Life during COVID-19 lockdown in Italy: the influence of cognitive state on psychosocial, behavioral and lifestyle profiles of older adults

How Technology, Health Information Seeking, and Socioeconomic Factors Are Associated With Coronavirus Disease 2019 Vaccination Readiness in Estonians Over 50 Years?

Despite the proven effectiveness of COVID-19 vaccines in preventing severe illness, many individuals, including older adults who are most susceptible to the virus, have opted against vaccination. Various factors could shape vaccination decisions, including seeking health information (HI). The internet is the primary source of HI today; however, older adults are often referred to as those missing out on digital benefits. The study explores the correlations between information and communication technology (ICT) use, online HI seeking, socioeconomic factors, and COVID-19 vaccination readiness among individuals aged 50 and above in Estonia. The survey data were gathered from 501 people aged 50 and older after the first lockdown in 2020. The outcomes revealed that vaccination readiness positively correlated with factors such as higher educational attainment, greater income, male gender, access to ICT, a readiness to employ digital technologies for health-related purposes, a greater demand for HI, and a higher frequency of seeking it online. There was some discrepancy in the preference of HI sources; for example, vaccination consenters preferred online versions of professional press publications and specific health portals. Based on the findings, it is advisable to encourage older adults to utilize the internet and new technology for health-related purposes. This practice expands the range of information sources available to them, ultimately enabling better decision-making regarding their health behaviors.

Association depressive symptoms with memory function and social capital before and during COVID-19 in community-dwelling older adults in rural Japan: A retrospective study with a longitudinal data

OBJECTIVES

This study aimed to investigate the impact of memory function and social capital on depressive symptoms during the COVID-19 pandemic among older adults in rural Japan.

METHODS

A retrospective study with longitudinal data was conducted during COVID-19 from May 2021 to November 2021 (T2) in Kurogawa, Japan. The candidate population for this study was 145 with the following requirements: (1) older individuals aged 65 years or above who were registered in the Kurogawa study, and (2) those with previous data (from November 2016 to February 2020; T1 as pre-pandemic). Memory function was assessed using the Wechsler Memory Scale-Revised Logical Memory II delayed recall part A (LM II-DR). Depressive symptoms were assessed using the Japanese version of the 15-item Geriatric Depression Scale (GDS-15). Social capital was evaluated through civic participation, social cohesion, and reciprocity. Fear of the COVID-19 infection (FCV-19S) was evaluated.

RESULTS

The final analysis included 96 participants (mean age = 81.0 years, SD = 4.8) Multivariate analysis for GDS-15 score by Mixed Model Repeated Measures (MMRM) revealed significant associations between LM II-DR (β = -0.13, 95% CI: -0.21-0.05, p = 0.002) and FCV-19S during COVID-19 (β = 0.08, 95% CI: 0.01-0.15, p = 0.02) with GDS-15 score. However, civic participation, social cohesion and reciprocity were not associated with GDS-15 score.

CONCLUSIONS

Among older adults in rural Japan, memory function and fear of the COVID-19 infection were significantly associated with depressive symptoms in MMRM analysis. However, social capital was not associated with depressive symptoms. This highlights the need to address memory function and fear of the COVID-19 infection in interventions for older adults during crises like the COVID-19 pandemic.

Depressive symptoms associated with infection prevention measures and daily lifestyle habit characteristics among Japanese community-dwelling older adults during the COVID-19 pandemic

AIM

This study aimed to clarify the relationship between depressive symptoms and infection prevention measures and daily lifestyle habits during the coronavirus disease 2019 pandemic among community-dwelling Japanese older adults.

METHODS

This cross-sectional study was conducted on older residents (age ≥65 years) living in the Tama area of Tokyo and Sapporo, Hokkaido, in 2021. A self-administered questionnaire survey was conducted to collect data on demographics, the impact of the pandemic on physical condition, and depressive symptoms, infection prevention measures, and daily lifestyle habits during the pandemic. The Geriatric Depression Scale was used to assess depressive symptoms.

RESULTS

In total, 554 respondents were included in the analysis. The results of multiple logistic regression analyses revealed that refraining from going out and visiting medical institutions were associated with depressive symptoms. Furthermore, those who went out almost every day were less likely to have depressive symptoms than the others, those who exercised almost every day were less likely to have depressive symptoms than were those who almost never exercised, and those who slept 6-7 h were less likely to have depressive symptoms than were those who slept ≤5 h.

