Cognitive symptoms among middle‐ and older‐age adults in Latin America during the coronavirus disease 2019 (COVID‐19) pandemic: Risk and protective factors
Authors: Marquine Maria J. , Madriaga Cecilia , Blumstein Yanina , Hughes Cecilia , Cancela Valentina , Muniz‐Terrera Graciela , Goyeneche Juan José , Triunfo Patricia , Scavino Marco , Breton Jordana , Guareña Lesley A. , Kamalyan Lily , Acosta Daisy M , Aguero Cinthya , Aguilar‐Navarro Sara Gloria , Babulal Ganesh , Baena Ana Y. , Brucki Sonia Maria Dozzi , Bustin Julian , Duque Lissette , Jiménez‐Velázquez Ivonne Z. , Maldonado Aleyda , de Oliveira Maira Okada , Serrano Cecilia , Slachevsky Andrea , Soto‐Añari Marcio F. , Rivera‐Fernandez Claudia , Quiroz Yakeel T. 
Published: June 2023

Background

The COVID‐19 pandemic has impacted daily life worldwide, with possible negative consequences for cognitive health. Self‐reported cognitive symptoms are linked to the development of Alzheimer’s disease and related dementias (ADRDs). Identifying risk and protective factors for cognitive symptoms during the pandemic is an important step towards the development of ADRD prevention efforts. We aimed to examine correlates of cognitive symptoms among middle‐ and older‐age adults in Latin America before the availability of vaccines to prevent COVID‐19, including sociodemographic factors and changes in life.

Method

Spanish‐speaking adults ages 55‐95 (N = 2,382, Table 1) living in Latin America completed an online survey between May and December 2020. Cognitive symptoms were assessed via the 12‐item Everyday Cognition (ECog) questionnaire. Negative (e.g., economic difficulties, limited social activities) and positive (e.g., more quality time with close others, increased time in nature/outside) life changes associated with the pandemic were measured via a subset of items from the Epidemic‐Pandemic Impacts Inventory. Sociodemographic factors included age, years of education, gender, occupation and socioeconomic status (SES). Covariates included time since March 2020 (estimated onset of the pandemic in Latin America), country of survey completion, and having experienced COVID‐19 symptoms. Multivariable linear regression models were ran on ECog total scores including covariates and sociodemographic factors (Model 1), and then adding terms for negative and positive life changes and their interaction (Model 2).

Results

Model 1 showed female gender (p = .04), not currently working (p = .02) and lower SES (p<.001) were independently associated with more cognitive symptoms. Model 2 showed a significant interaction between negative and positive life changes (p<.001), indicating that negative life changes were significantly associated with more cognitive symptoms, but this association was weaker among participants who reported at least one positive life change during the pandemic (Figure 1).

Conclusion

Cognitive symptoms might be more common among certain segments of the Latin American population, including women, and those who are not working and have low SES. The experience of positive life changes during the pandemic might buffer the detrimental impact of negative life changes on cognitive symptoms. These risk and protective factors might be considered in ADRD prevention efforts.