Prevalence and correlates of subjective cognitive concerns in Australian university students during the COVID-19 pandemic

Abstract

Introduction: Coronavirus (COVID-19) instigated unprecedented global effects on healthcare systems, economies, employment, education, travel, and social lives. In addition to increased mental health challenges, pandemic restrictions have triggered emerging cognitive concerns. University students are at particularly high risk of adverse lockdown-related effects, yet despite the substantial adaptions to learning necessitated by COVID-19, limited research has so far focused on the cognitive consequences of the pandemic among university students. This study aimed to comprehensively examine the nature, prevalence, and correlates of subjective cognitive concerns among 972 students (Median age = 22 years, 70% female) enrolled at Monash University, Australia, in December 2020.

Methods: Students completed the online THRIVE@Monash survey, 5 weeks following prolonged lockdown in Melbourne. Using group comparisons and hierarchical binary logistic regression analyses, we examined associations between demographic and enrolment characteristics, COVID-19-related experiences and impacts (author-developed questions), self-reported anxiety and depression symptoms (PROMIS Anxiety and Depression scales), and students' perceived changes in everyday cognitive functions (author-developed questions).

Results: Over 60% of students reported subjective cognitive concerns (SCCs). After controlling for anxiety and depression symptoms, students reporting more SCCs were more likely to be younger, from White/European ethnic backgrounds, and in their first year of undergraduate study. No differences in SCCs were found between male and female students. Greater worry, anxiety, or stress related to COVID-19 (e.g., infection, leaving the house, hygiene and exposure prevention, impact on physical and mental health), and time spent reading or talking about COVID-19, were generally not associated with SCCs after controlling for anxiety and depression symptoms.

Discussion: These findings highlight vulnerable subgroups of students who might benefit from regular monitoring, education, and interventions to support their cognitive health during the pandemic and beyond. In addition, cognitive concerns may provide additional insight into mental health problems among students, and emphasize the importance of understanding factors that impact students' long-term academic and career success.

Keywords: COVID-19; cognition; pandemic; subjective cognitive concerns; university students.

Figure 1

Percentages of students (scaled to 100%) endorsing subjective cognitive concerns (SCCs) relating to any domain (n = 901), concentration (n = 895), confidence in learning (n = 895), memory recall (n = 895), and muddled thoughts (n = 897). Percentages based on number of students with valid survey responses for each domain (i.e., excluding missing values).

Figure 2

Boxplots illustrating higher median scores for COVID-19-related worry in students reporting the presence of SCCs, across all cognitive domains. ***p < 0.001, Mann–Whitney U comparisons between students endorsing presence vs. absence of SCCs within each cognitive domain and overall. Not adjusted for differences in self-reported anxiety and depression symptoms.

Figure 3

Percent endorsement of SCCs for each domain, between students (A) with low (n = 681) vs. high (n = 217) levels of reported stress about restrictions on leaving the home, and (B) spending low (n = 763) vs. high (n = 135) amounts of their time reading or talking about COVID-19. Percentages based on number of students with valid survey responses (i.e., excluding missing values), and not adjusted for differences in self-reported anxiety and depression symptoms; *p < 0.05, **p < 0.01.

Figure 4

Boxplots illustrating higher median scores for anxiety related to COVID-19 exposure prevention and hygiene practices, in students reporting the presence of SCCs across all cognitive domains. ***p ≤ 0.001, for comparisons between students endorsing presence vs. absence of SCCs within each cognitive domain.

Figure 5

Endorsement of SCCs (scaled to 100%) across year level for undergraduate and postgraduate students. Based on number of students with valid survey responses (i.e., excluding missing values). Significant Year x Degree Type interaction for overall SCCs (71.4% first-year [Y1] undergraduates vs. 51.7% Y1 postgraduates), concentration (49.2% Y1 undergraduates vs. 25.8% Y1 postgraduates; and 50.8% second-year [Y2] undergraduates vs. 29.5% Y2 postgraduates), muddled thoughts (57.1% Y1 undergraduates vs. 19.1% Y1 postgraduates), and memory recall (36.5% Y1 undergraduates vs. 19.4% Y1 postgraduates), *p < 0.05, **p < 0.01, ***p < 0.001. Odds ratios (OR) with 95% confidence intervals displayed from hierarchical binary logistic regression analyses accounting for the influence of self-reported anxiety and depression scores on SCC endorsement (see main text).