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Nichols E, Petrosyan S, Lee J. Mental Health Impacts of COVID-19: Does Prepandemic Cognition and Dementia Status Matter? J Gerontol A Biol Sci Med Sci 2024; 79:glae028. [PMID: 38267562 PMCID: PMC10972580 DOI: 10.1093/gerona/glae028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic disrupted daily life and led to sharp shocks in trends for various health outcomes. Although substantial evidence exists linking the pandemic and mental health outcomes and linking dementia and mental health outcomes, little evidence exists on how cognitive status may alter the impact of COVID-19 on mental health. METHODS We used prepandemic data from the Longitudinal Aging Study in India-Diagnostic Assessment of Dementia study and 9 waves of data from the Real-Time Insights of COVID-19 in India study (N = 1 182). We estimated associations between measures of prepandemic cognition (continuous cognition based on 22 cognitive tests, dementia status) and mental health measures during the pandemic (Patient Health Questionnaire [PHQ]-4 [9 time points], PHQ-9 [2 time points], Beck Anxiety Inventory [3 time points]), adjusting for age, gender, rural/urban residence, state, education, and prepandemic mental health. RESULTS Summarizing across time points, PHQ-9 score was marginally or significantly associated with prepandemic cognition (PHQ-9 difference: -0.38 [-0.78 to 0.14] points per SD higher cognition; p = .06), and prepandemic dementia (PHQ-9 difference: 0.61 [0.11-1.13] points for those with dementia compared to no dementia; p = .02). Associations with BAI were null, whereas associations with PHQ-4 varied over time (p value for interaction = .02) and were strongest during the delta wave, when pandemic burden was highest. CONCLUSIONS We present initial evidence that mental health impacts of COVID-19 or other acute stressors may be unequally distributed across strata of cognitive outcomes. In dynamically changing environments, those with cognitive impairment or dementia may be more vulnerable to adverse mental health outcomes.
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Affiliation(s)
- Emma Nichols
- Center for Economic and Social Research, University of Southern California, Los Angeles, California, USA
| | - Sarah Petrosyan
- Center for Economic and Social Research, University of Southern California, Los Angeles, California, USA
| | - Jinkook Lee
- Center for Economic and Social Research, University of Southern California, Los Angeles, California, USA
- Department of Economics, University of Southern California, Los Angeles, California, USA
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Chia S, Xia J, Kwan YH, Lim ZY, Tan CS, Low SG, Xu B, Loo YX, Kong LY, Koh CW, Towle RM, Lim SF, Yoon S, Seah SSY, Low LL. Evaluating the association of COVID-19 restrictions on discharge planning and post-discharge outcomes in the community hospital and Singapore regional health system. FRONTIERS IN HEALTH SERVICES 2023; 3:1147698. [PMID: 37744642 PMCID: PMC10513784 DOI: 10.3389/frhs.2023.1147698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 08/24/2023] [Indexed: 09/26/2023]
Abstract
Objectives The COVID-19 is a global health issue with widespread impact around the world, and many countries initiated lockdowns as part of their preventive measures. We aim to quantify the duration of delay in discharge to community from Community Hospitals, as well as quantify adverse patient outcomes post discharge pre and during lockdown period. Design and methods We conducted a before-after study comparing the length of stay in Community Hospitals, unscheduled readmissions or Emergency Department attendance, patients' quality of life using EQ5D-5l, number and severity of falls, in patients admitted and discharged before and during lockdown period. Results The average length of stay in the lockdown group (27.77 days) were significantly longer than that of the pre-lockdown group (23.76 days), p = 0.003. There were similar proportions of patients with self-reported falls post discharge between both groups. Patients in the pre-lockdown group had slightly better EQ-5D-5l Index score at 0.55, compared to the lockdown study group at 0.49. Half of the patients in both groups were referred to Community Care Services on discharge. Conclusion Our study would help in developing a future systematic preparedness guideline and contingency plans in times of disease outbreak and other similar public health emergencies.
