked to neurotoxic effects and cognitive deficits. OBJECTIVE To determine whether decreases in cognitive function were accelerated after SARS-CoV-2 infection compared with individuals not infected. DESIGN, SETTING, AND PARTICIPANTS Multicenter, prospective cohort study from 2016 to 2022 among 3525 participants alive on March 1, 2020, and enrolled in The Atherosclerosis Risk in Communities (ARIC) study and the Collaborative Cohort of Cohorts for COVID-19 Research study who completed a prepandemic cognitive assessment and a pandemic-era assessment of SARS-CoV-2 infection. Final analyses performed in November 2024. EXPOSURE SARS-CoV-2 infection determined via self-report of a positive SARS-CoV-2 test or health care professional diagnosis of COVID-19, a positive SARS-CoV-2 antinucleocapsid antibody response, or presence of an administrative code for COVID-19 on medical records. MAIN OUTCOMES AND MEASURES A neuropsychological battery assessed multiple cognitive domains, and a cocalibrated confirmatory factor analysis generated factor scores for global cognitive function. The primary outcome was the rate of excess change in cognitive function. RESULTS The 3525 eligible participants had a mean (SD) age of 80.8 (4.7) years, 2085 (59.1%) were female, 752 (21.4%) were Black, and 2773 (78.6%) were White. SARS-CoV-2 infection was detected among 307 participants (8.7%), 103 of whom (33.6%) were hospitalized. Among uninfected participants, the mean annualized change in cognitive function was -0.09 (95% CI, -0.13 to -0.04). Compared with this rate, change was faster (β = -0.06; 95% CI, -0.09 to -0.02) among participants hospitalized for infection, but not different from participants who were infected but not hospitalized (β = 0.00; 95% CI, -0.02 to 0.03). The association among p articipants hospitalized for infection was evident in the cognitive domains of memory and executive function, but not language. CONCLUSIONS AND RELEVANCE This cohort study of older participants found accelerated decreases in cognition among individuals hospitalized for SARS-CoV-2 infection, but not nonhospitalized infection, in comparison with individuals not yet infected.
AB - IMPORTANCE SARS-CoV-2 infection has been linked to neurotoxic effects and cognitive deficits. OBJECTIVE To determine whether decreases in cognitive function were accelerated after SARS-CoV-2 infection compared with individuals not infected. DESIGN, SETTING, AND PARTICIPANTS Multicenter, prospective cohort study from 2016 to 2022 among 3525 participants alive on March 1, 2020, and enrolled in The Atherosclerosis Risk in Communities (ARIC) study and the Collaborative Cohort of Cohorts for COVID-19 Research study who completed a prepandemic cognitive assessment and a pandemic-era assessment of SARS-CoV-2 infection. Final analyses performed in November 2024. EXPOSURE SARS-CoV-2 infection determined via self-report of a positive SARS-CoV-2 test or health care professional diagnosis of COVID-19, a positive SARS-CoV-2 antinucleocapsid antibody response, or presence of an administrative code for COVID-19 on medical records. MAIN OUTCOMES AND MEASURES A neuropsychological battery assessed multiple cognitive domains, and a cocalibrated confirmatory factor analysis generated factor scores for global cognitive function. The primary outcome was the rate of excess change in cognitive function. RESULTS The 3525 eligible participants had a mean (SD) age of 80.8 (4.7) years, 2085 (59.1%) were female, 752 (21.4%) were Black, and 2773 (78.6%) were White. SARS-CoV-2 infection was detected among 307 participants (8.7%), 103 of whom (33.6%) were hospitalized. Among uninfected participants, the mean annualized change in cognitive function was -0.09 (95% CI, -0.13 to -0.04). Compared with this rate, change was faster (β = -0.06; 95% CI, -0.09 to -0.02) among participants hospitalized for infection, but not different from participants who were infected but not hospitalized (β = 0.00; 95% CI, -0.02 to 0.03). The association among p articipants hospitalized for infection was evident in the cognitive domains of memory and executive function, but not language. CONCLUSIONS AND RELEVANCE This cohort study of older participants found accelerated decreases in cognition among individuals hospitalized for SARS-CoV-2 infection, but not nonhospitalized infection, in comparison with individuals not yet infected.
UR - https://www.scopus.com/pages/publications/105009750608
UR - https://www.scopus.com/pages/publications/105009750608#tab=citedBy
U2 - 10.1001/jamanetworkopen.2025.18648
DO - 10.1001/jamanetworkopen.2025.18648
M3 - Article
C2 - 40587126
AN - SCOPUS:105009750608
SN - 2574-3805
VL - 8
JO - JAMA Network Open
JF - JAMA Network Open
IS - 6
M1 - 2518648
ER -
