Cognitive reserve and coping strategies predict the level of perceived stress during COVID-19 pandemic: A cross-sectional study

The Effect of COVID-19 on Middle-Aged Adults' Mental Health: A Mixed-Method Case-Control Study on the Moderating Effect of Cognitive Reserve

The COVID-19 pandemic has increased the vulnerability of adults to mental health effects, and the study of protective factors has become crucial. Cognitive reserve (CR) is a well-known protective factor against cognitive decline and several health factors; however, its protective effect on mental health during the pandemic has been rarely addressed. Thus, this study explored, through a mixed-method design, the effect of CR on perceived distress and PTSD-like symptoms in middle-aged participants who have survived severe COVID-19 and a matched control group. A total of 432 participants filled out self-report measures of CR, PTSD, depression, and anxiety, and were also asked to provide narration about their COVID-19-related experience. COVID-19 significantly affected the chances of reporting different mental health symptoms; levels of CR played a protective role in reducing their severity. Moreover, adults with higher CR seemed to be more realistic, focusing less on positive emotions, and elaborating more on the sense of anxiety when describing their experience: this might be an indication of a lower use of suppression to regulate emotions. Practical implications of these findings and future directions have been also discussed.

Risk factors for post-COVID cognitive dysfunctions: the impact of psychosocial vulnerability

BACKGROUND

Cognitive dysfunction is a well-established manifestation of the post-COVID syndrome. Psychological vulnerability to stressors can modify disease trajectories, causing long-term risk for negative outcomes. Nonetheless, how premorbid risk factors and response to stressor affect neuropsychological changes is still incompletely understood. In this study, we explored the impact of psychosocial variables on cognitive functioning in a post-COVID sample.

METHODS

All subjects were submitted to a comprehensive neuropsychological battery and an assessment of perceived loneliness, post-traumatic stress, and changes in anxiety and depression levels. A social vulnerability index was also calculated. The set of psycho-social variables was reduced to two Principal Component Analysis (PCA) components: distress and isolation.

RESULTS

Forty-five percent of individuals showed cognitive impairments, with predominant memory and executive deficits. Post-traumatic stress disorder was clinically relevant in 44% of the sample. Social vulnerability scores of the sample were comparable to those of general population. The individual performance in learning and response initiation/suppression was directly related to distress component, encasing anxiety, stress, and depression measures.

CONCLUSION

These findings suggest that psychosocial assessment of post-COVID patients can detect fragile individuals at risk of cognitive impairments. Dedicated psychological support services may play a useful role in the prevention of post-COVID cognitive dysfunction.

Understanding the relationships between physiological and psychosocial stress, cortisol and cognition

Stress is viewed as a state of real or perceived threat to homeostasis, the management of which involves the endocrine, nervous, and immune systems. These systems work independently and interactively as part of the stress response. The scientific stress literature, which spans both animal and human studies, contains heterogeneous findings about the effects of stress on the brain and the body. This review seeks to summarise and integrate literature on the relationships between these systems, examining particularly the roles of physiological and psychosocial stress, the stress hormone cortisol, as controlled by the hypothalamic-pituitary-adrenal (HPA) axis, and the effects of stress on cognitive functioning. Health conditions related to impaired HPA axis functioning and their associated neuropsychiatric symptoms will also be considered. Lastly, this review will provide suggestions of clinical applicability for endocrinologists who are uniquely placed to measure outcomes related to endocrine, nervous and immune system functioning and identify areas of intervention.

The relationship between cognitive reserve and cognition in healthy adults: a systematic review

The concept of Cognitive Reserve (CR) refers to the individual differences allowing some people to cope better with brain pathology. The aim of the present review was to explore the relationship between CR and cognition in adulthood. This association has been addressed in several neuro(psycho)logical disorders and in healthy elderly people. However, few studies explored this issue in adulthood (age range 18–65), when individuals might take advantage the most from psychoeducational approaches aimed at increasing CR. For our systematic review, we selected studies assessing CR and adopting neuropsychological and experimental tasks for evaluation of cognitive functioning in healthy individuals. In the selected articles, we examined the relationship of singular proxies, composite indexes or standardized scales of CR with measures of general cognition, attention, inhibitory control, verbal fluency, constructional abilities, and verbal and spatial memory. The results suggested a positive relationship between singular CR proxies, composite indexes or standardized scales, and almost all the explored cognitive domains. No clear conclusion could be made on constructional abilities due to the scarcity of available studies. CR seems associated with better cognitive performance in adulthood, but definite methodological improvements and the use of standardized scales for CR are necessary to reduce inconsistencies among studies.