{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T17:02:50Z","timestamp":1782925370171,"version":"3.54.5"},"reference-count":42,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T00:00:00Z","timestamp":1754438400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"FUNDACI\u00d3N IMSS, A.C."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medical Sciences"],"abstract":"<jats:p>Background\/Objectives: Cognitive impairment in older adults has emerged as a growing public health concern, particularly in relation to COVID-19 infection and its associated neuropsychiatric symptoms. The identification of modifiable risk factors may contribute to the development of targeted preventive strategies. This study aimed to assess predictors of cognitive impairment in older adults with and without recent SARS-CoV-2 infection. Methods: A prospective cohort study was conducted from June 2023 to March 2024 at a tertiary hospital in western Mexico. Adults aged 65 years or older with confirmed SARS-CoV-2 infection within the previous six months, along with uninfected controls, were enrolled. Cognitive function (Mini-Mental State Examination), depression (PHQ-9), anxiety (Geriatric Anxiety Inventory), insomnia (Insomnia Severity Index), functional status (Katz Index and Lawton\u2013Brody Scale), and laboratory markers were evaluated at baseline, three months, and six months. The primary outcome was cognitive impairment at six months. Independent predictors were identified using a multivariable generalized linear mixed-effects model. Results: Among the 111 participants, 20 (18.8%) developed cognitive impairment within six months. Low serum magnesium (adjusted risk ratio [aRR] 2.73; 95% CI 1.04\u20137.17; p = 0.041) and depression (aRR 5.57; 95% CI 1.88\u201316.48; p = 0.002) were independently associated with a higher risk. A significant synergistic among COVID-19, depression, and hypomagnesemia was observed (RR 44.30; 95% CI 9.52\u2013206.21; p &lt; 0.001), corresponding to the group with simultaneous presence of all three factors compared to the group with none. Conclusions: Depression and hypomagnesemia appear to be independent predictors of cognitive impairment in older adults with recent COVID-19 infection. These findings suggest potential targets for prevention and support the implementation of routine neuropsychiatric and biochemical assessments in this population.<\/jats:p>","DOI":"10.3390\/medsci13030114","type":"journal-article","created":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T10:13:51Z","timestamp":1754475231000},"page":"114","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Depression and Hypomagnesemia as Independent and Synergistic Predictors of Cognitive Impairment in Older Adults Post-COVID-19: A Prospective Cohort Study"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6727-0051","authenticated-orcid":false,"given":"Jos\u00e9","family":"Guzm\u00e1n-Esquivel","sequence":"first","affiliation":[{"name":"Clinical Epidemiology Research Unit, Mexican Institute of Social Security, Villa de Alvarez, Colima 29883, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1533-5834","authenticated-orcid":false,"given":"Brando S.","family":"Becerra-Galindo","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Mexican Institute of Social Security (IMSS), General Hospital of Zone No. 1, Villa de Alvarez, Colima 28984, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4685-3095","authenticated-orcid":false,"given":"Gustavo A.","family":"Hern\u00e1ndez-Fuentes","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, Mexico"},{"name":"Faculty of Chemical Sciences, University of Colima, Coquimatlan 28400, Mexico"},{"name":"State Cancerology Institute of Colima, Health Services of the Mexican Social Security Institute for Welfare (IMSS-BIENESTAR), Colima 28085, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco A.","family":"Ramos-Rojas","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Mexican Institute of Social Security (IMSS), General Hospital of Zone No. 1, Villa de Alvarez, Colima 28984, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osiris G.","family":"Delgado-Enciso","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah P.","family":"Guzm\u00e1n-Sol\u00f3rzano","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Research Unit, Mexican Institute of Social Security, Villa de Alvarez, Colima 29883, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3295-4768","authenticated-orcid":false,"given":"Janet","family":"Diaz-Martinez","sequence":"additional","affiliation":[{"name":"Research Center in Minority Institutions, Florida International University (FIU-RCMI), Miami, FL 33199, USA"},{"name":"Department of Dietetics & Nutrition, Robert Stempel College of Public Health & Social Work, Florida International University (FIU-RCMI), Miami, FL 33199, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ver\u00f3nica M.","family":"Guzm\u00e1n-Sandoval","sequence":"additional","affiliation":[{"name":"School of Psychology, University of Colima, Colima 28040, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3525-7821","authenticated-orcid":false,"given":"Carmen A.","family":"Sanchez-Ramirez","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valery","family":"Melnikov","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00e9ctor","family":"Ochoa-Diaz-Lopez","sequence":"additional","affiliation":[{"name":"Department of Health, El Colegio de La Frontera Sur, San Cristobal de Las Casas 29290, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2748-4327","authenticated-orcid":false,"given":"Daniel","family":"Montes-Galindo","sequence":"additional","affiliation":[{"name":"Faculty of Chemical Sciences, University of Colima, Coquimatlan 28400, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1744-9173","authenticated-orcid":false,"given":"Fabian","family":"Rojas-Larios","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9848-862X","authenticated-orcid":false,"given":"Iv\u00e1n","family":"Delgado-Enciso","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, Mexico"},{"name":"State Cancerology Institute of Colima, Health Services of the Mexican Social Security Institute for Welfare (IMSS-BIENESTAR), Colima 28085, Mexico"},{"name":"Department of Dietetics & Nutrition, Robert Stempel College of Public Health & Social Work, Florida International University (FIU-RCMI), Miami, FL 33199, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e16841","DOI":"10.2196\/16841","article-title":"Effectiveness of Exergaming in Improving Cognitive and Physical Function in People with Mild Cognitive Impairment or Dementia: Systematic Review","volume":"8","author":"Zhao","year":"2020","journal-title":"JMIR Serious Games"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1016\/S0140-6736(24)01296-0","article-title":"Dementia Prevention, Intervention, and Care: 2024 Report of the Lancet Standing Commission","volume":"404","author":"Livingston","year":"2024","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1016\/S2215-0366(21)00084-5","article-title":"6-Month Neurological and Psychiatric Outcomes in 236,379 Survivors of COVID-19: A Retrospective Cohort Study Using 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