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Affiliation(s)
- Shermain Chia
- Post-Acute and Continuing Care, Outram Community Hospital, Singapore, Singapore
| | - Jiawen Xia
- Research and Translational Innovation Office, Singhealth Community Hospitals, Singapore, Singapore
| | - Yu Heng Kwan
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | - Zhui Ying Lim
- Population Health & Integrated Care Office, Singapore General Hospital, Singapore, Singapore
| | - Chuen Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Sher Guan Low
- Post-Acute and Continuing Care, Sengkang Community Hospital, Singapore, Singapore
| | - Bangyu Xu
- Post-Acute and Continuing Care, Sengkang Community Hospital, Singapore, Singapore
| | - Yu Xian Loo
- Post-Acute and Continuing Care, Outram Community Hospital, Singapore, Singapore
| | - Lai Yee Kong
- Medical Social Services, Sengkang Community Hospital, Singapore, Singapore
| | - Chee Wai Koh
- Medical Social Services, Outram Community Hospital, Singapore, Singapore
| | - Rachel Marie Towle
- Specialty Nursing, Population Health & Integrated Care Office, Regional Health System, Singapore, Singapore
| | - Su Fee Lim
- Regional Health System Community Nursing, Population Health & Integrated Care Office, Singapore General Hospital, Singapore, Singapore
| | - Sungwon Yoon
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Sharna Si Ying Seah
- Research and Translational Innovation Office, Singhealth Community Hospitals, Singapore, Singapore
| | - Lian Leng Low
- Post-Acute and Continuing Care, Outram Community Hospital, Singapore, Singapore
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Grossman M, Seeley WW, Boxer AL, Hillis AE, Knopman DS, Ljubenov PA, Miller B, Piguet O, Rademakers R, Whitwell JL, Zetterberg H, van Swieten JC. Frontotemporal lobar degeneration. Nat Rev Dis Primers 2023; 9:40. [PMID: 37563165 DOI: 10.1038/s41572-023-00447-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/12/2023] [Indexed: 08/12/2023]
Abstract
Frontotemporal lobar degeneration (FTLD) is one of the most common causes of early-onset dementia and presents with early social-emotional-behavioural and/or language changes that can be accompanied by a pyramidal or extrapyramidal motor disorder. About 20-25% of individuals with FTLD are estimated to carry a mutation associated with a specific FTLD pathology. The discovery of these mutations has led to important advances in potentially disease-modifying treatments that aim to slow progression or delay disease onset and has improved understanding of brain functioning. In both mutation carriers and those with sporadic disease, the most common underlying diagnoses are linked to neuronal and glial inclusions containing tau (FTLD-tau) or TDP-43 (FTLD-TDP), although 5-10% of patients may have inclusions containing proteins from the FUS-Ewing sarcoma-TAF15 family (FTLD-FET). Biomarkers definitively identifying specific pathological entities in sporadic disease have been elusive, which has impeded development of disease-modifying treatments. Nevertheless, disease-monitoring biofluid and imaging biomarkers are becoming increasingly sophisticated and are likely to serve as useful measures of treatment response during trials of disease-modifying treatments. Symptomatic trials using novel approaches such as transcranial direct current stimulation are also beginning to show promise.
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Affiliation(s)
- Murray Grossman
- Department of Neurology and Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA
| | - William W Seeley
- Departments of Neurology and Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA.
- Department of Pathology, University of California, San Francisco, San Francisco, CA, USA.
