other·PMC10115807

The neuropsychology of healthy aging: the positive context of the University of the Third Age during the COVID-19 pandemic

Scientific Reports · 7 authors, 5 centres

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POPULATION39 cognitively healthy older adults (79% female; mean age 70.72 years, SD 5.62; mean education 13.28 years) from the University of the Third Age (UNITRE) in Turin, Italy

INTERVENTIONParticipation in UNITRE active and healthy aging programs (cognitive, physical, and social activities) before and during the pandemic, including continued distance learning during lockdown

COMPARISONWithin-subject comparison of neuropsychological, mood, and physical measures collected before the pandemic (April–October 2019) vs. during the pandemic (June–December 2021)

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TL;DR

This longitudinal study of 39 cognitively healthy older adults from the University of the Third Age (UNITRE) in Turin found that, contrary to widespread assumptions, participants maintained or even improved cognitive performance (global cognition, executive function, language comprehension) during the COVID-19 pandemic, despite increases in apathy and anxiety. Cognitive reserve appeared to play a protective role against pandemic-related emotional dysregulation. The findings suggest that continued social and educational engagement can support healthy cognitive aging even during major health emergencies.

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**Background:** The COVID-19 pandemic disproportionately affected older adults through both direct infection risk and the consequences of social isolation and lockdown measures. While much research focused on negative outcomes, few studies examined whether healthy older adults could maintain or improve neuropsychological functioning during the pandemic. Cognitive reserve (CR)—the brain's resilience to age-related changes—may protect against cognitive decline and emotional dysregulation. This study leveraged pre-pandemic data from a cohort of older adults enrolled in the University of the Third Age (UNITRE) in Turin, Italy, to assess longitudinal changes in cognition, mood, physical status, and emotional regulation during the pandemic.

**Methods:** From April to October 2019, 81 volunteers (60–80 years) from UNITRE underwent baseline neuropsychological assessment. After pandemic restrictions, 39 subjects (31 women; mean age 70.72 years, SD 5.62; mean education 13.28 years, SD 2.14) completed follow-up assessment between June and October 2021. Thirty-five subjects also participated in a psychophysiological assessment (October–December 2021) measuring heart rate variability (HRV) during presentation of 75 pandemic-related images. The neuropsychological battery assessed global cognition (ACE-R, MMSE), executive function (MoCA, TMT parts A and B), memory (RMT—15 immediate and delayed words), language comprehension (Token Test), mood (AES, BDI, HARS, MAS, DIS), and physical frailty (Fried phenotype, CIRS). Bayes factors (BFs) and paired t-tests compared pre- and during-pandemic measures. Correlation and multiple regression analyses examined relationships between neuropsychological changes and emotional (dys)regulation indexed by the LF/HF ratio of HRV.

**Key Results:** Participants showed significant improvements in global cognition (ACE-R: t = −2.952, p = 0.006), executive function (MoCA: t = −2.609, p = 0.013), and language comprehension (TT: t = −4.70, p = 0.001). Bayes factors confirmed stability in memory (RMT immediate: BF01 = 4.14; delayed: BF01 = 4.33), attention (TMT part A: BF01 = 5.46; part B: BF01 = 3.53; B-A: BF01 = 3.15), and global cognition (MMSE: BF01 = 4.22). Mood measures showed significant increases in apathy (AES: t = −7.43, p < 0.001) and anxiety (HARS: t = −3.71, p < 0.001), with 36% of the sample scoring below cut-off on AES and 13% on HARS during the pandemic. Depression (BDI: BF01 = 5.33), hypomania (MAS: BF01 = 5.51), and disinhibition (DIS: BF01 = 3.07) remained stable. Physical frailty status did not change significantly (McNemar χ² = 2.29, p = 0.515). The correlation matrix showed significant associations between LF/HF ratio and both AES (p < 0.05) and ACE-R (p < 0.05). A multiple regression model (R = 0.711, R² = 0.506) revealed that higher apathy was significantly predicted by lower ACE-R scores (t = −2.391, p = 0.024), higher HARS scores (t = 3.704, p = 0.001), and higher LF/HF ratio (t = 3.011, p = 0.006), while gender (p = 0.540) and age (p = 0.534) were not significant predictors.

