Impact of remote social interaction during the COVID-19 pandemic on the cognitive and psychological status of older adults with and without cognitive impairment: A randomized controlled study

PLoS One. 2024 Nov 12;19(11):e0311792. doi: 10.1371/journal.pone.0311792. eCollection 2024.

Abstract

Background: Social isolation and loneliness have both been associated with psychological health and cognitive decline in older adults. This study investigated the impact of social interaction through remote communication technologies during the COVID-19 pandemic on the cognitive and psychological status of older adults with and without cognitive impairment.

Methods: Participants were recruited from Boston (USA) and Chieti (Italy). The study used a randomized single-blinded controlled crossover design with an intervention (remote social conversations with research staff over 20-minute video or telephone calls three times per week) and a passive control condition, each one of 4-weeks duration. The primary outcome was a composite cognitive score change from baseline to week 4. Secondary outcomes included scales for mood, anxiety, and loneliness.

Results: Out of 196 participants recruited from April 2020 to April 2021, 17% dropped out. Based on the blind MoCA, 52% had cognitive impairment, and 25% were at risk of social isolation according to the Lubben social network scale. We observed that larger social networks were linked to better cognitive status and lower depression and anxiety levels, while loneliness was directly associated to depression severity. Older adults with cognitive impairment exhibited higher levels of depression and anxiety and were at greater risk for social isolation. In terms of the intervention, 91% preferred telephone over video calls. The intervention did not lead to improvements in cognitive or psychological scores.

Conclusions: More work is needed to assess the utility of this intervention for the support of a heterogenous cross-cultural sample of older adults at-risk for social isolation, including individuals with cognitive impairment. Future research should explore longer intervention periods, categorize participants by call type, and target those meeting social isolation criteria.

Trial registration: ClinicalTrials.gov NCT04480112.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anxiety / epidemiology
  • Anxiety / psychology
  • Boston / epidemiology
  • COVID-19* / epidemiology
  • COVID-19* / psychology
  • Cognition / physiology
  • Cognitive Dysfunction* / epidemiology
  • Cognitive Dysfunction* / psychology
  • Cross-Over Studies
  • Depression / epidemiology
  • Depression / psychology
  • Female
  • Humans
  • Italy / epidemiology
  • Loneliness* / psychology
  • Male
  • Middle Aged
  • Pandemics
  • SARS-CoV-2 / isolation & purification
  • Single-Blind Method
  • Social Interaction*
  • Social Isolation* / psychology

Associated data

  • ClinicalTrials.gov/NCT04480112

Grants and funding

This work was supported by a U.S. Veterans Affairs Clinical Science, Research & Development Merit Review Award [grant number CX002400] and by the National Institute on Aging [grant number P30 AG072978]. There was no additional external funding received for this study”.