| | - Adam L Boxer
- Departments of Neurology and Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Argye E Hillis
- Department of Neurology, Johns Hopkins University, Baltimore, MD, USA
| | | | - Peter A Ljubenov
- Departments of Neurology and Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Bruce Miller
- Departments of Neurology and Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Olivier Piguet
- School of Psychology and Brain and Mind Center, University of Sydney, Sydney, New South Wales, Australia
| | - Rosa Rademakers
- VIB Center for Molecular Neurology, University of Antwerp, Antwerp, Belgium
| | | | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The University of Gothenburg, Mölndal, Sweden
- Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
- UK Dementia Research Institute at UCL, London, UK
- Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong, China
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
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Tsatali M, Moraitou D, Boza ES, Tsolaki M. Cognition and Functionality Were Not Affected Due to the COVID-19 Pandemic in People with Mild Cognitive Impairment and AD Dementia Attending Digital Non-Pharmacologic Interventions. Brain Sci 2023; 13:1044. [PMID: 37508975 PMCID: PMC10376995 DOI: 10.3390/brainsci13071044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/05/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND The majority of previous studies showed that older adults with mild cognitive impairment (MCI) as well as Alzheimer's disease dementia (ADD) had impaired cognition and mood status, as well as increased behavioral disturbances after the first wave of the COVID-19 pandemic. However, there are still controversial data as regards the multifactorial impact of the restrictive measures on cognition, mood and daily function in older adults with MCI and ADD. AIM In the current study, the scope is to identify possible deterioration by means of cognitive and functional level due to mood and behavioral alterations during the second quarantine imposed in Greece between November 2020 and May 2021, as well as one year after the second quarantine, in May 2022. METHODS Participants were recruited from the two day centers of the Greek Association of Alzheimer Disease and Related Disorders (GAADRD). They underwent three yearly follow up assessments from May 2020 to May 2022 and participated in cognitive training interventions (through digital online means) during the aforementioned period. Mixed measures analyses of variance as well as path models were used for the study's purposes. RESULTS The study sample comprised 210 participants (175 people with MCI and 35 people with ADD). The mean age was 71.59 and 77.94 for people with MCI and mild ADD, respectively, whereas the average number of years of education was 12.65 for those with MCI and 9.83 for people with mild ADD. The results show that participants' deterioration rate (D), calculated by means of their performance in neuropsychological and functional assessments between 2020 and 2021 (D1) and 2021 and 2022 (D2), did not change significantly, except for the Rey Auditory Verbal Learning Test (RAVLT), since both groups displayed a larger D2 across the test conditions (immediate recall, fifth trial and delayed recall). Trail Making Test-B (TMT-B) performance, applied only in the MCI group, decreased more in relation to the deterioration rate D2. Additionally, two path models were applied to measure the direct relationships between diagnosis, performance in tests measuring mood and neuropsychiatric disturbances (NPI) and cognition, as measured by the RAVLT, in the 2020-2022 assessments. TMT-B was administered only in the MCI population, and therefore was not included in path models. The results show that participants' scores in RAVLT conditions were related to diagnosis and NPI performance, which was positively affected by diagnosis. No other relationships between RAVLT with mood tests were observed. CONCLUSIONS Our results show that after the second lockdown period, the neuropsychological performance of people with MCI and ADD, calculated by means of their D2, did not change, except from their verbal memory, as well as visual scanning and information processing, measured using the TMT-B. Therefore, it can be assumed that those who were enrolled in digital non-pharmacological interventions during the COVID-19 pandemic home restrictions did not experience increased cognitive and functional deterioration due to mood and behavioral alterations after the pandemic.
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Affiliation(s)
- Marianna Tsatali
- Greek Association of Alzheimer's Disease and Related Disorders, 54643 Thessaloniki, Greece
- Laboratory of Psychology, Department of Cognitive and Experimental Psychology, Faculty of Philosophy, School of Psychology, Aristotle University of Thessaloniki (AUTh), 54124 Thessaloniki, Greece
| | - Despina Moraitou
- Laboratory of Psychology, Department of Cognitive and Experimental Psychology, Faculty of Philosophy, School of Psychology, Aristotle University of Thessaloniki (AUTh), 54124 Thessaloniki, Greece
- Lab of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation, Aristotle University of Thessaloniki (CIRI-AUTh), 54124 Thessaloniki, Greece
| | - Evgenia Sakka Boza
- Greek Association of Alzheimer's Disease and Related Disorders, 54643 Thessaloniki, Greece
