The DOI matches its Crossref record; 39 of the 41 references it cites were found in a registry or an index; none of the 13 sources its claims cite is checked for support yet.
One-Year Trajectory of Cognitive Changes in Older Survivors of COVID-19 in Wuhan, China: A Longitudinal Cohort Study
Open accessAbstract
Importance: Determining the long-term impact of COVID-19 on cognition is important to inform immediate steps in COVID-19 research and health policy. Objective: To investigate the 1-year trajectory of cognitive changes in older COVID-19 survivors. Design, Setting, and Participants: This cohort study recruited 3233 COVID-19 survivors 60 years and older who were discharged from 3 COVID-19-designated hospitals in Wuhan, China, from February 10 to April 10, 2020. Their uninfected spouses (N = 466) were recruited as a control population. Participants with preinfection cognitive impairment, a concomitant neurological disorder, or a family history of dementia were excluded, as well as those with severe cardiac, hepatic, or kidney disease or any kind of tumor. Follow-up monitoring cognitive functioning and decline took place at 6 and 12 months. A total of 1438 COVID-19 survivors and 438 control individuals were included in the final follow-up. COVID-19 was categorized as severe or nonsevere following the American Thoracic Society guidelines. Main Outcomes and Measures: The main outcome was change in cognition 1 year after patient discharge. Cognitive changes during the first and second 6-month follow-up periods were assessed using the Informant Questionnaire on Cognitive Decline in the Elderly and the Telephone Interview of Cognitive Status-40, respectively. Based on the cognitive changes observed during the 2 periods, cognitive trajectories were classified into 4 categories: stable cognition, early-onset cognitive decline, late-onset cognitive decline, and progressive cognitive decline. Multinomial and conditional logistical regression models were used to identify factors associated with risk of cognitive decline. Results: Among the 3233 COVID-19 survivors and 1317 uninfected spouses screened, 1438 participants who were treated for COVID-19 (691 male [48.05%] and 747 female [51.95%]; median [IQR] age, 69 [66-74] years) and 438 uninfected control individuals (222 male [50.68%] and 216 female [49.32%]; median [IQR] age, 67 [66-74] years) completed the 12-month follow-up. The incidence of cognitive impairment in survivors 12 months after discharge was 12.45%. Individuals with severe cases had lower Telephone Interview of Cognitive Status-40 scores than those with nonsevere cases and control individuals at 12 months (median [IQR]: severe, 22.50 [16.00-28.00]; nonsevere, 30.00 [26.00-33.00]; control, 31.00 [26.00-33.00]). Severe COVID-19 was associated with a higher risk of early-onset cognitive decline (odds ratio [OR], 4.87; 95% CI, 3.30-7.20), late-onset cognitive decline (OR, 7.58; 95% CI, 3.58-16.03), and progressive cognitive decline (OR, 19.00; 95% CI, 9.14-39.51), while nonsevere COVID-19 was associated with a higher risk of early-onset cognitive decline (OR, 1.71; 95% CI, 1.30-2.27) when adjusting for age, sex, education level, body mass index, and comorbidities. Conclusions and Relevance: In this cohort study, COVID-19 survival was associated with an increase in risk of longitudinal cognitive decline, highlighting the importance of immediate measures to deal with this challenge.
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45 Own result · 8 Own method · 7 Not checked yet · 7 Own interpretation · 1 No basis given
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Severe COVID-19 was associated with a higher risk of early-onset cognitive decline (odds ratio [OR], 4.87; 95% CI, 3.30-7.20),late-onset cognitive decline (OR, 7.58; 95% CI, 3.58-16.03),and progressive cognitive decline (OR, 19.00; 95% CI, 9.14-39.51)”
§ One-Year Trajectory of Cognitive Changes in Older Survivors of COVID-19 in Wuhan, China A Longitudinal Cohort Study > Abstract
plaincorrelationaln = 1,438 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Adjustment for age, sex, education, BMI, and comorbidities is sufficient to control for confounding of the association between COVID-19 and cognitive decline.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Individuals with severe cases had lower Telephone Interview of Cognitive Status-40 scores than those with nonsevere cases and control individuals at 12 months (median [IQR]: severe, 22.50 [16.00-28.00];nonsevere, 30.00 [26.00-33.00];control, 31.00 [26.00-33.00]).”
