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Nikelski A, Trompetter EM, Boekholt M, Schumacher-Schönert F, Rädke A, Michalowsky B, Vollmar HC, Hoffmann W, Driessen M, Thyrian JR, Kreisel SH. [Everyday Life and Mental Health of Elderly with Cognitive Impairment During the Covid-19 Pandemic]. PSYCHIATRISCHE PRAXIS 2024. [PMID: 38272039 DOI: 10.1055/a-2230-2873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
OBJECTIVE The aim is to analyze pandemic-related effects on everyday life and psychosocial health in the understudied vulnerable group of cognitively impaired elderly people living at home. METHODS Structured telephone interviews in 2020 (n+=+141) and 2021 (n+=+107) were used to survey over-65s with cognitive impairment (MMSE Ø 23.4). The results from the 2021 survey presented here reflect experiences and attitudes, effects on daily life and health care, and psychosocial burdens and resources. Longitudinal analysis of selected indicators of burden is provided for n+=+66. RESULTS Even in the face of increasing concerns and moderate impacts on everyday life and health care, overall psychosocial health is proving to be good and largely stable over time. CONCLUSION Respondents have high levels of personal and social resources, and their coping with limitations is characterized by acceptance and willingness to adapt.
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Affiliation(s)
- Angela Nikelski
- Abteilung für Gerontopsychiatrie, Universitätsklinik für Psychiatrie und Psychotherapie, Evangelisches Klinikum Bethel gGmbH, Universitätsklinikum OWL der Universität Bielefeld, Bielefeld
| | - Eva M Trompetter
- Abteilung für Gerontopsychiatrie, Universitätsklinik für Psychiatrie und Psychotherapie, Evangelisches Klinikum Bethel gGmbH, Universitätsklinikum OWL der Universität Bielefeld, Bielefeld
| | - Melanie Boekholt
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), DZNE Rostock/Greifswald, Greifswald, Germany
| | - Fanny Schumacher-Schönert
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), DZNE Rostock/Greifswald, Greifswald, Germany
| | - Anika Rädke
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), DZNE Rostock/Greifswald, Greifswald, Germany
| | - Bernhard Michalowsky
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), DZNE Rostock/Greifswald, Greifswald, Germany
| | | | - Wolfgang Hoffmann
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), DZNE Rostock/Greifswald, Greifswald, Germany
- Institut für Community Medicine, Abteilung Versorgungsepidemiologie und Community Health, Universitätsmedizin Greifswald, Greifswald
| | - Martin Driessen
- Universitätsklinik für Psychiatrie und Psychotherapie, Evangelisches Klinikum Bethel gGmbH, Universitätsklinikum OWL der Universität Bielefeld
| | - Jochen René Thyrian
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), DZNE Rostock/Greifswald, Greifswald, Germany
- Institut für Community Medicine, Abteilung Versorgungsepidemiologie und Community Health, Universitätsmedizin Greifswald, Greifswald
| | - Stefan H Kreisel
- Abteilung für Gerontopsychiatrie, Universitätsklinik für Psychiatrie und Psychotherapie, Evangelisches Klinikum Bethel gGmbH, Universitätsklinikum OWL der Universität Bielefeld, Bielefeld
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Bormann M, Neidlein C, Keppler AM, Prall WC, Böcker W, Fürmetz J. [Influence of the COVID-19 pandemic on fracture epidemiology exemplified by tibial plateau fractures]. UNFALLCHIRURGIE (HEIDELBERG, GERMANY) 2023; 126:967-974. [PMID: 36576535 PMCID: PMC9795428 DOI: 10.1007/s00113-022-01263-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/08/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND During the COVID-19 pandemic interventions, such as contact restrictions, lockdowns and postponement of elective surgeries were taken to ease the burden on the healthcare system. Among the population, these interventions led to changes in recreational behavior as well as personal transportation. OBJECTIVE This paper examines the epidemiological data of tibial plateau fractures (TPF) before and during the pandemic and to what extent pandemic control measures had an impact. MATERIAL AND METHODS In this retrospective monocentric study of a German level 1 trauma center, the intra-articular tibial plateau fractures of the years 2019 and 2020 were compared regarding incidence, demographics, cause of the accident, and treatment strategy. Fracture classification was according to Schatzker, AO/OTA, and Moore. RESULTS Incidence showed a decrease of -8.5% as well as a shift in the age incidence curves. There was a decrease in incidence during lockdown periods but also an increase in late summer 2020 compared to 2019. Tripping accidents (+12.4%) and bicycle accidents (+6.6%) increased in the pandemic year, whereas motorized traffic accidents (-7%) and skiing accidents (-10%) decreased. In terms of fracture morphology, 2020 showed an increase in impression fractures and a decrease in complex fractures. The number of surgically treated patients decreased by 7.3%. CONCLUSION The 12 months of pandemic resulted in only a slight incidence decrease of intra-articular tibial plateau fractures. The pandemic control measures showed effects within the calendar year and led directly and indirectly to a change in incidence, cause of the accident, fracture entities and care strategy.