CONCLUSIONS

The findings of the present study suggest the necessity of having a place where older adults with physical and lifestyle concerns can consult with healthcare providers in a location other than a medical institution, even during infectious disease outbreaks. In addition, increasing the frequencies of going out and independent exercise and sleeping 6-7 h may help prevent depression among older adults.

The Impact of the COVID-19 Pandemic on the Psychological Well-Being of Caregivers of People with Dementia or Mild Cognitive Impairment: A Systematic Review and Meta-Analysis

The aim of this systematic review was to investigate the effects of the COVID-19 lockdown on the psychological well-being of caregivers of people with dementia or mild cognitive impairment (PwD/MCI). Electronic databases were searched from inception to August 2022 for observational studies investigating the COVID-19 lockdown and psychological well-being of caregivers of PwD/MCI. Summary estimates of standardized mean differences (SMD) in psychological well-being scores pre- versus during COVID-19 were calculated using a random-effects model. Fifteen studies including 1702 caregivers (65.7% female, mean age 60.40 ± 12.9 years) with PwD/MCI were evaluated. Five studies found no change in psychological well-being parameters, including depression, anxiety, distress, caregiver burden, and quality of life. Ten studies found a worsening in at least one parameter: depression (six studies, n = 1368; SMD = 0.40; 95%CI: 0.09-0.71; p = 0.01, I2 = 86.8%), anxiety (seven studies, n = 1569; SMD = 1.35; 95%CI: 0.05-2.65; I2 = 99.2%), caregiver distress (six studies, n = 1320, SMD = 3.190; 95%CI: 1.42-4.95; p < 0.0001; I2 = 99.4%), and caregiver burden (four studies, n = 852, SMD = 0.34; 95%CI: 0.13-0.56; p = 0.001; I2 = 54.1%) (p < 0.05). There was an increase in depression, anxiety, caregiver burden, and distress in caregivers of PwD/MCI during the lockdown in the COVID pandemic. This could have longer term consequences, and it is essential that caregivers' psychological well-being is assessed and supported, to benefit both themselves and those for whom they care.

Long-term functional ability trajectories and mental health among older people before and after the COVID-19 pandemic onset in Chile

OBJECTIVES

Despite the advances in understanding the complex association between functional abilities and mental health in old age, studies have overlooked two important aspects. First, traditionally, research has employed cross-sectional designs, measuring limitations at a single time point. Second, most gerontological studies on this field have been conducted before the COVID-19 pandemic onset. This study aims to explore the association between diverse long-term functional ability trajectories across late adulthood and old age, and older people's mental health in Chile, before and after the COVID-19 pandemic onset.

METHODS

We use data from the population-representative and longitudinal 'Chilean Social Protection Survey', sequence analysis to reconstruct functional ability trajectory types from 2004 to 2018, and bivariate and multivariate analyses to measure their association with depressive symptoms in early 2020 (N = 891) and late 2020 (N = 672). We analyzed four age groups defined by their age at baseline (2004): people aged 46-50, 51-55, 56-60, and 61-65.

RESULTS

Our findings indicate that erratic or equivocal patterns of functional limitations across time (with people transiting back and forth between low and high levels of limitations) show the worst mental health outcomes, both before and after the pandemic onset. Prevalence of people with depression increased after the COVID-19 onset in most groups, being particularly high among those with previous equivocal functional ability trajectories.

CONCLUSIONS

The relationship between functional ability trajectories and mental health calls for a new paradigm, moving away from age as the main policy guide, and highlighting the need to adopt strategies to improve population-level functional status as an efficient policy to address the challenges of population aging.

Prevalence and factors associated with anxiety and depression among community-dwelling older adults in Hunan, China: a cross-sectional study

BACKGROUND

Older adults' psychological health is a public health issue that cannot be ignored, especially when these psychological health problems and related factors change across different social backgrounds because of rapid changes in traditions and family structures and the epidemic responses after the outbreak of COVID-19 in China. The aim of our study is to determine the prevalence of anxiety and depression and their associated factors among community-dwelling older adults in China.

