Poor Memory Performance Linked to Greater COVID-19 Hospitalization, Mortality Risk

Poor memory performance is associated with an increased risk for COVID-19 hospitalization and mortality in adults aged 50 years and older, according to study results published in Frontiers in Public Health.

Researchers conducted an analysis to evaluate whether prepandemic memory function was associated with COVID-19 hospitalization and mortality among adults aged 50 years and older. Patients with confirmed COVID-19 infection and complete covariate data were included. Data were sourced from 3 prospective cohort studies: Survey of Health, Ageing and Retirement in Europe (SHARE; 25 European countries and Israel), Health and Retirement Study (HRS; United States), and English Longitudinal Study of Ageing (ELSA; United Kingdom). Baseline memory was assessed prepandemic (2017-2019) using immediate and delayed 10-word recall testing. COVID-19 outcomes were determined via self/proxy reports, hospital records, and death data (mortality available only for SHARE). Logistic regression models were employed for statistical analysis.

A total of 4062 (SHARE), 1349 (HRS), and 278 (ELSA) patients were included in the final analysis, of whom the median ages were 67.0 (IQR 62.0-74.0), 64.0 (IQR 59.0-71.0), and 66.0 (IQR 57.0-73.0) years, 40.9%, 42.0%, and 36.7% were men, median number of immediate 10-words recall scores were 6, 6, and 6.5, and delayed 10-words recall scores were 4, 5, and 5, respectively.

COVID-19 hospitalization occurred in 610 (15.0%) patients in SHARE, 142 (10.5%) in HRS, and 39 (14.0%) in ELSA, with hospitalized patients recalling fewer words on both immediate and delayed recall tests. Crude odds ratios (ORs) for hospitalization per word decrease in immediate recall were 1.15 (95% CI, 1.09-1.22) in SHARE, 1.07 (95% CI, 0.94-1.21) in HRS, and 1.34 (95% CI, 1.02-1.77) in ELSA; for delayed recall, crude ORs per word decrease were 1.11 (95% CI, 1.06-1.17), 1.12 (95% CI, 1.01-1.24), and 1.25 (95% CI, 1.01-1.55), respectively.

In SHARE, 102 (2.5%) patients died of COVID-19 or related complications, with decedents recalling fewer words than survivors. Adjusted OR for mortality per word decrease was significant for delayed recall (OR, 1.14; 95% CI, 1.01-1.28) but not for immediate recall (OR, 1.06; 95% CI, 0.93–1.20).

Sensitivity analyses showed results were largely consistent, although imputation of missing data rendered the delayed recall-mortality association nonsignificant. Other factors linked to hospitalization or mortality included older age, male sex, overweight/obesity, physical inactivity, lower socioeconomic status, and certain chronic diseases.

Study limitations include reliance on self-reported outcomes, the potential influence of unmeasured variables, and the lack of end-of-life data from HRS and ELSA prevented the analysis of COVID-19 mortality in these 2 cohorts.

The researchers concluded, “Further studies are warranted to validate these associations in recent omicron waves of the COVID-19 pandemic and in clinical settings, and to elucidate the underlying mechanisms in order to improve the management of COVID-19.”

This article originally appeared on Infectious Disease Advisor