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Affiliation(s)
- Markus Bormann
- Muskuloskelettales Universitätszentrum München, Ludwig-Maximilians-Universität München (LMU), Marchioninistr. 15, 81377, München, Deutschland
| | - Claas Neidlein
- Muskuloskelettales Universitätszentrum München, Ludwig-Maximilians-Universität München (LMU), Marchioninistr. 15, 81377, München, Deutschland
| | - Alexander Martin Keppler
- Muskuloskelettales Universitätszentrum München, Ludwig-Maximilians-Universität München (LMU), Marchioninistr. 15, 81377, München, Deutschland
| | - Wolf Christian Prall
- Muskuloskelettales Universitätszentrum München, Ludwig-Maximilians-Universität München (LMU), Marchioninistr. 15, 81377, München, Deutschland
- Abteilung für Knie‑, Hüft‑, Schulter- und Ellenbogenchirurgie, Schön Klinik München, Harlachinger Str. 51, 81547, München, Deutschland
| | - Wolfgang Böcker
- Muskuloskelettales Universitätszentrum München, Ludwig-Maximilians-Universität München (LMU), Marchioninistr. 15, 81377, München, Deutschland
| | - Julian Fürmetz
- Muskuloskelettales Universitätszentrum München, Ludwig-Maximilians-Universität München (LMU), Marchioninistr. 15, 81377, München, Deutschland.
- Sporttraumatologie und Arthroskopische Chirurgie, BG Unfallklinik Murnau, Professor-Küntscher-Str. 8, 82418, Murnau, Deutschland.
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Wittmann FG, Zülke A, Pabst A, Luppa M, Thyrian JR, Kästner A, Hoffmann W, Kaduszkiewicz H, Döhring J, Escales C, Gensichen J, Zöllinger I, Kosilek RP, Wiese B, Oey A, König HH, Brettschneider C, Frese T, Riedel-Heller SG. COVID-19 government measures and their impact on mental health: a cross-sectional study of older primary care patients in Germany. Front Public Health 2023; 11:1141433. [PMID: 37283986 PMCID: PMC10239963 DOI: 10.3389/fpubh.2023.1141433] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 05/09/2023] [Indexed: 06/08/2023] Open
Abstract
Background With the outbreak of COVID-19, government measures including social distancing and restrictions of social contacts were imposed to slow the spread of the virus. Since older adults are at increased risk of severe disease, they were particularly affected by these restrictions. These may negatively affect mental health by loneliness and social isolation, which constitute risk factors for depressiveness. We aimed to analyse the impact of perceived restriction due to government measures on depressive symptoms and investigated stress as mediator in an at-risk-population in Germany. Methods Data were collected in April 2020 from the population of the AgeWell.de-study, including individuals with a Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) score ≥9, using the depression subscale of the Brief Symptom Inventory (BSI-18) and the Perceived Stress Scale (PSS-4). Feeling restricted due to COVID-19 government measures was surveyed with a standardized questionnaire. Stepwise multivariate regressions using zero-inflated negative binomial models were applied to analyse depressive symptoms, followed by a general structural equation model to assess stress as mediator. Analysis were controlled for sociodemographic factors as well as social support. Results We analysed data from 810 older adults (mean age = 69.9, SD = 5). Feeling restricted due to COVID-19 government measures was linked to increased depressiveness (b = 0.19; p < 0.001). The association was no longer significant when adding stress and covariates (b = 0.04; p = 0.43), while stress was linked to increased depressive symptoms (b = 0.22; p < 0.001). A final model confirms the assumption that the feeling of restriction is mediated by stress (total effect: b = 0.26; p < 0.001). Conclusion We found evidence that feeling restricted due to COVID-19 government measures is associated with higher levels of depressive symptoms in older adults at increased risk for dementia. The association is mediated by perceived stress. Furthermore, social support was significantly associated with less depressive symptoms. Thus, it is of high relevance to consider possible adverse effects of government measures related to COVID-19 on mental health of older people.