- Also stated in: § Cognitive Impairment 12 Months After Discharge · plain
“Individuals with severe cases also had lower TICS-40 scores than those with nonsevere cases (median [IQR] severe, 22.50 [16.00-28.00]vs nonsevere, 30.00 [26.00-33.00];P < .001)and control individuals (median [IQR] severe, 22.50 [16.00-28.00]vs control, 31.00 [26.00-33.00];P < .001) at 12 months.”
§ One-Year Trajectory of Cognitive Changes in Older Survivors of COVID-19 in Wuhan, China A Longitudinal Cohort Study > Abstract
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Exclusion of participants with self-reported or diagnosed preinfection cognitive impairment accurately identifies those without preinfection impairment.
- Also stated in: § Cognitive Impairment 12 Months After Discharge · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The IQCODE score (higher score indicates larger longitudinal cognitive decline) at 6 months' follow-up was higher in individuals with severe cases than in those with nonsevere cases (median [IQR], 3.63 [3.15-4.36]vs 3.18 [3.00-3.56];P < .001)”
§ One-Year Trajectory of Cognitive Changes in Older Survivors of COVID-19 in Wuhan, China A Longitudinal Cohort Study > Longitudinal Cognitive Change During Follow-up
plaincorrelationaln = 158 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The proportion of participants with longitudinal cognitive decline during the first 6 months was higher among those with severe cases than those with nonsevere cases (60.77% vs 28.86%; P < .001)”
§ One-Year Trajectory of Cognitive Changes in Older Survivors of COVID-19 in Wuhan, China A Longitudinal Cohort Study > Longitudinal Cognitive Change During Follow-up
plaincorrelationaln = 158 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and control individuals (median [IQR], 24.00 [18.25-29.00]vs 30.00 [26.00-33.25];P < .001) at 6 months.”
§ One-Year Trajectory of Cognitive Changes in Older Survivors of COVID-19 in Wuhan, China A Longitudinal Cohort Study > Cognitive Impairment 12 Months After Discharge
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Uninfected spouses are a valid control group for COVID-19 survivors, comparable on factors affecting cognition.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and control individuals (median [IQR], 3.63 [3.15-4.36]vs 3.06 [3.00-3.38];P < .001)”
§ One-Year Trajectory of Cognitive Changes in Older Survivors of COVID-19 in Wuhan, China A Longitudinal Cohort Study > Longitudinal Cognitive Change During Follow-up
plaincorrelationaln = 158 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Uninfected spouses are a valid control group for COVID-19 survivors, comparable on factors affecting cognition.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Individuals with severe cases had lower TICS-40 scores (indicating worse cognition) than those with nonsevere cases (median [IQR], 24.00 [18.25-29.00]vs 30.00 [26.00-33.00];P < .001)”
§ One-Year Trajectory of Cognitive Changes in Older Survivors of COVID-19 in Wuhan, China A Longitudinal Cohort Study > Cognitive Impairment 12 Months After Discharge
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Severe COVID-19 was associated with a higher risk of early-onset cognitive decline (odds ratio [OR], 4.87; 95% CI, 3.30-7.20),late-onset cognitive decline (OR, 7.58; 95% CI, 3.58-16.03),and progressive cognitive decline (OR, 19.00; 95% CI, 9.14-39.51)”
§ One-Year Trajectory of Cognitive Changes in Older Survivors of COVID-19 in Wuhan, China A Longitudinal Cohort Study > Abstract
plaincorrelationaln = 1,438 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Adjustment for age, sex, education, BMI, and comorbidities is sufficient to control for confounding of the association between COVID-19 and cognitive decline.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Severe COVID-19 was associated with a higher risk of early-onset cognitive decline (odds ratio [OR], 4.87; 95% CI, 3.30-7.20),late-onset cognitive decline (OR, 7.58; 95% CI, 3.58-16.03),and progressive cognitive decline (OR, 19.00; 95% CI, 9.14-39.51)”
§ One-Year Trajectory of Cognitive Changes in Older Survivors of COVID-19 in Wuhan, China A Longitudinal Cohort Study > Abstract
plaincorrelationaln = 1,438 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Adjustment for age, sex, education, BMI, and comorbidities is sufficient to control for confounding of the association between COVID-19 and cognitive decline.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The incidence of cognitive impairment in survivors 12 months after discharge was 12.45%.”