METHODS

A cross-sectional study was conducted from March to May 2021 with 1173 participants aged 65 years or above from three communities in Hunan Province, China who were selected using convenience sampling. A structured questionnaire including sociodemographic characteristics, clinical characteristics, the Social Support Rating Scale (SSRS), the 7-Item Generalized Anxiety Disorder scale (GAD-7), and the Patient Health Questionnaire-9 Item (PHQ-9) was used to collect relevant demographic and clinical data and to measure social support status, anxiety symptoms, and depressive symptoms, respectively. Bivariate analyses were conducted to explore the difference in anxiety and depression based on samples' different characteristics. The multivariable logistic regression analysis was performed to test for significant predictors of anxiety and depression.

RESULTS

The prevalence of anxiety and depression were 32.74% and 37.34%, respectively. Multivariable logistic regression analysis revealed that being female, being unemployed before retirement age, lacking physical activity, having physical pain, and having three or more comorbidities were significant predictors for anxiety. Subjective social support and support utilization were significant protective factors. Regarding depression, religion, lacking physical activity, having physical pain, having three or more comorbidities were found to be significant predictors. Support utilization was a significant protective factor.

CONCLUSIONS

The study group showed a high prevalence of anxiety and depression. Gender, employment status, physical activity, physical pain, comorbidities, and social support were associated with psychological health problems of older adults. These findings suggest that governments should focus on the psychological health problems of older adults by raising community awareness of issues related to older adults' psychological health. They should also screen for anxiety and depression among high-risk groups and encourage individuals to seek supportive counseling.

Longitudinal Aging Study Amsterdam COVID-19 exposure index: a cross-sectional analysis of the impact of the pandemic on daily functioning of older adults

OBJECTIVES

The aim of this study was to develop an index to measure older adults' exposure to the COVID-19 pandemic and to study its association with various domains of functioning.

DESIGN

Cross-sectional study.

SETTING

The Longitudinal Aging Study Amsterdam (LASA), a cohort study in the Netherlands.

PARTICIPANTS

Community-dwelling older adults aged 62-102 years (n=1089) who participated in the LASA COVID-19 study (June-September 2020), just after the first wave of the pandemic.

PRIMARY OUTCOME MEASURES

A 35-item COVID-19 exposure index with a score ranging between 0 and 1 was developed, including items that assess the extent to which the COVID-19 situation affected daily lives of older adults. Descriptive characteristics of the index were studied, stratified by several sociodemographic factors. Logistic regression analyses were performed to study associations between the exposure index and several indicators of functioning (functional limitations, anxiety, depression and loneliness).

RESULTS

The mean COVID-19 exposure index score was 0.20 (SD 0.10). Scores were relatively high among women and in the southern region of the Netherlands. In models adjusted for sociodemographic factors and prepandemic functioning (2018-2019), those with scores in the highest tertile of the exposure index were more likely to report functional limitations (OR: 2.24; 95% CI: 1.48 to 3.38), anxiety symptoms (OR: 3.14; 95% CI: 1.82 to 5.44), depressive symptoms (OR: 2.49; 95% CI: 1.55 to 4.00) and loneliness (OR: 2.97; 95% CI: 2.08 to 4.26) than those in the lowest tertile.

CONCLUSIONS

Among older adults in the Netherlands, higher exposure to the COVID-19 pandemic was associated with worse functioning in the physical, mental and social domain. The newly developed exposure index may be used to identify persons for whom targeted interventions are needed to maintain or improve functioning during the pandemic or postpandemic.

Longitudinal Aging Study Amsterdam COVID-19 exposure index: a cross-sectional analysis of the impact of the pandemic on daily functioning of older adults

OBJECTIVES

The aim of this study was to develop an index to measure older adults' exposure to the COVID-19 pandemic and to study its association with various domains of functioning.

DESIGN

Cross-sectional study.

SETTING

The Longitudinal Aging Study Amsterdam (LASA), a cohort study in the Netherlands.

PARTICIPANTS

Community-dwelling older adults aged 62-102 years (n=1089) who participated in the LASA COVID-19 study (June-September 2020), just after the first wave of the pandemic.

