COVID-19 and Cognitive and Mental Health during Post-Infection Phase: A Study Among Middle-Aged and Older Indigenous Adults from Brazilian Amazons

Camila Carlos Bezerra, Noeli das Neves Toledo, Sonia Maria Dozzi Brucki, Juliana Nery Souza-Talarico
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Abstract

Objectives to examine the rate of self-reported COVID-19 and its association with mental and cognitive health during the post-infection phase among middle-aged and older indigenous adults. Method A cross-sectional study was conducted, including one hundred forty-one individuals ≥50 and over from a urban indigenous community in Amazonas, Brazil. COVID-19 was deduced from self-reported infections. Cognitive function was evaluated using the Mini-Mental State Exam (MMSE), Brief Cognitive Screening Battery (BCSB), and language fluency tests. Meanwhile, mental health was assessed through validated scales examining happiness, stress and depression symptoms. The association between the rate of COVID-19 and cognitive and mental wellbeing was analyzed using logistic and linear regressions, adjusted for covariates. Results From March 2020 to February 2022, 65.2% of the urban indigenous group tested positive for COVID-19. Lower functional capacity decreased the odds of contracting COVID-19 (p=0.03). Adjusted linear regression models, showed that COVID-19 was associated with higher BCSB learning (p= 0.017) and delayed recall (p=0.028). Female, higher age, lower functional capacity and hospitalization were associated with worse cognitive performance (p<0.05). No impact of mental health indicators on past COVID-19 infection was noted. Discussion COVID-19 was prevalent among urban Indigenous Brazilians. Unexpectedly, it was linked to enhanced learning and memory, not mental health issues. Cognitive performance was lower for males, older individuals, those with less functional ability, and hospitalized patients, indicating that participant characteristics and disease severity affect the COVID-19 and cognition relationship. Longitudinal studies across diverse Indigenous communities are necessary to understand COVID-19's impact on their cognitive and mental health.
COVID-19 与感染后阶段的认知和心理健康:一项针对巴西亚马逊地区中老年土著成年人的研究
目的 研究中老年原住民自我报告的 COVID-19 感染率及其与感染后阶段精神和认知健康的关系。方法 对巴西亚马孙一个城市原住民社区中 141 名年龄≥50 岁及以上的人进行了横断面研究。根据自我报告的感染情况推断出 COVID-19。认知功能的评估采用了迷你精神状态检查(MMSE)、简易认知筛查电池(BCSB)和语言流畅性测试。与此同时,心理健康通过有效的幸福感、压力和抑郁症状量表进行评估。采用逻辑回归和线性回归分析了 COVID-19 的比率与认知和心理健康之间的关系,并对协变量进行了调整。结果 从 2020 年 3 月到 2022 年 2 月,65.2% 的城市原住民检测出 COVID-19 阳性。较低的机能降低了感染 COVID-19 的几率(p=0.03)。调整后的线性回归模型显示,COVID-19 与较高的 BCSB 学习(p= 0.017)和延迟回忆(p=0.028)相关。女性、高年龄、低功能能力和住院治疗与认知表现较差有关(p<0.05)。心理健康指标对既往感染 COVID-19 没有影响。讨论 COVID-19 在巴西城市原住民中很普遍。出乎意料的是,它与学习能力和记忆力的增强有关,而与心理健康问题无关。男性、老年人、功能较弱者和住院病人的认知能力较低,这表明参与者的特征和疾病严重程度会影响 COVID-19 与认知能力的关系。有必要对不同的土著社区进行纵向研究,以了解 COVID-19 对其认知和心理健康的影响。
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