| | - Magdalini Tsolaki
- Greek Association of Alzheimer's Disease and Related Disorders, 54643 Thessaloniki, Greece
- Lab of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation, Aristotle University of Thessaloniki (CIRI-AUTh), 54124 Thessaloniki, Greece
- 1st Department of Neurology, Medical School, Aristotle University of Thessaloniki (AUTh), 54124 Thessaloniki, Greece
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Giebel C, Talbot CV, Wharton E, Lorenz-Dant K, Suárez-González A, Cannon J, Tetlow H, Lion KM, Thyrian JR. The early impacts of COVID-19 on unpaid carers of people living with dementia: part II of a mixed-methods systematic review. Aging Ment Health 2023; 27:547-562. [PMID: 35818800 DOI: 10.1080/13607863.2022.2084510] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 05/14/2022] [Indexed: 11/01/2022]
Abstract
OBJECTIVES With a lack of existing comprehensive reviews, the aim of this mixed-method systematic review was to synthesise the evidence on the early impacts of the pandemic on unpaid dementia carers across the globe. METHODS This review was registered on PROSPERO [CDR42021248050]. PubMed, CINAHL, Embase, Scopus and Web of Science were searched from 2020 to July 2021. Studies were included if they reported on the different impacts of the pandemic on unpaid dementia carers aged 18+, with papers published in English, German, Polish, or Spanish. A number of research team members were involved in the selection of studies following PRISMA guidance. RESULTS Thirty-six studies (43 papers) from 18 countries reported on the early impact of the pandemic on unpaid dementia carers. Impacts were noted on accessing care and support; carer burden; and well-being. Studies found that carers had limited access to care and support services, increased workload, enhanced feelings of social isolation, and reduced wellbeing. Specifically, reductions in access to care and support increased carer's unpaid caring tasks, removing any opportunities for temporary respite, and thus further increasing carer burden and reducing mental well-being in many. CONCLUSIONS The needs of unpaid dementia carers appear to have increased during the pandemic, without adequate support provided. Policy initiatives need to enable better mental health support and formal care provision for unpaid carers and their relatives with dementia, whilst future research needs to explore the long-term implications of carer needs in light of care home restrictions and care delivery.
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Affiliation(s)
- Clarissa Giebel
- Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK
- NIHR ARC NWC, Liverpool, UK
| | | | - Emily Wharton
- NIHR ARC NWC, Liverpool, UK
- School for Sport and Exercise Science, Liverpool John Moore's University, Liverpool, UK
| | - Klara Lorenz-Dant
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | | | | | - Hilary Tetlow
- NIHR ARC NWC, Liverpool, UK
- SURF Liverpool, Liverpool, UK
| | - Katarzyna M Lion
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Jochen René Thyrian
- German Centre for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
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6
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Perach R, Read S, Hicks B, Harris PR, Rusted J, Brayne C, Dangoor M, Miles E, Dixon J, Robinson L, Thomas A, Banerjee S. Predictors of loneliness during the Covid-19 pandemic in people with dementia and their carers in England: findings from the DETERMIND-C19 study. Aging Ment Health 2023; 27:521-532. [PMID: 35658781 DOI: 10.1080/13607863.2022.2080179] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVES To identify factors that predict the risk of loneliness for people with dementia and carers during a pandemic. METHODS People with dementia and their carers completed assessments before (July 2019-March 2020; 206 dyads) and after (July-October 2020) the first Covid-19 'lockdown' in England. At follow-up, the analytic sample comprised 67 people with dementia and 108 carers. We built a longitudinal path model with loneliness as an observed outcome. Carer type and social contacts at both measurements were considered. Other social resources (quality of relationship, formal day activities), wellbeing (anxiety, psychological wellbeing) and cognitive impairment were measured with initial level and change using latent growth curves. We adjusted for socio-demographic factors and health at baseline. RESULTS In carers, higher levels of loneliness were directly associated with non-spouse coresident carer type, level and increase of anxiety in carer, more formal day activities, and higher cognitive impairment in the person with dementia. In people with dementia, non-spouse coresident carer type, and higher initial levels of social resources, wellbeing, and cognitive impairment predicted the changes in these factors; this produced indirect effects on social contacts and loneliness. CONCLUSION Loneliness in the Covid-19 pandemic appears to be shaped by different mechanisms for people with dementia and their carers. The results suggest that carers of those with dementia may prioritize providing care that protects the person with dementia from loneliness at the cost of experiencing loneliness themselves. Directions for the promotion of adaptive social care during the Covid-19 pandemic and beyond are discussed.