- Also stated in: § Cognitive Impairment 12 Months After Discharge · plain
“The overall incidence of cognitive impairment in survivors 12 months after discharge was 12.45%.”
§ One-Year Trajectory of Cognitive Changes in Older Survivors of COVID-19 in Wuhan, China A Longitudinal Cohort Study > Abstract
plainn = 1,438- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Exclusion of participants with self-reported or diagnosed preinfection cognitive impairment accurately identifies those without preinfection impairment.
- Also stated in: § Cognitive Impairment 12 Months After Discharge · plain
- It may state two separate claims as one. 5
- Probably not a substantial claim. 3
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“In this study, nonsevere COVID-19 was associated with cognitive impairment at 12 months and late-onset cognitive decline in the paired cohort, but not in the whole cohort.”
§ One-Year Trajectory of Cognitive Changes in Older Survivors of COVID-19 in Wuhan, China A Longitudinal Cohort Study > Discussion
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Among the participants who completed the 12-month follow-up, COVID-19 survivors were not different from control individuals in age, sex distribution, education level, BMI, and frequency of comorbidities, including hypertension, diabetes, hyperlipidemia, stroke, coronary heart disease, and COPD (Table 1).”
§ One-Year Trajectory of Cognitive Changes in Older Survivors of COVID-19 in Wuhan, China A Longitudinal Cohort Study > Demographic Characteristics of Participants
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The association between IQCODE and TICS-40 scores was analyzed to ensure the consistency of the 2 cognitive assessments verified in previous studies.20,21”
§ One-Year Trajectory of Cognitive Changes in Older Survivors of COVID-19 in Wuhan, China A Longitudinal Cohort Study > Cognitive Assessment
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Telephone interviews were conducted to assess cognition by a group of trained raters (L.-R.W., L.J., Y.Y., X.C., Y.L., Y.C).”
§ One-Year Trajectory of Cognitive Changes in Older Survivors of COVID-19 in Wuhan, China A Longitudinal Cohort Study > Cognitive Assessment
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“In the paired subgroup of 438 COVID-19 survivors and their uninfected spouses, survivors were older (median [IQR] age, 68 [65-78] vs 67 [66-74]; P < .001)and had a higher frequency of hypertension (47.03% vs 34.47%; P < .001)than their spouses (eTable 3 in the Supplement).”
§ One-Year Trajectory of Cognitive Changes in Older Survivors of COVID-19 in Wuhan, China A Longitudinal Cohort Study > Demographic Characteristics of Participants
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“several cross-sectional studies showing that SARS-CoV-2 infection is associated with an increase in risk of cognitive impairment”
§ One-Year Trajectory of Cognitive Changes in Older Survivors of COVID-19 in Wuhan, China A Longitudinal Cohort Study > Discussion
What the sources say
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Chronic systemic inflammation after SARS-CoV-2 infection exacerbates neurodegeneration, thus potentially leading to long-term cognitive deficits.”
§ One-Year Trajectory of Cognitive Changes in Older Survivors of COVID-19 in Wuhan, China A Longitudinal Cohort Study > Discussion
What the sources say
- Not checked yetcites [35] source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“the mismatch of sample sizes between survivors and control individuals and the relatively high rate of loss-to-follow-up weakened the power of the findings”
§ One-Year Trajectory of Cognitive Changes in Older Survivors of COVID-19 in Wuhan, China A Longitudinal Cohort Study > Limitations
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper relies on this without support.
Adjustment for age, sex, education, BMI, and comorbidities is sufficient to control for confounding of the association between COVID-19 and cognitive decline.
“when adjusting for age, sex, education level, body mass index, and comorbidities.”
The paper relies on this without support.
Exclusion of participants with self-reported or diagnosed preinfection cognitive impairment accurately identifies those without preinfection impairment.