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Affiliation(s)
- Felix G. Wittmann
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - Andrea Zülke
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - Melanie Luppa
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - Jochen René Thyrian
- Institute for Community Medicine, University Medicine Greifswald (UMG), Greifswald, Germany
- German Centre for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany
- Faculty V: School of Life Sciences, University of Siegen, Siegen, Germany
| | - Anika Kästner
- Institute for Community Medicine, University Medicine Greifswald (UMG), Greifswald, Germany
| | - Wolfgang Hoffmann
- Institute for Community Medicine, University Medicine Greifswald (UMG), Greifswald, Germany
- German Centre for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany
| | | | - Juliane Döhring
- Institute of General Practice, University of Kiel, Kiel, Germany
| | | | - Jochen Gensichen
- Institute of General Practice/Family Medicine, University Hospital of LMU Munich, Munich, Germany
| | - Isabel Zöllinger
- Institute of General Practice/Family Medicine, University Hospital of LMU Munich, Munich, Germany
| | - Robert Philipp Kosilek
- Institute of General Practice/Family Medicine, University Hospital of LMU Munich, Munich, Germany
| | - Birgitt Wiese
- Hannover Medical School, Institute for General Practice, Work Group Medical Statistics and IT-Infrastructure, Hannover, Germany
| | - Anke Oey
- Hannover Medical School, Institute for General Practice, Work Group Medical Statistics and IT-Infrastructure, Hannover, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Service Research, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Brettschneider
- Department of Health Economics and Health Service Research, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Thomas Frese
- Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Steffi G. Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
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4
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Beach B, Steel N, Steptoe A, Zaninotto P. Associations of cognitive impairment with self-isolation and access to health and care during the COVID-19 pandemic in England. Sci Rep 2023; 13:5026. [PMID: 36977759 PMCID: PMC10043531 DOI: 10.1038/s41598-023-31241-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 03/08/2023] [Indexed: 03/30/2023] Open
Abstract
This research explored experiences across three cognitive function groups (no impairment, mild impairment, and dementia) with respect to shielding (either self-isolating or staying at home), COVID-19 infection, and access to health/care services during the COVID-19 pandemic. Analyses were conducted using data from the English Longitudinal Study of Ageing (ELSA) COVID-19 sub-study collected in 2020. We report bivariate estimates across our outcomes of interest by cognitive function group along with multivariate regression results adjusting for demographic, socioeconomic, geographic, and health characteristics. Rates of shielding were high across all cognitive function groups and three measured time points (April, June/July, and Nov/Dec 2020), ranging from 74.6% (95% confidence interval 72.9-76.2) for no impairment in Nov/Dec to 96.7% (92.0-98.7) for dementia in April (bivariate analysis). 44.1% (33.5-55.3) of those with dementia experienced disruption in access to community health services by June/July compared to 34.9% (33.2-36.7) for no impairment. A higher proportion of those with mild impairment reported hospital-based cancellations in June/July (23.1% (20.1-26.4)) and Nov/Dec (16.3% (13.4-19.7)) than those with no impairment (18.0% (16.6-19.4) and 11.7% (10.6-12.9)). Multivariate adjusted models found that those with dementia were 2.4 (1.1-5.0) times more likely than those with no impairment to be shielding in June/July. All other multivariate analyses found no statistically significant differences between cognitive function groups. People with dementia were more likely than people with no impairment to be shielding early in the pandemic, but importantly they were no more likely to experience disruption to services or hospital treatment.
