ArticleJournal of the Chinese Medical Association : JCMA2026
Decline in dementia patients during the COVID-19 pandemic: A cohort study in Taiwan.
Article in Journal of the Chinese Medical Association : JCMA, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe cognitive consequences of coronavirus disease 2019 (COVID-19) in patients with dementia remain uncertain. This study examined whether COVID-19 infection was associated with cognitive decline.
methodsFrom October 2020 to October 2022, COVID-19-naive patients with dementia were recruited from a hospital-based memory clinic in Taipei. During follow-up, patients who developed COVID-19 were classified as the infected group, while others served as controls. For controls, baseline and follow-up were defined as two consecutive annual cognitive assessments. For infected patients, baseline and follow-up were the nearest assessments before and after COVID-19 infection, respectively. The mean assessment interval was approximately 1 year in both groups. Outcomes included the Mini-Mental State Examination (MMSE), Clinical Dementia Rating Sum of Boxes (CDR-SB), and Cognitive Abilities Screening Instrument (CASI). Linear mixed-effects models assessed whether cognitive trajectories differed by COVID-19 status.
resultsAfter excluding patients without eligible follow-up data, infected patients were matched with controls by age and sex. Overall, 44 patients with dementia who developed COVID-19 and 22 who remained uninfected were included in the study. Baseline demographic characteristics and cognitive scores were comparable. The mean age was 84.1 years, with 36% (24/66) male. At follow-up, cognitive performance did not differ significantly between infected and control groups. Within-group analyses showed significant declines in MMSE, CDR-SB, and CASI in the infected group, whereas controls declined significantly only in CASI. In adjusted mixed-effects models, the COVID-19 × time interaction was not significant (β = -0.427; p = 0.676), suggesting no significant difference in MMSE decline trajectory between groups. Higher education was associated with higher MMSE scores (β = 0.553; p = 0.002). Sensitivity analyses supported these findings.
conclusionAfter accounting for age, sex, education, and assessment interval, COVID-19 infection was not associated with faster cognitive decline. Participants with more education generally had higher MMSE scores, but education did not significantly alter the rate of decline.
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