“Participants were excluded if they met the following conditions: (1) did not agree to participate, did not understand the items in the questionnaires, or had communicative obstacles owing to language or hearing reasons; (2) had self-reported or diagnosed cognitive impairment preinfection;”
The paper relies on this without support.
The 1-year follow-up period is sufficient to capture the long-term trajectory of cognitive changes after COVID-19.
“In this study, we investigated the 1-year dynamic trajectory of cognitive changes in older COVID-19 survivors.”
The paper relies on this without support.
Uninfected spouses are a valid control group for COVID-19 survivors, comparable on factors affecting cognition.
“Uninfected spouses who lived with the patients were recruited as control individuals.”
The paper relies on this without support.
The long-term pattern of cognitive change among COVID-19 survivors is still not clear.
“Postinfection cognitive outcomes following COVID-19 have been reported but the long-term dynamic trajectory of cognitive changes in COVID-19 survivors remains unclear.”
The paper relies on this without support.
Cognitive decline may be affected by both preexisting cognitive impairment and COVID-19.
“As cognitive decline might be affected by both preexisting cognitive impairment and COVID-19, we excluded participants with known preexisting cognitive impairment and a family history of dementia.”
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In the citing paper
“Previous studies have demonstrated an association between COVID-19 and long-term brain atrophy and cognitive impairment in older individuals.282,283”
From Antiageing strategy for neurodegenerative diseases: from mechanisms to clinical advances (2025) · cites this paper as [282]
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Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ One-Year Trajectory of Cognitive Changes in Older Survivors of COVID-19 in Wuhan, China A Longitudinal Cohort Study > Demographic Characteristics of Participants
“hypertension (51.15% vs 47.28%; P < .001)”
§ One-Year Trajectory of Cognitive Changes in Older Survivors of COVID-19 in Wuhan, China A Longitudinal Cohort Study > Conclusions
“| Hypertension | 561 (39.01) | 133 (51.15) | 426 (36.16) | 151 (34.47) | .09 b | <.001 b |”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
“control individuals (80 [30.77%] vs 23 [5.25%];P < .001)”
§ One-Year Trajectory of Cognitive Changes in Older Survivors of COVID-19 in Wuhan, China A Longitudinal Cohort Study > Longitudinal Cognitive Change During Follow-up
Reported 23 · recomputed 22
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Self-citation
Metadata
- Authors
- Liu, Y.-H., Chen, Y., Wang, Q.-H., Wang, L.-R., Jiang, L., Yang, Y., Chen, X., Li, Y., Cen, Y., Xu, C., Zhu, J., Li, W., Wang, Y.-R., Zhang, L.-L., Liu, J., Xu, Z.-Q., & Wang, Y.-J.
- Affiliations
- Army Medical University (CN)
- Department of Neurology and Centre for Clinical Neuroscience, Daping Hospital, Third Military Medical University, Chongqing, China
- Department of Oncology, General Hospital of the Central Theatre Command of the People’s Liberation Army, Wuhan, China
- Corresponding author
- Wang, Yan-Jiang
- Venue
- JAMA Neurology
- Publisher
- American Medical Association (AMA)
- Published
- 2022-05-01
- Volume
- 79
- Issue
- 5
- Pages
- 509
- ISSN
- 2168-6149 (ISSN-L)
- PMC
- PMC8905512
- OpenAlex
- W4220684118
- Cited by
- 225
- References
- 41
- Citations by year
- 2026: 16 · 2025: 32 · 2024: 54 · 2023: 83 · 2022: 39
- FWCI
- 27.38
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- JAMA Neurology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Natural Science Foundation of China (81930028)
- Topics
- Health Sciences › Medicine › Clinical Neurology › Long-Term Effects of COVID-19
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Keywords
- COVID-19 pandemic, cognitive decline, older adults, long-term cognitive outcomes, cognitive trajectories, post-COVID cognitive impairment, risk factors for cognitive decline, severe COVID-19, long COVID, Wuhan, SARS-CoV-2, dementia risk, hypertension
- MeSH terms
- COVID-19, SARS-CoV-2, Aged, Cognition, Female, Humans, Longitudinal Studies, Male, Cohort Studies, Survivors, Cognitive Dysfunction
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-05, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-05 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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