PRIMARY OUTCOME MEASURES

A 35-item COVID-19 exposure index with a score ranging between 0 and 1 was developed, including items that assess the extent to which the COVID-19 situation affected daily lives of older adults. Descriptive characteristics of the index were studied, stratified by several sociodemographic factors. Logistic regression analyses were performed to study associations between the exposure index and several indicators of functioning (functional limitations, anxiety, depression and loneliness).

RESULTS

The mean COVID-19 exposure index score was 0.20 (SD 0.10). Scores were relatively high among women and in the southern region of the Netherlands. In models adjusted for sociodemographic factors and prepandemic functioning (2018-2019), those with scores in the highest tertile of the exposure index were more likely to report functional limitations (OR: 2.24; 95% CI: 1.48 to 3.38), anxiety symptoms (OR: 3.14; 95% CI: 1.82 to 5.44), depressive symptoms (OR: 2.49; 95% CI: 1.55 to 4.00) and loneliness (OR: 2.97; 95% CI: 2.08 to 4.26) than those in the lowest tertile.

CONCLUSIONS

Among older adults in the Netherlands, higher exposure to the COVID-19 pandemic was associated with worse functioning in the physical, mental and social domain. The newly developed exposure index may be used to identify persons for whom targeted interventions are needed to maintain or improve functioning during the pandemic or postpandemic.

Perceptions of societal ageism and declines in subjective memory during the COVID-19 pandemic: Longitudinal evidence from US adults aged ≥55 years

The cognitive health of older adults since the COVID-19 pandemic onset is unclear, as is the potential impact of pandemic-associated societal ageism on perceived cognition. We investigated associations between perceptions of societal ageism and changes in subjective memory over a 10-month period during the COVID-19 pandemic. We collected longitudinal data from monthly online questionnaires in the nationwide COVID-19 Coping Study of US adults aged ≥55 from April 2020 to January 2021 (N = 4444). We analyzed the data using multivariable longitudinal multilevel models. We identified an overall decline in subjective memory, especially in the initial months of the pandemic. Adults who perceived that societal respect for older adults decreased during the pandemic experienced more rapid declines in their subjective memory. These findings suggest that aging adults perceived a decline in their memory, especially during the initial months of the COVID-19 pandemic. Societal interventions to combat ageism may help improve subjective memory and could decrease risk for cognitive decline among middle-aged and older adults.

Changes in Brain-Health Related Modifiable Risk Factors in Older Adults After One Year of COVID-19-Restrictions

Background

The COVID-19 pandemic has major influence on lifestyle and mental health, which might affect brain-health and increase the risk of cognitive decline, particularly in older adults. We aimed to describe changes in modifiable risk factors related to brain-health in older adults after one year of COVID-19 restrictions.

Methods

An online survey was disseminated between February and March 2021 to 17,773 registrants of the Dutch Brain Research Registry, aged ≥50, without a self-reported diagnosis of mild cognitive impairment or dementia. Participants were asked to report potential changes in behaviors during the COVID-19 pandemic, compared to pre-pandemic, in eight domains related to brain health: physical activity, sleep, feeling of memory decline, perceived stress, feeling of loneliness, diet, alcohol consumption, and smoking. We used negative binomial regression analyses to relate (socio)demographics, subjective memory complaints and COVID-19 related aspects (fear of, or current/past COVID-19 infection) to the number of reported detrimental and beneficial changes as dependent variable.

Results

3,943 participants (66 ± 8 years old; 76% female; 71% highly educated) completed the survey. After one year of COVID-19-restrictions, 74% reported at least one detrimental lifestyle change unfavorable for their brain health, most frequently reported were feelings of loneliness, sleep problems, and less physical activity. 60% of participants reported at least one beneficial change, which were most often more physical activity, healthier dietary habits, and less alcohol consumption. Individuals who are younger [incidence rate ratio (IRR) = 0.99, 95% CI = 0.98-0.99], female (1.20, 1.11-1.30), living alone (1.20, 1.11-1.28) and in urban environments (1.18, 1.08-1.29), who are less satisfied with their income (1.38, 1.17-1.62), experiencing subjective memory complaints (1.40, 1.28-1.52) and those with a past or current (1.19, 1.06-1.34) or fear of a COVID-19 infection (1.33, 1.25-1.42) reported higher numbers of detrimental changes.

