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The risk of cognitive decline and dementia in older adults diagnosed with COVID-19: A systematic review and meta-analysis
Journal article   Peer reviewed

The risk of cognitive decline and dementia in older adults diagnosed with COVID-19: A systematic review and meta-analysis

A. Shrestha, R. Chen, M. Kunasekaran, D. Honeyman, A. Notaras, B. Sutton, A. Quigley and C. Raina MacIntyre
Ageing research reviews, Vol.101, pp.1-15
11/2024
DOI: https://doi.org/10.1016/j.arr.2024.102448
PMID: 39127446
Appears in  Recent Faculty of Health Publications

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Abstract

Cognitive impairment COVID-19 Dementia Long COVID
Background: Cognitive impairment can be caused by infections with various pathogens, including SARS-CoV-2. Research has yet to determine the true incidence and course of cognitive impairment in older adults following COVID-19. Furthermore, research has theorised that COVID-19 is associated with dementia progression and diagnosis but this association has yet to be fully described. Methods: A systematic review was registered in Prospero and conducted on the databases PubMed, Embase, Ovid, CENTRAL and Cochrane Library. Studies reporting cognitive impairment and dementia outcomes in post-acute and post-COVID-19 patients aged ≥65 years, and which included control data, were included in this review. Results: 15,124 articles were identified by the search strategy. After eliminating duplicate titles and completing title, abstracts and full-text review, 18 studies were included comprising of 412,957 patients with COVID-19 (46.63 % male) and 411,929 patients without COVID-19 (46.59 % male). The overall mean Montreal Cognitive Assessment (MoCA) score in COVID-19 patients was 23.34 out of 30 (95 % CI [22.24, 24.43]). indicating cognitive impairment. The overall proportion of patients identified as having new onset cognitive impairment was 65 % (95 % CI [44,81]). Subgroup analyses indicated that time since infection significantly improves overall MoCA score and reduces proportion of patients with cognitive impairment. Conclusion: This study indicates that cognitive impairment may be an important sequela of COVID-19. Further research with adequate sample sizes is warranted regarding COVID-19’s association with new-onset dementia and dementia progression, and the effect of repeat infections. There is a need for development of diagnostic and management protocols for COVID-19 patients with cognitive impairment.

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