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Affiliation(s)
- Rotem Perach
- School of Psychology, University of Sussex, Brighton, UK
| | - Sanna Read
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Ben Hicks
- Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - Peter R Harris
- School of Psychology, University of Sussex, Brighton, UK
| | | | - Carol Brayne
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Margaret Dangoor
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Eleanor Miles
- School of Psychology, University of Sussex, Brighton, UK
| | - Josie Dixon
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | | | - Alan Thomas
- Institute for Ageing, Newcastle University, Newcastle, UK
| | - Sube Banerjee
- Brighton and Sussex Medical School, University of Sussex, Brighton, UK.,Faculty of Health, University of Plymouth, Plymouth, UK
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Giebel C, Lion KM, Lorenz-Dant K, Suárez-González A, Talbot C, Wharton E, Cannon J, Tetlow H, Thyrian JR. The early impacts of COVID-19 on people living with dementia: part I of a mixed-methods systematic review. Aging Ment Health 2023; 27:533-546. [PMID: 35763444 DOI: 10.1080/13607863.2022.2084509] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 05/14/2022] [Indexed: 11/01/2022]
Abstract
Objectives: The aim of this Part I systematic review was to understand the impact of the COVID-19 pandemic on the lives of people with dementia living in the community or in residential care. Part II focused on unpaid carers.Methods: This review was registered on PROSPERO [CRD42021248050]. Five data bases (PubMed, CINAHL, Embase, Scopus, Web of Science) were searched in July 2021. Studies were included if they reported on the impacts of the pandemic on people living with dementia, either in the community or residential settings, and published in English, German, Polish, or Spanish. Risk of bias was assessed using the Standard Quality Assessment QualSyst.Results: Forty papers from 33 studies reported on the effects of COVID-19 on people with dementia. Included studies were conducted across 15 countries, focusing on single-country evaluations except in one study. Three studies focused on care homes, whilst the remainder reported on the community. Studies were categorised into five impacts: Cognition; Independence and physical functioning; Behavioural symptoms; Well-being; and Access to care. All studies evidenced the negative pandemic impacts, including faster cognitive, physical, and behavioural deterioration, limited access to care, and poorer mental and social health.Conclusions: Future restrictions need to consider the need for people with dementia to stay cognitively, physically, and socially stimulated to live well, and this review provides a call for a future pandemic strategy for dementia. Longitudinal research is required on the long-term impacts of the pandemic on the lives of people with dementia, including time to care home entry.
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Affiliation(s)
- Clarissa Giebel
- Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK
- NIHR ARC NWC, Liverpool, UK
| | - Katarzyna M Lion
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Klara Lorenz-Dant
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | | | - Catherine Talbot
- Faculty of Science & Technology, Bournemouth University, Poole, UK
| | - Emily Wharton
- NIHR ARC NWC, Liverpool, UK
- School of Sport and Exercise Sciences, Liverpool John Moore's University, Liverpool, UK
| | - Jacqueline Cannon
- School of Sport and Exercise Sciences, Liverpool John Moore's University, Liverpool, UK
| | - Hilary Tetlow
- NIHR ARC NWC, Liverpool, UK
- Lewy Body Society, Wigan, UK
| | - Jochen René Thyrian
- Lewy Body Society, Wigan, UK
- SURF Liverpool, Liverpool, UK
- German Centre for Neurodegenerative Diseases (DZNE), Greifswald, Germany
- Institute for Community Medicine, University of Greifswald, Greifswald, Germany
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Hill JE, Gomez KU, Harrison J. Dementia and the risk of poor outcomes as a result of the COVID-19 pandemic. BRITISH JOURNAL OF NEUROSCIENCE NURSING 2022; 18:226-228. [PMID: 38800135 PMCID: PMC7615974 DOI: 10.12968/bjnn.2022.18.5.226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
People with dementia belong to some of the most vulnerable groups and their vulnerability has been augmented by the Covid-19 pandemic. This article provides a critical appraisal and evaluation of a systematic review that has investigated the relationship between dementia and COVID-19 related outcomes.