Discussion

The COVID-19 pandemic has influenced lifestyle in both positive and negative ways. We identified (socio)demographic factors associated with more detrimental changes in modifiable risk factors related to brain health, suggesting that some individuals are more vulnerable for the impact of the COVID-19 pandemic. These findings provide an opportunity for targeted prevention and education to promote a healthy lifestyle during and after the pandemic.

The Effects of COVID-19 lockdown on neuropsychiatric symptoms in patients with dementia or mild cognitive impairment: A systematic review and meta-analysis

The COVID-19 pandemic may have a disproportionate impact on people with dementia/mild cognitive impairment (MCI) due to isolation and loss of services. The aim of this systematic review was to investigate the effects of the COVID-19 lockdown on neuropsychiatric symptoms (NPS) in people living with dementia/MCI. Two authors searched major electronic databases from inception to June 2021 for observational studies investigating COVID-19 and NPS in people with dementia/MCI. Summary estimates of mean differences in NPS scores pre- versus post-COVID-19 were calculated using a random-effects model, weighting cases using inverse variance. Study quality and risk of bias were assessed by the Newcastle-Ottawa Scale. From 2730 citations, 21 studies including 7139 patients (60.0% female, mean age 75.6 ± 7.9 years, 4.0% MCI) with dementia were evaluated in the review. Five studies found no changes in NPS, but in all other studies, an increase in at least one NPS or the pre-pandemic Neuropsychiatric Inventory (NPI) score was found. The most common aggravated NPS were depression, anxiety, agitation, irritability, and apathy during lockdown, but 66.7% of the studies had a high bias. Seven studies including 420 patients (22.1% MCI) yielded enough data to be included in the meta-analysis. The mean follow-up time was 5.9 ± 1.5 weeks. The pooled increase in NPI score before compared to during COVID-19 was 3.85 (95% CI:0.43 to 7.27; P = 0.03; I²  = 82.4%). All studies had high risk of bias. These results were characterized by high heterogeneity, but there was no presence of publication bias. There is an increase in the worsening of NPS in people living with dementia/MCI during lockdown in the COVID pandemic. Future comparative studies are needed to elucidate whether a similar deterioration might occur in people without dementia/MCI.

Effect of COVID-19 quarantine on cognitive, functional and neuropsychiatric symptoms in patients with mild cognitive impairment and dementia

BACKGROUND

During the last two years, COVID-19 affected older people with dementia or mild cognitive impairment (MCI), but conflicting and sparse results are still present. The objective of this study was to investigate the frequency and type of changes in functional, cognitive and behavioral and psychological symptoms of dementia (BPSD), and caregiver's stress during the period of quarantine in 2020 in patients affected by dementia/MCI living in Palermo, Sicily.

METHODS

Outpatients affected by MCI/dementia were evaluated before and after COVID-19 quarantine. Functional status was investigated using basic and instrumental activities of daily living (ADL); cognitive performance with the mini-mental state examination; BPSD through the neuropsychiatric inventory (NPI). All scales were reported as pre/post-COVID-19 quarantine and a logistic regression analysis was performed for investigating the factors associated with worsening in NPI in patients and their caregivers.

RESULTS

One hundred patients (mean age 77.1; females = 59%) were evaluated over a median of 10 months. In the sample as whole, a significant decline in functional and cognitive status was observed (p < 0.001 for both comparisons). The NPI significantly increased by 3.56 ± 8.96 points after the COVID-19 quarantine (p < 0.0001), while the caregivers' stress increased by 1.39 ± 3.46 points between the two evaluations (p < 0.0001). The decline was more evident in people with milder dementia. Higher values of instrumental ADL at baseline were associated with a significant lower worsening in NPI and caregiver's stress.

CONCLUSIONS

COVID-19 quarantine negatively affected functional, cognitive, and neuropsychiatric symptoms in older people affected by dementia/MCI, highlighting the impact of COVID-19 quarantine for this population.

Minimal Impact of COVID-19 Pandemic on the Mental Health and Wellbeing of People Living With Dementia: Analysis of Matched Longitudinal Data From the IDEAL Study

OBJECTIVE

Research suggests a decline in the mental health and wellbeing of people with dementia (PwD) during the COVID-19 pandemic; however few studies have compared data collected pre-pandemic and during the pandemic. Moreover, none have compared this change with what would be expected due to dementia progression. We explored whether PwD experienced changes in mental health and wellbeing by comparing pre-pandemic and pandemic data, and drew comparisons with another group of PwD questioned on two occasions prior to the pandemic.

