Brain Health and the COVID-19 Pandemic

01 Introduction

We are very aware that the COVID-19 pandemic has had far-reaching impacts on both our society and us as individuals. The restrictions that we experienced such as social distancing, lockdowns and quarantines had never previously been experienced by most of us. There have been concerns that these restrictions could have affected our neuropsychological function with particular concerns for older adults due to their increased dementia risk with age. Links between Covid infection and longer-term effects on cognition have already been reported but a recent study gives information on the broader effects of the pandemic on our brain health.

It is already known that our risk of dementia can be reduced by our behaviours, in particular, exercise, diet, and alcohol use. Previous research (2) has shown that there was increased alcohol use during the pandemic and a reduction in physical activity (3). The social isolation experienced in the pandemic by many people led to loneliness which brings with it a risk of depression. Depression is a risk factor for dementia. Studies have shown that poor mental health became more common during the pandemic (4)

02 The PROTECT study

A research team at the University of Exeter (1) recently published a study examining cognitive decline in older adults in the UK during and after the pandemic. Cognitive decline is the condition of having memory loss, reduced or slower thinking skills, or other impairment in mental capabilities. The research investigated executive function which includes working memory, flexible thinking, self-control and mental skills that we use every day to learn, work and manage daily life.

The researchers had set up the PROTECT study in 2015 and were able to utilise data from this existing study. PROTECT is a 25-year study of people over 40 in which participants provide information about themselves, their lifestyle and health and complete annual online assessments and tests to measure their brain function.

The study reported on people already part of the PROTECT study who were 50 years or older. There were over 3000 participants in the study and they completed a number of different online tests on attention, memory and executive function. They also self-reported health information as well as their exercise patterns and alcohol use. The researchers analysed all the participants together and also analysed two sub-groups separately; those with mild cognitive impairment and people with a history of COVID-19 from March 2020 to February 2022.

03 Results

The study found that people aged 50 years and older in the UK had a faster decline in their executive function and working memory during the first year of the pandemic than in the pre-pandemic year. This was the period when there were 3 lockdown periods. The decline was more marked in those with existing mild cognitive decline or a history of COVID-19 and their decline was sustained in the second year of the pandemic.

The research was able to analyse the association between accelerated cognitive decline and known dementia risk factors. In the first year of the pandemic, cognitive decline was associated with decreased frequency of exercise and increased alcohol intake. In the second year, only frequency of exercise had an association with decline except for people with mild cognitive impairment or with a history of COVID-19 for whom increased alcohol use continued to be associated with worsening working memory.

04 Conclusions

As an observational study, it cannot prove cause and effect; however, the findings suggest that reduced exercise and increased alcohol use increased cognitive decline during the pandemic. Depression and loneliness are also likely to have played a part.

05 What is the relevance to you?

The study supports other research that we should be physically active, limit alcohol use and socialise to reduce our risk of dementia later on.

If you are a carer or relative of someone with existing mild cognitive decline, be aware that this may have gotten worse during and after the pandemic.

05 References

1. Corbett A, Williams G, Creese B et al Cognitive decline in older adults in the UK during and after the COVID-19 pandemic: a longitudinal analysis of PROTECT study data Lancet Healthy Longev 2023;4:e591

2. Schmidt RA Genoir R, Jim J Vigo D Rhm J Rush B the early impact of COVID-19 on the indigence prevalence and severity of alcohol us and other drugs: a Systematic review Drug Alcohol Depend 2021 228 109065

3. Stockwell S Trott M Tully M et al Changes in physical activity and sedentary behaviours from before to during the COVID-19 pandemic lockdown: a systematic review BMJ open Sport Excer Med 2021:7:e000960

4. Fierily A, Sampogna G, Giallonardo V et al Effects of the e lockdown on the mental health of the general population during the COVID-19 Pandemic in Italy: results from the COMET collaborative network Eur Psychiatry 2020;63:e87

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