Psychosocial Impact of the COVID-19 Pandemic on Older Adults With and Without Cognitive Impairment: A Cross-Sectional Study

Objectives 1) To develop and test the validity of the Psychosocial Pandemic Impact Scale (PPIS); 2) test associations between PPIS scores and demographics/cognitive performance in older adults; 3) answer whether the PPIS scores would differ between cognitively healthy (HOA) or mildly impaired older adults (MCI), and between those assessed before and after vaccines were available in Brazil. Design Cross-sectional study. Setting Community-dwelling older adults registered to participate in a remote randomized clinical trial of computerized cognitive training were assessed online during the COVID-19 pandemic in Brazil. Participants A sample of 181 older adults (>60 years) was used for the PPIS psychometric analysis, from which 120 who completed baseline cognitive, quality of life, and mood assessments were included in the group comparisons and correlational analysis. Measurements The psychosocial pandemic impact scale (PPIS); The Montreal Cognitive Assessment (MoCA; used as a brief screening tool); The verbal fluency test (to assess executive function) and the Verbal memory and learning with the Portuguese version of the rey auditory verbal learning test (RAVLT); The geriatric anxiety inventory (GAI); The Geriatric Depression Scale - Short Form (GDS); The WHOQOL-BREF and WHOQOL-OLD quality of life questionnaires; The Katz and Lawton scales and the Activities of Daily Living Questionnaire (ADLQ) to measure daily function. Results The PPIS demonstrated good internal consistency (α = .84) and sampling adequacy (MSA= .85) and was significantly associated with validated measures of anxiety and depression (GAI: ρ = 0.49, p< 0.001; GDS: ρ = 0.48, p=0.006) and quality of life (WHOQOL-Bref: ρ = -0.46, p< 0.001; WHOQOL-Old: ρ = -0.24, p=0.03), confirming construct validity and scale reliability. HOA who were female and had more years of education and those with MCI who were younger and had better memory reported higher PPIS scores. One-way ANOVAs including age and education as covariates revealed that people with MCI reported higher PPIS scores than HOA before vaccination (p = 0.01), but not after. While HOA assessed before and after vaccines were available showed similar PPIS scores, those with MCI assessed after had a trend towards lower scores than those assessed before (p = 0.06). Conclusions Our study provides a reliable instrument for assessing older adults' psychosocial pandemic impact and shows that people with MCI might be more vulnerable to such effects—which are mediated by memory performance, age, education, and gender. This data can help clinicians to identify and propose interventions targeting vulnerable populations during public health emergencies.

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