METHODS

Community-dwelling PwD enrolled in the IDEAL programme were split into two groups matched for age group, sex, dementia diagnosis, and time since diagnosis. Although each group was assessed twice, one was assessed prior to and during the pandemic (pandemic group; n = 115) whereas the other was assessed prior to the pandemic (pre-pandemic group; n = 230). PwD completed measures of mood, sense of self, wellbeing, optimism, quality of life, and life satisfaction.

RESULTS

Compared to the pre-pandemic group, the pandemic group were less likely to report mood problems, or be pessimistic, but more likely to become dissatisfied with their lives. There were no changes in continuity in sense of self, wellbeing, and quality of life.

DISCUSSION

Results suggest the pandemic had little effect on the mental health and wellbeing of PwD, with any changes observed likely to be consistent with expected rates of decline due to dementia. Although personal accounts attest to the challenges experienced, PwD appear to have been resilient to the impact of lockdown and social restrictions during the pandemic.

Factors Associated with Depression and Anxiety in Adults ≥60 Years Old during the COVID-19 Pandemic: A Systematic Review

COVID-19 represents a threat to public health and the mental health of the aged population. Prevalence and risk factors of depression and anxiety have been reported in previous reviews in other populations; however, a systematic review on the factors associated with depression and anxiety in older adults is not currently present in the literature. We searched PubMed, Embase, Scopus, ProQuest Psychology Database, Science Direct, Cochrane Library and SciELO databases (23 February 2021). The results were obtained by entering a combination of MeSH or Emtree terms with keywords related to COVID-19, elderly, depression and anxiety in the databases. A total of 11 studies were included in the systematic review. Female gender, loneliness, poor sleep quality and poor motor function were identified as factors associated with both depression and anxiety. Aspects related to having a stable and high monthly income represent protective factors for both depression and anxiety, and exercising was described as protective for depression. This study synthesised information and analysed the main factors associated with depression and anxiety in the older population during the COVID-19 pandemic. However, the cross-sectional design of most of the included studies does not allow a causal relationship between the factors analysed and depression or anxiety.

Impact of COVID-19 on 'Living Well' with Mild-to-Moderate Dementia in the Community: Findings from the IDEAL Cohort

BACKGROUND

Negative impacts of the COVID-19 pandemic on people with dementia have been widely-documented, but most studies have relied on carer reports and few have compared responses to information collected before the pandemic.

OBJECTIVE

We aimed to explore the impact of the pandemic on community-dwelling individuals with mild-to-moderate dementia and compare responses with pre-pandemic data.

METHODS

During the second wave of the pandemic, we conducted structured telephone interviews with 173 people with dementia and 242 carers acting as informants, all of whom had previously participated in the IDEAL cohort. Where possible, we benchmarked responses against pre-pandemic data.

RESULTS

Significant perceived negative impacts were identified in cognitive and functional skills and ability to engage in self-care and manage everyday activities, along with increased levels of loneliness and discontinuity in sense of self and a decline in perceived capability to 'live well'. Compared to pre-pandemic data, there were lower levels of pain, depression, and anxiety, higher levels of optimism, and better satisfaction with family support. There was little impact on physical health, mood, social connections and relationships, or perceptions of neighborhood characteristics.

CONCLUSION

Efforts to mitigate negative impacts of pandemic-related restrictions and restore quality of life could focus on reablement to address the effects on participation in everyday activities, creating opportunities for social contact to reduce loneliness, and personalized planning to reconnect people with their pre-COVID selves. Such efforts may build on the resilience demonstrated by people with dementia and carers in coping with the pandemic.

Tele-neuropsychological assessment tools in Italy: a systematic review on psychometric properties and usability

Background

The current COVID-19 pandemic has abruptly catalysed a shift towards remote assessment in neuropsychological practice (tele-neuropsychology, t-NPs). Although the validity of t-NPs diagnostics is gaining recognition worldwide, little is known about its implementation in Italy. The present review by the Italian working group on tele-neuropsychology (TELA) aims at describing the availability, psychometric properties, and feasibility of t-NPs tools currently available in Italy.

