Lockdown Effects on Healthy Cognitive Aging During the COVID-19 Pandemic: A Longitudinal Study

Abstract

The COVID-19 pandemic is a health issue leading older adults to an increased vulnerability to unfavorable outcomes. Indeed, the presence of physical frailty has recently led to higher mortality due to SARS-CoV-2 infection. However, no longitudinal studies have investigated the role of neuropsychogeriatric factors associated with lockdown fatigue in healthy cognitive aging. Eighty-one healthy older adults were evaluated for their neuropsychological characteristics, including physical frailty, before the pandemic (T0). Subsequently, 50 of them agreed to be interviewed and neuropsychologically re-assessed during the lockdown (T1) and immediately after it (T2). Moreover, during another home confinement, they performed a psychological screening (T3) to evaluate possible mood changes and fatigue. According to Fried's frailty criteria, at T0, 63% of the sample was robust, 34.5% pre-frail, and only 2.5% frail. Significantly, these subjects presented a decrease in handgrip strength and walking speed (29.6 and 6.1%, respectively). Results from Principal Component Analyses and multiple regression models highlighted the contribution of “cognitive” and “psychological” factors (i.e., attentive-executive performance and mood deflections) in explaining handgrip strength and gait speed. At T3, lockdown fatigue was explained by higher scores on the Beck Depression Inventory and lower scores on the Trail Making Test part A. Results from a moderated-mediation model showed that the effect of psychomotor speed on lockdown fatigue was mediated by depression, with a moderating effect of gait speed. Our findings highlight the complex interrelationship between cognitive, psychological, and physical factors in the emergence of pandemic fatigue in a carefully selected older population.

Are Sleep Problems Related to Psychological Distress in Healthy Aging during the COVID-19 Pandemic? A Review

“…Indeed, during a difficult period, such as the COVID-19 pandemic, social distancing and isolation might exacerbate sleep problems and psychological distress already present in the older population, leading to greater negative health status outcomes [50]. Moreover, cognitive, psychological, and functional aspects in older adults in healthy aging may have a critical role in both fatigue due to home confinement restrictive measures [52] and the perceived threat of SARS-CoV-2's risk of contagion [54].…”

“…As previously stated, some studies showed associations between sleep problems and mood changes; other studies considered the impact of individual aspects, lifestyle, and attitudes adopted by older adults during the COVID-19 lockdown; finally, others found no significant differences in sleep patterns comparing before with during the pandemic period. In our recent study [52], which aimed to analyze the influence of cognitive, psychological, and functional factors on the lockdown fatigue, we also asked a group of healthy aging subjects if they had experienced any lifestyle changes, such as in sleep quality, during the COVID-19 home confinement. Consistent with the evidence in the literature, we observed heterogeneous results (i.e., improvement, similarity, and worsening, in 12, 56, and 32% of the sample, respectively).…”

“…Furthermore, anxiety and depression are the most frequently reported and studied psychological changes in the literature regarding the COVID-19 pandemic [100]. They are very common in older adults, as a consequence to social isolation [101], particularly with regard to fear of contagion [54,102] and the so-called "lockdown fatigue" [52].…”

“…These problems are also found in healthy aging subjects. In particular, a recent study found that the so-called "lockdown fatigue" seemed to be related to the complex interrelationship between cognitive, psychological, and physical factors in the older population [52]. In this direction, another study showed that mood deflection, in terms of anxiety, a physical pre-frailty status [53], and a decrease in the speed of processing environmental information, could influence the perceived threat of SARS-CoV-2 infection risk in healthy aging subjects [54].…”

The Role of Neuropsychological Factors in Perceived Threat of SARS-CoV-2 in Healthy Ageing

“…As a result of COVID-19 containment measures, older adults may experience physical and other mental health problems [5], such as depressive mood and anxiety-related fear of contagion [6]. In line with these aspects, a recent study [7] highlighted how both cognitive and physical issues related to the COVID-19 pandemic may play a key role in the novel "lockdown fatigue". In particular, the authors found that pandemic fatigue was associated with decreased processing and walking speed and with mood changes in terms of depression.…”