Cognitive Decline Before and During COVID-19 Pandemic Among Older People With Multimorbidity: A Longitudinal Study.
Chenglong Li, Rong Hua, Darui Gao and 2 others
PMID 36774966WHAT IT FOUND
During the pandemic, older adults with two or more chronic conditions showed faster drops in memory and thinking than those with none.
Their risk of new dementia was higher, but the dementia finding was tied to hypertension and diabetes.
Key findings
01During the pandemic, participants with multimorbidity had significantly faster declines in global cognition, memory, and executive function than those with no chronic conditions; participants with one chronic condition did not.
02During the pandemic, 277 incident dementia cases were identified, and participants with multimorbidity had a higher adjusted risk of new dementia than those with no chronic conditions.
03The dementia-risk association weakened when hypertension, diabetes, blood pressure, blood glucose, or related treatments were considered; only multimorbidity that included both hypertension and diabetes stayed consistently associated.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is an observational cohort, so it cannot show that the pandemic or multimorbidity caused cognitive decline or dementia. The cognitive tests were brief and covered only memory and executive function, so decline in other thinking domains may have been missed. Dementia was not confirmed by formal clinical evaluation; it relied on self-reported diagnosis or a low cognitive score. Many participants were excluded, and they were older, more likely to have multimorbidity, and had worse cognition, so selection bias remained possible. The dementia association changed when hypertension, diabetes, blood pressure, blood glucose, or related treatments were adjusted, so the study does not identify a single cause.
The easy way to misread this
Do not read the elevated dementia risk as proof that multimorbidity alone causes dementia. The study was observational, and the risk became statistically insignificant when hypertension, diabetes, blood pressure, blood glucose, or related treatments were adjusted.