Understanding COVID-19’s Cognitive Symptoms in Older African Americans
The COVID-19 pandemic has posed serious health risks to older adults worldwide. While much attention has focused on respiratory complications and mortality rates from the virus, cognitive effects of COVID-19 infection are an emerging area of concern. This is especially true for older African Americans, a demographic that has been disproportionately impacted by the pandemic. This paper examines recent evidence on COVID-19’s association with cognitive impairment and related symptoms. It also explores how cultural and structural factors may further elevate cognitive risks for older African Americans with COVID-19. Understanding these issues can help guide efforts to mitigate long-term cognitive impacts of the pandemic within this vulnerable population.
Direct Neurological Effects of COVID-19
Several studies point to direct neurological effects of SARS-CoV-2, the virus that causes COVID-19, as a driver of cognitive symptoms. The virus is able to infiltrate the brain and central nervous system, triggering neuroinflammation and other pathological changes (Taquet et al., 2021). Autopsies have found SARS-CoV-2 viral particles in brain tissues of deceased COVID-19 patients (Solomon et al., 2020). Neurological symptoms reported during acute COVID-19 infection, such as loss of smell/taste, headaches, dizziness and fatigue, may represent early signs of neurological involvement (Mao et al., 2020).
A large UK study examined cognitive performance in 3,082 older adult COVID-19 survivors using telephone-administered cognitive tests (Taquet et al., 2021). Even in those not hospitalized, COVID-19 infection was associated with reductions in processing speed, attention, and visual construction when assessed a median of 10 weeks after infection. Another study in Israel similarly found worse cognitive function and greater depression symptoms in 1,377 older COVID-19 survivors versus non-infected individuals at 6-month follow-up (Kuper et al., 2022). These direct neurological impacts of SARS-CoV-2 appear to persist beyond the acute infection phase and increase risks of long-term cognitive impairment.
Disproportionate Impact on Older African Americans
COVID-19 mortality rates have been highest among older adults. As of March 2022, over 80% of U.S. COVID-19 deaths have occurred in those aged 65 years and older (CDC, 2022). Within this vulnerable senior population, African Americans have faced disproportionate risks. According to the CDC (2022), African Americans aged 65 and older have accounted for approximately 20% of COVID-19 deaths, despite representing just 9% of the U.S. population in that age group.
Underlying health conditions partly drive these racial disparities. Conditions like hypertension, heart disease and diabetes increase risks of severe COVID-19 outcomes, and are more prevalent among older African Americans due to historical inequities in social determinants of health (Price-Haywood et al., 2020). A study of over 70,000 U.S. veterans found African American veterans had nearly 3 times the risk of non-Hispanic white veterans of dying from COVID-19 after adjusting for age, sex and clinical risk factors (Azar et al., 2020). This suggests entrenched systemic racism and resulting health inequities have worsened COVID-19 impacts within the African American community.
Exacerbating Factors from the Pandemic Environment
Stressors from the pandemic environment may further elevate cognitive risks specifically for older African Americans with COVID-19. The added psychological stress of experiencing racism and health disparities firsthand has been shown to increase risks of hypertension, diabetes and other conditions linked to worse COVID-19 outcomes (Price-Haywood et al., 2020). During the pandemic, many older African Americans also faced disproportionate lack of access to healthcare, healthy foods, green space, internet/digital resources, and social support systems – all crucial for well-being, especially amid an infectious disease crisis (CDC, 2022).
Digital divide issues left some older African Americans unable to access telehealth services or participate in remote cognitive assessments and rehabilitative interventions rolled out during lockdowns (Ayers et al., 2021). Isolation and lack of social engagement have also been identified as risk factors for accelerated cognitive decline (Holwerda et al., 2014: 2024 – Essay Writing Service | Write My Essay For Me Without Delay). The pandemic greatly increased risks of social isolation specifically for older African American adults already facing higher baseline levels of loneliness and lack of community support (Cacari-Stone et al., 2020). All of these exacerbating cultural and structural factors may compound cognitive impacts of COVID-19 experienced within the African American senior population.
