Positive Life Change During Pandemic Linked to Fewer Cognitive Symptoms Among Latin American Elderly

María Marquine, PhD

Undergoing a single positive life change—such as spending more time with friends and family or more time outside—during the COVID-19 pandemic appeared to serve as a buffer of sorts for the effect of negative life changes—such as economic difficulties and limited social activities—on cognitive symptoms among a cohort of Latin American individuals older than 55 years. Data suggest that negative life changes were significantly associated with an increase in cognitive symptoms, which was lessened among those who had reported at least 1 positive life change.¹

Additionally, the presence of more cognitive symptoms during the early portion of the pandemic was also associated with female gender (P = .04), lower socioeconomic status (P <.001), and unemployment (P = .02). The cohort consisted of Spanish-speaking adults aged 55-95 years (n = 2382) who were living in Latin America that completed an online survey between May 2020 and December 2020.

The data were presented at the Alzheimer’s Association International Conference (AAIC), held July 31 to August 4, 2022, in San Diego, California, by María Marquine, PhD, an associate professor of medicine and psychiatry and director of Disparities Research in the Division of Geriatrics, Gerontology, and Palliative Care at the University of California, San Diego. “Identifying risk and protective factors for cognitive symptoms during the pandemic is an important step towards the development of prevention efforts,” Marquine said in a statement.²

Among those who reported at least 1 positive life change, the total number of cognitive symptoms was estimated at 0.85 (SE, 0.07; P <.001) compared with 1.63 (SE, 0.24) for those without a positive life change.

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“The experience of positive life changes during the pandemic might buffer the detrimental impact of negative life changes on cognitive symptoms,” Marquine said,² adding that, “This study is an example of how investigators from diverse countries in Latin America and the United States, many of whom had never worked together before and had limited resources, came together under difficult circumstances but with a shared goal to advance scientific understanding about Alzheimer’s, and the important contributions that such multicultural partnerships can yield.”

Of the total study population, 6.09% (n = 145) reported experiencing COVID-19 symptoms. Geographically, participants reported residence in Uruguay (59.7%; n = 1423), Mexico (13.1%; n = 311), Peru (6.4%; n = 153), Chile (6.4%; n = 152), Dominican Republic (4.9%; n = 117), Argentina (4.5%; n = 106), Colombia (2.1%; n = 50), Ecuador (1.6%; n = 39), Puerto Rico (0.8%; n = 19) or other (0.5%; n = 12). Participants were an average age of 65.3 years, and 62.3% were women.

This work by Marquine et al is one of many assessing the effect of the COVID-19 pandemic on those with Alzheimer and related dementias (ADRD) published or presented since its onset. In February 2022, data published in JAMA Neurology suggested that the pandemic may be associated with excess mortality among older adults with ADRD.³

That work, from Lauren Gilstrap, MD, MPH, and colleagues, Investigators included a total of 26,952,752 Medicare enrollees from 2019 and 26,688,136 from 2020, comparing mortality rates from March through December 2019 with March through December 2020. In 2019, patients without ADRD had a mean age of 74.1 years (SD, 8.8) and those with ADRD had a mean age of 82.6 years (AD, 8.4). Among all enrollees without ADRD, adjusted mortality in 2020 was 12.4% higher when compared with 2019 (95% CI, 12.1-12.6) and among those with ADRD, adjusted mortality in 2020 was 25.7% higher when compared with 2019 (95% CI, 25.3-26.2).³

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REFERENCES
1. Marquine M. Cognitive symptoms among middle- and older-age adults in Latin America during the coronavirus disease 2019 (COVID-19) pandemic: Risk and protective factors. presented at: AAIC; July 31-August 4, 2022; Virtual + San Diego, CA.
2. One positive life change during the pandemic may buffer against cognitive symptoms. Alzheimer’s Association. July 31, 2022. Accessed July 31, 2022.
3. Gilstrap L, Zhou W, Alsan M, Nanda A, Skinner JS. Trends in mortality rates among Medicare enrollees with Alzheimer disease and related dementias before and during the early phase of the COVID-19 pandemic. JAMA Neurol. 2022;79(4):342-348. doi:10.1001/jamaneurol.2022.0010