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Affiliation(s)
- Brian Beach
- UCL Research Department of Epidemiology & Public Health, University College London, London, UK.
| | - Nicholas Steel
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Andrew Steptoe
- UCL Research Department of Behavioural Science & Health, University College London, London, UK
| | - Paola Zaninotto
- UCL Research Department of Epidemiology & Public Health, University College London, London, UK
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Gerhards SK, Luppa M, Röhr S, Pabst A, Bauer A, Frankhänel T, Döhring J, Escales C, Zöllinger IR, Oey A, Brettschneider C, Wiese B, Hoffmann W, Gensichen J, König HH, Frese T, Thyrian JR, Kaduszkiewicz H, Riedel-Heller SG. Depression and Anxiety in Old Age during the COVID-19 Pandemic: A Comparative Study of Individuals at Cardiovascular Risk and the General Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2975. [PMID: 36833671 PMCID: PMC9957242 DOI: 10.3390/ijerph20042975] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/02/2023] [Accepted: 02/06/2023] [Indexed: 05/22/2023]
Abstract
Our study aims to examine the associations of sociodemographic factors, social support, resilience, and perceptions of the COVID-19 pandemic with late-life depression and anxiety symptoms in a cardiovascular risk group and a matched sample from the German general population during the beginning of the pandemic and draw a comparison regarding psychosocial characteristics. Data of n = 1236 participants (aged 64-81 years) were analyzed, with n = 618 participants showing a cardiovascular risk profile, and n = 618 participants from the general population. The cardiovascular risk sample had slightly higher levels of depressive symptoms and felt more threatened by the virus due to pre-existing conditions. In the cardiovascular risk group, social support was associated with less depressive and anxiety symptoms. In the general population, high social support was associated with less depressive symptoms. Experiencing high levels of worries due to COVID-19 was associated with more anxiety in the general population. Resilience was associated with less depressive and anxiety symptoms in both groups. Compared to the general population, the cardiovascular risk group showed slightly higher levels of depressive symptomatology even at the beginning of the pandemic and may be supported by addressing perceived social support and resilience in prevention programs targeting mental health.
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Affiliation(s)
- Sina K. Gerhards
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, 04103 Leipzig, Germany
| | - Melanie Luppa
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, 04103 Leipzig, Germany
| | - Susanne Röhr
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, 04103 Leipzig, Germany
- Health and Ageing Research Team (HART), School of Psychology, Massey University, Palmerston North 4474, New Zealand
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, 04103 Leipzig, Germany
| | - Alexander Bauer
- Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, 06112 Halle (Saale), Germany
| | - Thomas Frankhänel
- Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, 06112 Halle (Saale), Germany
| | - Juliane Döhring
- Institute of General Practice, University of Kiel, 24105 Kiel, Germany
| | - Catharina Escales
- Institute of General Practice, University of Kiel, 24105 Kiel, Germany
| | - Isabel Renate Zöllinger
- Institute of General Practice/Family Medicine, University Hospital of LMU Munich, 80336 Munich, Germany
| | - Anke Oey
- Institute for General Practice, Work Group Medical Statistics and IT-Infrastructure, Hannover Medical School, 30625 Hannover, Germany
| | - Christian Brettschneider
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Birgitt Wiese
- Institute for General Practice, Work Group Medical Statistics and IT-Infrastructure, Hannover Medical School, 30625 Hannover, Germany
| | - Wolfgang Hoffmann
- Institute for Community Medicine, University Medicine Greifswald, 17475 Greifswald, Germany
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, 17489 Greifswald, Germany
| | - Jochen Gensichen
- Institute of General Practice/Family Medicine, University Hospital of LMU Munich, 80336 Munich, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Thomas Frese
- Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, 06112 Halle (Saale), Germany
| | - Jochen René Thyrian
- Institute for Community Medicine, University Medicine Greifswald, 17475 Greifswald, Germany
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, 17489 Greifswald, Germany
| | | | - Steffi G. Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, 04103 Leipzig, Germany
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"Because if I don't hold his hand then I might as well not be there": Experiences of Dutch and UK care home visiting during the COVID-19 pandemic. Int Psychogeriatr 2023; 35:107-116. [PMID: 35039101 DOI: 10.1017/s1041610221002799] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES To explore and compare the experiences of care home visits during the pandemic in the UK and the Netherlands. DESIGN Qualitative semi-structured interview studies. SETTING AND PARTICIPANTS Family carers of relatives residing in care homes in the UK and the Netherlands were interviewed remotely. METHODS Family carers were asked about their experiences of care home visits during the pandemic, and specifically in the Netherlands after care homes had reopened. Transcripts were analyzed in each country separately in the native language using thematic analysis, before discussing findings at multiple analysis meetings. RESULTS Across 125 interviews, we developed four themes: (1) different types of contact during lockdown; (2) deterioration of resident health and well-being; (3) emotional distress of both visitors and residents; and (4) compliance to guidelines and regulations. Visiting in both the UK and the Netherlands was beneficial, if possible in the UK, yet was characterized by alternative forms of face-to-face visits which was emotionally distressing for many family carers and residents. In the Netherlands, government guidance did enable early care home visitation, while the UK was lacking any guidance leading to care homes implementing restrictions differently. CONCLUSIONS AND IMPLICATIONS Early and clear guidance, as well as communication, is required in future pandemics, and in this ongoing pandemic, to enable care home visits between residents and loved ones. It is important to take learnings from this global pandemic to reimagine long-term care, highlighting the value of socializing for care home residents.