Methods

Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. This work was pre-registered on the Prospective Register of Systematic Reviews (PROSPERO; CRD42021239687). Observational studies reporting telephone-, videoconference- or web-based assessment of cognition/behaviour in Italian both healthy participants (HPs) and patients were included. Bias assessment was performed through ad hoc scales.

Results

Fourteen studies were included from an initial N = 895 (4 databases searched). Studies were subdivided into those focused on psychometric properties and those characterized by a predominant applied nature. The majority of studies addressed either adult/elderly HPs or neurological/internal patients. Multi-domain screening tools for cognition, behaviour, mood/anxiety and quality of life were the most represented. Findings regarding validity, reliability, sensitivity, specificity and clinical usability were reported for cognitive screenings — the telephone- and videoconference-based Mini-Mental State Examination and the Telephone Interview for Cognitive Status.

Discussion

Positive albeit preliminary evidence regarding psychometric properties and feasibility in both clinical and non-clinical populations of Italian t-NPs brief screening tools are herewith provided. Further studies exploring clinical usability of t-NPs and psychometric properties/feasibility of tests for the in-depth assessment of specific cognitive domains are necessary.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10072-021-05719-9.

Are Sleep Problems Related to Psychological Distress in Healthy Aging during the COVID-19 Pandemic? A Review

The SARS-CoV-2 pandemic, characterized by home confinement and other restrictive measures to reduce the spread of the infection, led to significant changes in people's habits and lifestyle. One of the most common problems is the worsening of sleep quality or quantity, which could have negative effects on psychological wellbeing, particularly in older adults. The purposes of the present literature review considering healthy aging subjects are (a) to examine the existing research on sleep alterations during the current pandemic and (b) to highlight possible relationships between sleep problems and psychological distress. A systematic search strategy was implemented according to PRISMA guidelines in the international literature online databases, up to 1 July 2021. After identification and screening phases, 11 articles were included in this review. The studies found possible associations between sleep problems and mood changes-particularly in terms of depression and anxiety. In addition, altered sleep patterns seemed to be related to changes in individual aspects, lifestyle, and attitudes adopted by older adults during the COVID-19 lockdown. Thus, the pandemic could affect the sleep and psychological wellbeing of the older population, even in healthy aging.

Discourse of Folk Literature on Healthy Ageing: A Case Study in Sindh, Pakistan during the Pandemic Crisis

Due to COVID-19 and the repeated imposition of lockdowns in Pakistan’s Sindh province, the life of senior citizens has become challenging. Given the scarcity of health care policies targeted at Sindh’s aged persons, the use of folk literature as therapy has increased to support against isolation, depression, and distress caused by COVID-19 and lockdowns. Although research on healthy ageing from medical and health care perspectives has been increasingly conducted in different contexts, there is a need to explore how folk literature can contribute to psychological, spiritual, and social wellbeing. Therefore, this research, conducted by collecting data from 15 aged participants through interviews and conversations, seeks to explore how senior Sindhis have used folk literature such as poetry, proverbs, and tales as therapy for their healing. Findings show that the participants’ use of Sindhi folk literature contributes to their psychological (eudemonic, evaluative, and hedonic) wellbeing, spiritual healing, and social satisfaction.

Pathways Improving Compliance with Preventive Behaviors during the Remission Period of the COVID-19 Pandemic

The COVID-19 pandemic poses a significant threat to people's lives. Compliance with preventive behaviors, recommended by public health authorities, is essential for infection control. In the remission stage, one year after the initial COVID-19 outbreak in China, we advanced a moderated parallel mediation model of the link between risk perception and compliance with preventive behaviors as well as a serial mediation model of the link between optimism and compliance with preventive behaviors, explaining the roles of various psychosocial factors in these associations. In January 2021, 200 participants under 50 years of age, located in 80 Chinese cities, participated in an online survey assessing risk perception, compliance with preventive behaviors, fear, anxiety, political trust, government dependency, and dispositional optimism. The results showed that the effect of risk perception on compliance with preventive behaviors was mediated by political trust and fear, and was moderated by government dependency. Anxiety and fear serially mediated the effect of optimism on compliance with preventive behaviors. Our study provided implications for future research to reduce negative emotions, strengthen confidence in the government, and sustain moderate government dependency accompanied by individual self-efficacy.