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Affiliation(s)
| | | | - Joanna Harrison
- Synthesis, Economic Evaluation and Decision Science Group, University of Central Lancashire
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9
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Quinn C, Gamble LD, Parker S, Martyr A, Collins R, Victor C, Dawson E, Hunt A, Pentecost C, Allan L, Clare L. Impact of COVID-19 on carers of people with dementia in the community: Findings from the British IDEAL cohort. Int J Geriatr Psychiatry 2022; 37:10.1002/gps.5708. [PMID: 35394090 PMCID: PMC9087398 DOI: 10.1002/gps.5708] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 03/21/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Unpaid carers for people with dementia play a crucial role in society. Emerging evidence suggests the COVID-19 pandemic has negatively impacted on carers. This study sought to explore the impact of the COVID-19 pandemic on carers for community-dwelling people with dementia and compare responses with pre-pandemic data. METHODS Data were collected between September 2020 and April 2021 in England and Wales. Carers were identified from the Improving the experience of Dementia and Enhancing Active Life (IDEAL) cohort and data were collected either through the telephone, video conferencing, or an online questionnaire. Responses from 242 carers were compared against benchmark data from the IDEAL cohort collected pre-pandemic. Analyses were conducted for the full sample of carers and spousal/partner carers only. RESULTS In total 48.8% of carers thought their healthcare needs were negatively affected during the pandemic. Compared with pre-pandemic data carers were more lonely and experienced less life satisfaction. There was little impact on carers' experience of caregiving, although carers felt trapped in their caregiving role. Carers were more optimistic and had higher social contact with relatives. There were changes in the methods carers used for contacting relatives and friends. Most carers coped very or fairly well during the pandemic. There was little difference in the experiences of spousal/partner carers and the full sample. CONCLUSIONS After a long period of providing care under pandemic conditions carers require additional support. This support needs to be focused on alleviating feelings of loneliness and increasing life satisfaction. Services need to consider how to improve access to health care, particularly resuming face-to-face appointments.
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Affiliation(s)
- Catherine Quinn
- Centre for Applied Dementia Studies, Faculty of Health StudiesBradford UniversityBradfordUK
- Wolfson Centre for Applied Health ResearchBradfordUK
| | - Laura D. Gamble
- Population Health Sciences InstituteNewcastle UniversityNewcastle upon TyneUK
| | - Sophie Parker
- College of Medicine and HealthUniversity of ExeterExeterUK
| | - Anthony Martyr
- College of Medicine and HealthUniversity of ExeterExeterUK
| | - Rachel Collins
- College of Medicine and HealthUniversity of ExeterExeterUK
| | - Christina Victor
- College of Health, Medicine and Life SciencesBrunel University LondonLondonUK
| | - Eleanor Dawson
- College of Medicine and HealthUniversity of ExeterExeterUK
| | - Anna Hunt
- College of Medicine and HealthUniversity of ExeterExeterUK
| | | | - Louise Allan
- College of Medicine and HealthUniversity of ExeterExeterUK
- NIHR Applied Research Collaboration South‐West PeninsulaExeterUK
| | - Linda Clare
- College of Medicine and HealthUniversity of ExeterExeterUK
- NIHR Applied Research Collaboration South‐West PeninsulaExeterUK
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10
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Yuan S, Zhang W, Yao Q, Lü W, Yu W, Zhong F, Wang Y, Xing D, Wang X, Song J, Huang H, Chen C, Liu J, Yu W, Lü Y. The Neuropsychiatric Changes After COVID-19 Quarantine in Patients With Cognitive Impairment and Their Caregivers in Chongqing, China: A Cohort Study. Front Aging Neurosci 2022; 13:762907. [PMID: 35221981 PMCID: PMC8868570 DOI: 10.3389/fnagi.2021.762907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 12/29/2021] [Indexed: 12/14/2022] Open
Abstract
BackgroundThe follow-up study on neuropsychiatric changes after the lifting of coronavirus disease 2019 (COVID-19) quarantine in patients with cognitive impairment and their caregivers is still lacking, and relative information is needed to formulate more comprehensive healthcare prevention measures worldwide.AimsTo provide data on the changes in neuropsychiatric performance after the lifting of COVID-19 quarantine in patients with cognitive disorders and their caregivers.MethodsTwo surveys in Chongqing, China were conducted via telephonic interview with 531 patients and their caregivers. The baseline survey was performed from February 11 to 23, 2020, and the follow-up was from October 24 to November 9, 2020. The data of neuropsychiatric symptoms (NPSs), sleep, nutrition, and chronic diseases of patients, as well as the burden of care, anxiety, and depression of caregivers were evaluated.ResultsSignificant alleviation of NPSs after the lifting of COVID-19 quarantine was observed in patients with mild cognitive impairment (MCI) and dementia (both P < 0.05). Compared with baseline, the prevalence for NPSs of all participants dropped from 57.94 to 38.82%. Among NPS subdomains, apathy displayed the biggest decline at follow-up by 10.72%, followed by nighttime behavior by 8.65%. Mixed effect generalized estimation equation analysis showed significant amelioration in hallucination, depression, apathy, irritability, aberrant motor behavior, and nighttime behavior (all P < 0.05), with the most prominent changes in nighttime behavior and apathy. Among the patients with unsatisfactory control of chronic disease, the medication adherence rate dropped by approximately 30% after the lifting of quarantine. More importantly, around 13% increase of care burden was observed among the caregivers at follow-up, with both depression and anxiety rising by nearly 4%.ConclusionThe prolonged quarantine may exacerbate NPS in patients with memory disorders, while the care burden and mental stability of the caregivers after the pandemic should also be concerned.