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Dehghani M, Ebrahimi F. ParsBERT topic modeling of Persian scientific articles about COVID-19. INFORMATICS IN MEDICINE UNLOCKED 2023; 36:101144. [PMID: 36573134 PMCID: PMC9771580 DOI: 10.1016/j.imu.2022.101144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 12/03/2022] [Accepted: 12/04/2022] [Indexed: 12/24/2022] Open
Abstract
Purpose The COVID-19 pandemic has indisputably impacted every aspect of human life, and a host of studies have investigated its different aspects. This paper models the contents of Persian literature on COVID-19. Method This is a descriptive-exploratory study in which 815 articles were collected from the Magiran database. The articles were published before March 2022. The abstracts and titles were used in the modeling. The modeling was performed by combining the latent Dirichlet allocation (LDA) algorithm with ParsBERT. Findings Topic modeling indicated ten major topics, including medicine, psychology, humanities, politics, management, biology, economics, culture, engineering, and religion. The articles under the category of medicine had the largest cluster (42.3%), while engineering and religion had the smallest clusters (1.1% each). Conclusion The found topics in the created clusters have structural relationships. The COVID-19 effect on physical and mental health (medical and psychological topics) is the most crucial factor. These clusters provide evidence that COVID-19 affects all facets of human society at three levels: the individual, family, and society. Aside from the ten critical clusters in the humanities field, the utmost disorder is related to teaching and learning. For the first time, this research has presented a model of scientific communication in the field of COVID-19 based on the data collected from a Persian database - Magiran.
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Affiliation(s)
- Mohammad Dehghani
- School of Electrical and Computer Engineering, University of Tehran, Tehran, Iran,Corresponding author
| | - Fezzeh Ebrahimi
- Department of Knowledge and Information Science, University of Isfahan, Isfahan, Iran
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Platen M, Bohlken J, Hoffmann W, Kostev K, Michalowsky B. The long-term impact of the COVID-19 pandemic on primary and specialized care provision and disease recognition in Germany. Front Public Health 2022; 10:1006578. [PMID: 36466500 PMCID: PMC9712961 DOI: 10.3389/fpubh.2022.1006578] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 10/31/2022] [Indexed: 11/19/2022] Open
Abstract
Background The COVID-19 pandemic and the imposed lockdowns severely affected routine care in general and specialized physician practices. Objective To describe the long-term impact of the COVID-19 pandemic on the physician services provision and disease recognition in German physician practices and perceived causes for the observed changes. Design Observational study based on medical record data and survey data of general practitioners and specialists' practices. Participants 996 general practitioners (GPs) and 798 specialist practices, who documented 6.1 million treatment cases for medical record data analyses and 645 physicians for survey data analyses. Main measures Within the medical record data, consultations, specialist referrals, hospital admissions, and documented diagnoses were extracted for the pandemic (March 2020-September 2021) and compared to corresponding pre-pandemic months in 2019. The additional online survey was used to assess changes in practice management during the COVID-19 pandemic and physicians' perceived main causes of affected primary and specialized care provision. Main results Hospital admissions (GPs: -22% vs. specialists: -16%), specialist referrals (-6 vs. -3%) and recognized diseases (-9 vs. -8%) significantly decreased over the pandemic. GPs consultations initially decreased (2020: -7%) but compensated at the end of 2021 (+3%), while specialists' consultation did not (-2%). Physicians saw changes in patient behavior, like appointment cancellation, as the main cause of the decrease. Contrary to this, they also mentioned substantial modifications of practice management, like reduced (nursing) home visits (41%) and opening hours (40%), suspended checkups (43%), and delayed consultations for high-risk patients (71%). Conclusion The pandemic left its mark on primary and specialized healthcare provision and its utilization. Both patient behavior and organizational changes in practice management may have caused decreased and non-compensation of services. Evaluating the long-term effect on patient outcomes and identifying potential improvements are vital to better prepare for future pandemic waves.
