ImportanceSARS-CoV-2 infection is associated with persistent, relapsing, or new symptoms or other health effects occurring after acute infection, termed postacute sequelae of SARS-CoV-2 infection (PASC), also known as long COVID. Characterizing PASC requires analysis of prospectively and uniformly collected data from diverse uninfected and infected individuals.ObjectiveTo develop a definition of PASC using self-reported symptoms and describe PASC frequencies across cohorts, vaccination status, and number of infections.Design, Setting, and ParticipantsProspective observational cohort study of adults with and without SARS-CoV-2 infection at 85 enrolling sites (hospitals, health centers, community organizations) located in 33 states plus Washington, DC, and Puerto Rico. Participants who were enrolled in the RECOVER adult cohort before April 10, 2023, completed a symptom survey 6 months or more after acute symptom onset or test date. Selection included population-based, volunteer, and convenience sampling.ExposureSARS-CoV-2 infection.Main Outcomes and MeasuresPASC and 44 participant-reported symptoms (with severity thresholds).ResultsA total of 9764 participants (89% SARS-CoV-2 infected; 71% female; 16% Hispanic/Latino; 15% non-Hispanic Black; median age, 47 years [IQR, 35-60]) met selection criteria. Adjusted odds ratios were 1.5 or greater (infected vs uninfected participants) for 37 symptoms. Symptoms contributing to PASC score included postexertional malaise, fatigue, brain fog, dizziness, gastrointestinal symptoms, palpitations, changes in sexual desire or capacity, loss of or change in smell or taste, thirst, chronic cough, chest pain, and abnormal movements. Among 2231 participants first infected on or after December 1, 2021, and enrolled within 30 days of infection, 224 (10% [95% CI, 8.8%-11%]) were PASC positive at 6 months.Conclusions and RelevanceA definition of PASC was developed based on symptoms in a prospective cohort study. As a first step to providing a framework for other investigations, iterative refinement that further incorporates other clinical features is needed to support actionable definitions of PASC.

Memory complaints by healthy older people usually show little relation to objective memory performance. If subjective memory evaluations are not driven by actual memory problems, what is the cause of these complaints? Correlations of an objective measure of memory as well as measures of personality, emotional distress, and health with subjective memory evaluations were examined in 283 community-dwelling people aged 45 to 94 years. Stepwise regression analysis revealed that a combination of personality measures (Conscientiousness, self-esteem, Neuroticism) explained about a third of the variance in memory complaints compared with only 4% unique variance associated with the objective memory measure. Successful interventions for memory concerns in nondemented older people need to be tailored to the individual.

Objectives Older adults are at higher risk for death and infirmity from COVID-19 than younger and middle-age adults. The current study examines COVID-19-specific anxiety and proactive coping as potential risk and resilience factors that may be differentially important for younger and older adults in understanding stress experienced due to the COVID-19 pandemic. Method Five hundred and fifteen adults aged 20-79 in the U.S. reported on their anxiety about developing COVID-19, proactive coping, and stress related to COVID-19 in an online survey. Results Although there were no age differences in stress levels, anxiety about developing COVID-19 was associated with more COVID-19 stress for older adults relative to younger adults, but proactive coping was associated with less COVID-19 stress for older adults relative to younger adults. Discussion Our results suggest that anxiety might function as a risk factor whereas proactive coping may function as a resilience factor for older adults’ COVID-19 stress. We encourage future context-dependent investigations into mental health among older adults during this pandemic and beyond.