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Affiliation(s)
- Shiyun Yuan
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wenbo Zhang
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qiang Yao
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, China
| | - Wenqi Lü
- Department of Psychiatry, West China Hospital, Sichuan University, Sichuan, China
| | - Wuhan Yu
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Fuxin Zhong
- Institutes of Neuroscience, Chongqing Medical University, Chongqing, China
| | - Yan Wang
- Foreign Language College, Chongqing Medical University, Chongqing, China
| | - Dianxia Xing
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaoqin Wang
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jiaqi Song
- Institutes of Neuroscience, Chongqing Medical University, Chongqing, China
| | - Hong Huang
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Chenxi Chen
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Junjin Liu
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Weihua Yu
- Institutes of Neuroscience, Chongqing Medical University, Chongqing, China
| | - Yang Lü
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- *Correspondence: Yang Lü,
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Ammapattian T, Anu KM, Vasanthra C, Antony S, Rao G, Prasad K, Issac T, Thangaraju S. Home-based care of persons with dementia during COVID-19 pandemic: Caregivers' experiences. JOURNAL OF GERIATRIC MENTAL HEALTH 2022. [DOI: 10.4103/jgmh.jgmh_10_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
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Stubbs M, Govia I, Robinson JN, Amour R, Freeman E. The Experiences of Caregivers of Persons Living with Dementia in Jamaica during COVID-19. Gerontol Geriatr Med 2021; 7:23337214211043384. [PMID: 34595330 PMCID: PMC8477703 DOI: 10.1177/23337214211043384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This article provides descriptive insights of the experiences of family caregivers of persons living with dementia during the COVID-19 pandemic. Data were generated as part of a qualitative cross-national project to explore the costs and consequences of providing unpaid dementia care. Participants in Jamaica, who were recruited using community gatekeepers, information booths at health fairs, conferences, and other outreach events, were contacted by telephone to discuss their experiences of the pandemic. When face-to-face in-depth interview data collection was suspended due to the pandemic, ethical approval was received to contact all research participants who were informal unpaid family caregivers, both those whose care recipients had died and those who were active caregivers (N = 19). Participants in this study were the 10 active family caregivers (nF = 8; aged 45+; 60% from high socio-economic status). Their updates and reflections during these calls were documented in fieldnotes and analyzed for key themes. Data showed that the pandemic has illustrated the direct costs, both financial and otherwise, that informal dementia carers bear in Jamaica. It also intensified pre-existing challenges faced by family carers. We provide recommendations for sustainable support for family carers.
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Affiliation(s)
- Marissa Stubbs
- Epidemiology Research Unit, Caribbean Institute for Health Research, The University of the West Indies, Mona Campus, Kingston, Jamaica
| | - Ishtar Govia
- Epidemiology Research Unit, Caribbean Institute for Health Research, The University of the West Indies, Mona Campus, Kingston, Jamaica
| | - Janelle N Robinson
- Epidemiology Research Unit, Caribbean Institute for Health Research, The University of the West Indies, Mona Campus, Kingston, Jamaica
| | - Rochelle Amour
- Epidemiology Research Unit, Caribbean Institute for Health Research, The University of the West Indies, Mona Campus, Kingston, Jamaica
| | - Emily Freeman
- Care Policy Evaluation Centre, The London School of Economics and Political Science, London, UK
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