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Affiliation(s)
- Moritz Platen
- German Center for Neurodegenerative Diseases (DZNE), Greifswald, Germany
| | - Jens Bohlken
- Institute for Social Medicine, Occupational Medicine, and Public Health (ISAP) of the Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Wolfgang Hoffmann
- German Center for Neurodegenerative Diseases (DZNE), Greifswald, Germany,Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, University Medicine Greifswald (UMG), Greifswald, Germany
| | | | - Bernhard Michalowsky
- German Center for Neurodegenerative Diseases (DZNE), Greifswald, Germany,*Correspondence: Bernhard Michalowsky
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Chirico I, Ottoboni G, Giebel C, Pappadà A, Valente M, Degli Esposti V, Gabbay M, Chattat R. COVID-19 and community-based care services: Experiences of people living with dementia and their informal carers in Italy. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e3128-e3137. [PMID: 35188317 PMCID: PMC9111588 DOI: 10.1111/hsc.13758] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 01/14/2022] [Accepted: 02/06/2022] [Indexed: 05/11/2023]
Abstract
The COVID-19 pandemic has significantly limited access to health and social care support systems for people with dementia and their carers, compounding the severe social restrictions. The aim of this study was to investigate the experiences of COVID-19 among community-dwelling people with dementia and their informal carers in Italy. Specifically, we focused on access to community-based services and adopted solutions to provide support and care during exceptional times. Informal carers, caring for someone with dementia and attending community-based services in Italy, participated in remote semi-structured interviews between October and November 2020. Participants were asked about the effects of social isolation and closure of in-person services on their daily lives as well as the challenges of dementia care. Transcripts were analysed using inductive thematic analysis. 22 informal carers were interviewed. Three themes emerged: (1) Disruptions to people with dementia's lives and health; (2) COVID-19 as an additional stressor for carers; and (3) New ways of caring for people with dementia during COVID-19. Face-to-face social care and social support services were suddenly interrupted and restrictions on social distancing were introduced, thus leading to people with dementia's impaired health and increased behavioural and psychological symptoms. Not only the amount but also the intensity of care increased, with no chance of respite for informal carers. Overall remote activities provided participants with emotional and social benefits, while allowing the continuity of relationships with services staff and users and of care. However, according to carers, a combination of virtual and face-to-face activities could better counterbalance the multiple adverse outcomes of COVID-19. Public health measures should be designed carefully to consider the safety needs and the physical, psychological and social needs of people with dementia. Within a holistic care approach, social care services need to be enabled better to guarantee high-quality care even during pandemic times.
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Affiliation(s)
- Ilaria Chirico
- Department of PsychologyUniversity of BolognaBolognaItaly
| | | | - Clarissa Giebel
- Department of Primary Care & Mental HealthUniversity of LiverpoolLiverpoolUK
- NIHR ARC NWCLiverpoolUK
| | | | - Marco Valente
- Department of PsychologyUniversity of BolognaBolognaItaly
| | | | - Mark Gabbay
- Department of Primary Care & Mental HealthUniversity of LiverpoolLiverpoolUK
- NIHR ARC NWCLiverpoolUK
| | - Rabih Chattat
- Department of PsychologyUniversity of BolognaBolognaItaly
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Lion KM, Moyle W, Cations M, Day S, Pu L, Murfield J, Gabbay M, Giebel C. How Did the COVID-19 Restrictions Impact People Living With Dementia and Their Informal Carers Within Community and Residential Aged Care Settings in Australia? A Qualitative Study. JOURNAL OF FAMILY NURSING 2022; 28:205-218. [PMID: 35674356 DOI: 10.1177/10748407221101638] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The aim of this study was to explore how formal social support changed after implementation of the COVID-19 public health measures and how these restrictions affected people living with dementia and their informal carers in Australia. Sixteen informal carers and two people living with dementia were interviewed between August and November 2020. Participants were asked about their experiences of the pandemic and the impact that the restrictions had on their lives and care. Thematic analysis identified four overarching themes describing (a) prepandemic limitations of the aged care system, (b) the aged care system's response to the COVID-19 restrictions, (c) changes affecting informal carers, and (d) the challenges faced by people living with dementia. The findings highlighted the challenges faced by the Australian aged care system before the pandemic and the additional burden placed on informal carers who supported people living with dementia across residential and home settings during the pandemic.