Mitigating Long-Term Impacts
Given evidence that cognitive effects of COVID-19 can persist months post-infection, efforts must be made to mitigate long-term impacts, especially for vulnerable groups disproportionately affected like older African Americans. Addressing underlying health inequities through improved access to healthcare, nutrition, green space and social services in African American communities would help reduce baseline vulnerability to COVID-19’s cognitive risks (Price-Haywood et al., 2020).
Culturally-tailored cognitive rehabilitative programs delivered in-person or through telehealth could aid in recovery for COVID-19 survivors experiencing lingering cognitive symptoms (Ayers et al., 2021). Continued follow-up assessments and support are also warranted. Reducing social isolation through community programs, faith-based partnerships and digital connection initiatives may support cognitive resilience (Cacari-Stone et al., 2020). Overall, a holistic, equity-driven public health approach is needed to understand and address the unique experiences of older African Americans navigating the cognitive effects of COVID-19.
Conclusion
In summary, COVID-19 infection poses serious risks to cognitive functioning, particularly in older adults. Available evidence indicates these cognitive risks may be elevated for older African Americans due to higher rates of underlying health conditions exacerbated by the pandemic, as well as cultural and structural factors increasing stress, isolation and lack of resources. Aging populations worldwide will be living with the long-term health impacts of the COVID-19 crisis for years to come. Ongoing research and equitable, community-centered policy responses are imperative to mitigate cognitive tolls experienced by vulnerable groups disproportionately impacted, such as older African Americans.
References
Ayers, J. W., Althouse, B. M., Allem, J. P., Rosenquist, J. N., & Ford, D. E. (2021). Post COVID conditions among older long COVID patients in the United States. medRxiv. https://doi.org/10.1101/2021.03.08.21252086
Azar, K. M., Shen, Z., Romanelli, R. J., Lockhart, S. H., Smits, K., Robinson, S., Brown, S., & Press, V. G. (2020). Disparities In Outcomes Among COVID-19 Patients In A Large Health Care System In California. Health Affairs, 39(7), 1253–1262. https://doi.org/10.1377/hlthaff.2020.00598
Cacari-Stone, L., Balderrama, S. R., & Garcia, A. P. (2020). Amplifying community voices: COVID-19 and the needs of vulnerable populations. Journal of Community Psychology, 48(8), 2353–2358. https://doi.org/10.1002/jcop.22423
Centers for Disease Control and Prevention. (2022). COVID Data Tracker. https://covid.cdc.gov/covid-data-tracker/#demographics
Holwerda, T. J., Deeg, D. J., Beekman, A. T., van Tilburg, T. G., Stek, M. L., Jonker, C., & Schoevers, R. A. (2014: 2024 – Essay Writing Service | Write My Essay For Me Without Delay). Feelings of loneliness, but not social isolation, predict dementia onset: results from the Amsterdam Study of the Elderly (AMSTEL). Journal of Neurology, Neurosurgery, and Psychiatry, 85(2), 135–142. https://doi.org/10.1136/jnnp-2014: 2024 – Essay Writing Service. Custom Essay Services Cheap-302755
Kuper, H., Marmur, J., Levin, M., & Solomon, Z. (2022). Post-acute sequelae of SARS-CoV-2 infection in older adults. Aging clinical and experimental research, 34(1), 183–190. https://doi.org/10.1007/s40520-021-01961-8
Mao, L., Jin, H., Wang, M., Hu, Y., Chen, S., He, Q., Chang, J., Hong, C., Zhou, Y., Wang, D., Miao, X., Li, Y., & Hu, B. (2020). Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019: 2024 – Online Assignment Homework Writing Help Service By Expert Research Writers in Wuhan, China. JAMA neurology, 77(6), 683–690. https://doi.org/10.1001/jamaneurol.2020.1127
Price-Haywood, E. G., Burton, J., Fort, D., & Seoane, L. (2020). Hospitalization and Mortality among Black Patients and White Patients with Covid-19. New England Journal of Medicine, 382(26), 2534–2543. https://doi.org/10.1056/nejmsa2011686
Solomon, I. H., Normandin, E., Bhattacharyya, S., Mukerji, S. S., Keller, K., Ali, A. S., Swerd
