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To investigate whether reductions in primary and specialist healthcare service use during the pandemic were associated with changes in cognitive, physical, and mental health in community-dwelling older adults, with attention to sex differences. Data from the Norwegian Tr\u00f8ndelag Health Study collected before (HUNT4 70\u2009+\u2009, 2017\u20132019) and after the pandemic (HUNT AiT, 2021\u20132023) included 5387 participants (53% women) aged 70\u2009+\u2009. Propensity score matching, accounting for baseline confounders, was used to examine associations between reduced healthcare service use and cognitive, physical, and mental health changes from pre- to post-pandemic. Reduced contact with general practitioners was associated with greater cognitive decline among women (MoCa-change\u2009\u2212\u20090.32 [95% CI\u2009\u2212\u20090.62,\u2009\u2212\u20090.32]). No differences were observed in physical or mental health. Reductions in other primary care services (e.g., in-home nursing, practical assistance) were associated with greater decline in cognitive function (MoCa-change\u2009\u2212\u20090.94 [\u2212\u20091.53,\u2009\u2212\u20090.36]), particularly among men (MoCa-change\u2009\u2212\u20092.12 [\u2212\u20093.13,\u2009\u2212\u20091.11]). Men also had a decline in physical function (SPPB-change\u2009\u2212\u20091.06 [\u2212\u20091.79,\u2009\u2212\u20090.33]). No differences in mental health were observed. Reductions in specialist healthcare services were unrelated to health changes in the overall sample but linked to improved physical function in women (SPPB-change 0.32 [0.11, 0.53]). Although associations between reduced healthcare service use during the pandemic and cognitive, physical, and mental health were limited, findings highlight the importance of sustaining access to primary care for older adults during public health crises.<\/jats:p>\n                  <jats:p>\n                    <jats:bold>Trial registration<\/jats:bold>\n                    The study is pre-registered at ClinicalTrials.gov 02.02.2021, with the identification number NCT 04792086.\n                  <\/jats:p>","DOI":"10.1007\/s11357-025-01909-x","type":"journal-article","created":{"date-parts":[[2025,9,27]],"date-time":"2025-09-27T02:33:58Z","timestamp":1758940438000},"page":"4313-4325","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cognitive function, physical function, and mental health in older adults amid reduced primary and specialist healthcare service use during COVID-19: the HUNT study"],"prefix":"10.1007","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9361-2388","authenticated-orcid":false,"given":"Tanja Louise","family":"Ibsen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ekaterina","family":"Zotcheva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sverre","family":"Bergh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debby","family":"Gerritsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gill","family":"Livingston","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilde","family":"Lur\u00e5s","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Svenn-Erik","family":"Mamelund","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne Marie Mork","family":"Rokstad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bj\u00f8rn Heine","family":"Strand","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard C. 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All procedures were conducted in accordance with REK guidelines and the ethical standards laid out in the Declaration of Helsinki. This research is part of a larger project registered at ClinicalTrials.gov (Identifier: NCT04792086). Written informed consent was obtained from all participants in the HUNT4 70\u2009+\u2009and the HUNT AiT study. In cases where individuals were unable to provide consent due to cognitive limitations, consent was provided by a legally authorized representative. The consent form specified that collected data could be linked with other registries for use in ethically approved studies, as applied in the current research.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}