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Affiliation(s)
| | - Wendy Moyle
- Griffith University, Brisbane, Queensland, Australia
| | - Monica Cations
- Flinders University, Adelaide, South Australia, Australia
| | - Sally Day
- Flinders University, Adelaide, South Australia, Australia
| | - Lihui Pu
- Griffith University, Brisbane, Queensland, Australia
| | - Jenny Murfield
- Griffith University, Brisbane, Queensland, Australia
- Deakin University, Geelong, Victoria, Australia
| | - Mark Gabbay
- University of Liverpool, Liverpool, UK
- National Institute of Health Research Applied Research Collaboration North West Coast, Liverpool, UK
| | - Clarissa Giebel
- University of Liverpool, Liverpool, UK
- National Institute of Health Research Applied Research Collaboration North West Coast, Liverpool, UK
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11
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Soysal P, Smith L, Trott M, Alexopoulos P, Barbagallo M, Tan SG, Koyanagi A, Shenkin S, Veronese N. The Effects of COVID-19 lockdown on neuropsychiatric symptoms in patients with dementia or mild cognitive impairment: A systematic review and meta-analysis. Psychogeriatrics 2022; 22:402-412. [PMID: 35128762 PMCID: PMC9115368 DOI: 10.1111/psyg.12810] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 12/28/2021] [Accepted: 01/12/2022] [Indexed: 01/10/2023]
Abstract
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.
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Affiliation(s)
- Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Lee Smith
- Cambridge Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Mike Trott
- Cambridge Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Panagiotis Alexopoulos
- Department of Psychiatry, Patras University General Hospital, Faculty of Medicine, School of Health Sciences, University of Patras, Patras, Greece.,Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Faculty of Medicine, Technische Universität München, Munich, Germany
| | - Mario Barbagallo
- Geriatric Unit, Department of Medicine, University of Palermo, Palermo, Italy
| | - Semen Gokce Tan
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Barcelona, Spain.,ICREA, Pg. Lluis Companys 23, Barcelona, Spain
| | - Susan Shenkin
- Geriatric Medicine Unit, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Nicola Veronese
- Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
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12
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Seeking medical services among rural empty-nest elderly in China: a qualitative study. BMC Geriatr 2022; 22:202. [PMID: 35287598 PMCID: PMC8922892 DOI: 10.1186/s12877-022-02911-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 03/02/2022] [Indexed: 11/10/2022] Open
Abstract
Background The number of empty-nest elderly in China is rapidly increasing. Empty-nest elderly could not receive adequate daily care, economic support and spiritual consolation from their children. Rural empty-nest elderly are facing more serious health challenges than those in urban areas. Objective This study aimed to understand the experiences of rural empty-nest elderly in seeking medical services in China. Methods The method of inductive content analysis was used to collect and analyze data. Data were collected by in-depth interviews. A total number of 16 participants were involved in this study. A semi-structured interview guideline, which was discussed in depth and agreed upon by all researchers, was used to encourage participants to talk about their experiences in seeking medical services. Results Rural empty-nest elderly is facing a great challenge in seeking medical services in China. There are some barriers for rural nest elderly to get access to healthcare services, such as low-income status, high expenditure of medical treatment and inadequate health insurance coverage. Due to the absence of the companionship of their adult children, empty-nest elderly have to rely on their neighbors and relatives to seek medical services. Conclusions Rural empty-nest elderly have great difficulty in seeking medical services in China. More efforts should be made to get medical services more accessible to rural empty-nest elderly.