Cross-sectional and longitudinal relationships between memory complaint and memory performance were examined in a sample of old-old participants from the Berlin Aging Study (BASE; N = 504, ages 70 to 100, age M = 84.7 at study onset). Participants were measured 4 times over the course of 6 years. Similar to many previous studies, initial cross-sectional memory complaints were predicted by depression and neuroticism, but not memory performance. Subjective age also predicted memory complaint independent of other variables. Latent growth curve models based on age and time in the study revealed that memory complaints did not change in level with age or time, and manifested no reliable random effects (individual differences in change). These models also detected no significant relationship between changes in memory and either initial memory complaint or changes in memory complaint over age or over time. None of the covariates that predicted initial memory complaints were related to changes in memory complaints over time. An autoregressive latent variable model for memory complaints, consistent with a conceptualization of complaints as judgments constructed from beliefs and other influences in the moment, did detect a concurrent effect of memory on memory complaints at the third occasion, controlling on initial complaints. These results suggest that for the oldest-old, changes in memory complaints may not primarily reflect monitoring of actual age-related memory changes, but rather are affected by other variables, including age-based memory stereotypes, neuroticism, depression, and concerns about aging.

As COVID-19 continues to impact global society, healthcare professionals (HCPs) are at risk for a number of negative well-being outcomes due to their role as care providers. The objective of this study was to better understand the current psychological impact of COVID-19 on HCPs in the United States This study used an online survey tool to collect demographic data and measures of well-being of adults age 18 and older living in the United States between March 20, 2020 and May 14, 2020. Measures included anxiety and stress related to COVID-19, depressive symptoms, current general anxiety, health questions, tiredness, control beliefs, proactive coping, and past and future appraisals of COVID-related stress. The sample included 90 HCPs and 90 age-matched controls (M age = 34.72 years, SD = 9.84, range = 23-67) from 35 states of the United States. A multivariate analysis of variance was performed, using education as a covariate, to identify group differences in the mental and physical health measures. HCPs reported higher levels of depressive symptoms, past and future appraisal of COVID-related stress, concern about their health, tiredness, current general anxiety, and constraint, in addition to lower levels of proactive coping compared to those who were not HCPs (p < 0.001, η 2 = 0.28). Within the context of this pandemic, HCPs were at increased risk for a number of negative well-being outcomes. Potential targets, such as adaptive coping training, for intervention are discussed.

Clinical diagnostic criteria for memory loss in adults typically assume that subjective memory ratings accurately reflect compromised memory functioning. Research has documented small positive between-person associations between subjective memory and memory performance in older adults. Less is known, however, about whether within-person fluctuations in subjective memory covary with within-person variance in memory performance and depressive symptoms. The present study applied multilevel models of change to nine waves of data from 27,395 participants of the Health and Retirement Study (HRS; mean age at baseline = 63.78; SD = 10.30; 58% women) to examine whether subjective memory is associated with both between-person differences and within-person variability in memory performance and depressive symptoms and explored the moderating role of known correlates (age, gender, education, and functional limitations). Results revealed that across persons, level of subjective memory indeed covaried with level of memory performance and depressive symptoms, with small-to-moderate between-person standardized effect sizes (0.19 for memory performance and 0.21 for depressive symptoms). Within individuals, occasions when participants scored higher than usual on a test of episodic memory or reported fewer-than-average depressive symptoms generated above-average subjective memory. At the within-person level, subjective memory ratings became more sensitive to within-person alterations in memory performance over time and those suffering from functional limitations were more sensitive to within-person alterations in memory performance and depressive symptoms. We take our results to suggest that within-person changes in subjective memory in part reflect monitoring flux in one’s own memory functioning, but are also influenced by flux in depressive symptoms.

Research has shown the personality variables of conscientiousness and neuroticism to be related to subjective memory in older adults. This study was designed to determine the specific facets of these traits involved in the relation between personality and memory complaints. Subjective memory evaluations were examined in 85 community-dwelling people aged 56 to 94 years. Regression analysis revealed that one facet of conscientiousness (self-discipline) and two facets of neuroticism (self-consciousness and anxiety) explained almost one third of the variance in subjective memory complaints. Anxiety acted as a suppressor variable to enhance the contribution of self-consciousness. Objective measures of episodic and prospective memory were not related to subjective memory. Effective treatments of memory complaints in healthy older adults may have to focus on enhancing self-discipline and self-concept.

Cognitive impairment is associated with worse diabetes care management. Surprisingly, the presence of a caregiver is not protective. Further research is necessary to examine the healthcare needs of cognitively impaired, diabetic patients and their caregivers.