**Clinical Implications:** This study provides novel evidence that healthy older adults can maintain or even improve cognitive function during a major health crisis when they remain socially and educationally engaged. The findings highlight the protective role of cognitive reserve against pandemic-related emotional dysregulation and apathy. The UNITRE model—combining cognitive stimulation, social interaction, and physical activity—represents a scalable intervention to promote healthy aging and resilience. These results are particularly relevant given global demographic trends (by 2050, 2 billion people will be over 60) and the need for evidence-based strategies to support cognitive health during future health emergencies. Limitations include the small sample size (n = 39), predominantly female and medium-to-high socioeconomic status participants, and the lack of a control group not engaged in similar programs.

PICO

PPOPULATION

39 cognitively healthy older adults (79% female; mean age 70.72 years, SD 5.62; mean education 13.28 years) from the University of the Third Age (UNITRE) in Turin, Italy

IINTERVENTION

Participation in UNITRE active and healthy aging programs (cognitive, physical, and social activities) before and during the pandemic, including continued distance learning during lockdown

OOUTCOME

Cognitive performance (ACE-R, MMSE, MoCA, RMT, TMT, Token Test), mood (AES, BDI, HARS, MAS, DIS), physical frailty status, and emotional (dys)regulation (LF/HF ratio of HRV)

STUDY TYPE

other

SPECIALTY

Not tagged

SUMMARISED BY

AI pipeline

FIDELITY CHECK

100% · A

ORIGINAL PAPER

PMC10115807

The neuropsychology of healthy aging: the positive context of the University of the Third Age during the COVID-19 pandemic

Scientific Reports

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ABSTRACT

Abstract Older adults have been reported to have increased susceptibility to the adverse effects of SARS-CoV-2 infection, such as fatal outcomes, cognitive decline, and changes in physical and/or mental health. However, few studies have examined neuropsychological changes by comparing measurements before and during the pandemic in healthy older people. In addition, no longitudinal studies have examined whether older adults may have responded positively to the pandemic. We examined these issues through a 2-year neuropsychological study before and during the pandemic period. Results showed that scores before and during the pandemic were the same in memory and attention, whereas global cognitive, executive, and language functions improved. Participants also showed no longitudinal changes in depression, hypomania, and disinhibition, while apathy and, to a lesser extent, anxiety increased significantly. To examine possible signs of pandemic-related emotional (dys)regulation, subjects were shown images at follow-up that recalled the most dramatic lockdown phase while heart rate variability was recorded. Higher apathy was predicted by poorer global cognitive performance, increased anxiety, and emotional dysregulation as measured by a higher ratio of low-to-high frequency heart rate variability. Thus, preserved global cognition appears to play a protective role against the effects of pandemic-related anxiety and emotional dysregulation on apathy. Subject terms: Human behaviour, Cognitive ageing

CITATION EXPORT

Martina Amanzio, Giuseppina Elena Cipriani, Massimo Bartoli et al.. The neuropsychology of healthy aging: the positive context of the University of the Third Age during the COVID-19 pandemic. Scientific Reports. (2023). https://doi.org/10.1038/s41598-023-33513-4

AUTHORS

7 · 5 CENTRES

Martina Amanzio, Giuseppina Elena Cipriani, Massimo Bartoli, Nicola Canessa, Francesca Borghesi, Alice Chirico, Pietro Cipresso

1Department of Psychology, University of Turin, 10024 Turin, Italy
2ICoN Center, Scuola Universitaria Superiore IUSS, 27100 Pavia, Italy
3Istituti Clinici Scientifici Maugeri IRCCS, Cognitive Neuroscience Laboratory of Pavia Institute, 27100 Pavia, Italy
4Department of Psychology, Research Center in Communication Psychology, Università Cattolica del Sacro Cuore, 20123 Milan, Italy
5Istituto Auxologico Italiano, IRCCS, 20145 Milan, Italy