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13
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Giebel C, Hanna K, Marlow P, Cannon J, Tetlow H, Shenton J, Faulkner T, Rajagopal M, Mason S, Gabbay M. Guilt, tears and burnout—Impact of
UK
care home restrictions on the mental well‐being of staff, families and residents. J Adv Nurs 2022; 78:2191-2202. [PMID: 35188292 PMCID: PMC9303866 DOI: 10.1111/jan.15181] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/07/2021] [Accepted: 01/12/2022] [Indexed: 12/23/2022]
Abstract
Aims The aim of this study was to explore the impact of the pandemic on the emotional and mental well‐being of family carers, care home staff and residents, in light of changing restrictions, increased testing and vaccination rollout in the UK. Design Longitudinal, qualitative semi‐structured interview study. Methods Remote semi‐structured interviews were conducted with family carers of care home residents with dementia and care home staff from different care homes across the UK. Baseline and follow‐up interviews were conducted in October/November 2020 and March 2021, respectively. Data were analysed using inductive thematic analysis involving members of the public with caring experiences. Results In all, 42 family carers and care home staff participated at baseline, with 20 family carers and staff followed up. We identified four themes: (1) Developing anger and frustration; (2) Impact on relationships; (3) Stress and burnout; and (4) Behavioural changes, and perceived impact on residents. The mental health of everyone involved, including family carers, care home staff and residents, has been negatively affected, and relationships between family carers and staff have been severely strained. There was a general lack of adequate mental health support, with little relief. Conclusions The pandemic has had a detrimental impact on the lives of those surrounding care homes—from residents and staff to family carers. Consideration should be given on how to best support the mental health needs of all three groups, by providing adequate easily accessible mental health care for all. This should also focus on rebuilding the relationships between family carers and care home staff. Impact This is the first paper to highlight the effects of the long‐lasting and miscommunicated restrictions on residents, carers and care home staff, and highlight the urgent need for continued mental health support.
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Affiliation(s)
- Clarissa Giebel
- Department of Primary Care & Mental Health University of Liverpool Liverpool UK
- NIHR ARC NWC Liverpool UK
| | - Kerry Hanna
- NIHR ARC NWC Liverpool UK
- School of Health Sciences University of Liverpool Liverpool UK
| | | | | | - Hilary Tetlow
- NIHR ARC NWC Liverpool UK
- SURF Liverpool Liverpool UK
| | | | | | - Manoj Rajagopal
- NIHR ARC NWC Liverpool UK
- Lancashire & South Cumbria NHS Trust Lancaster UK
| | - Stephen Mason
- NIHR ARC NWC Liverpool UK
- Institute of Life Course and Medical Sciences University of Liverpool Liverpool UK
| | - Mark Gabbay
- Department of Primary Care & Mental Health University of Liverpool Liverpool UK
- NIHR ARC NWC Liverpool UK
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14
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Giebel C, Lion K, Mackowiak M, Chattat R, Kumar PNS, Cations M, Gabbay M, Moyle W, Ottoboni G, Rymaszewska J, Senczyszyn A, Szczesniak D, Tetlow H, Trypka E, Valente M, Chirico I. A qualitative 5-country comparison of the perceived impacts of COVID-19 on people living with dementia and unpaid carers. BMC Geriatr 2022; 22:116. [PMID: 35148712 PMCID: PMC8840054 DOI: 10.1186/s12877-022-02821-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 02/03/2022] [Indexed: 12/02/2022] Open
Abstract
Background Emerging evidence shows an impact of the COVID-19 pandemic on people living with dementia and informal carers, without any evidence-based global comparison to date. The aim of this international study was to explore and compare the perceived impact of COVID-19 and associated public health restrictions on the lives of people living with dementia and informal carers and access to dementia care across five countries. Methods Informal carers and people living with dementia who were residing in the community in the UK, Australia, Italy, India, and Poland were interviewed remotely between April and December 2020. Participants were asked about their experiences of the pandemic and how restrictions have impacted on their lives and care. Transcripts were analysed by researchers in each country using inductive thematic analysis. Results Fifteen people living with dementia and 111 informal carers participated across the five countries. Four themes emerged: (1) Limited access and support; (2) Technology and issues accessing remote support; (3) Emotional impact; and (4) Decline of cognitive and physical health reported by carers. Whilst variations were noted, the pandemic has indirectly affected people with dementia and carers across all five countries. The pandemic removed access to social support services and thus increased carer burden. Remote services were not always provided and were very limited in benefit and usability for those with dementia. As a result, carers appeared to notice reduced cognitive and physical health in people with dementia. Particular differences were noted between India and Poland vs. the UK, Italy, and Australia, with less impact on care provision in the former due to limited uptake of support services pre-pandemic based on cultural settings. Conclusions The pandemic has amplified dementia as a global public health problem, and people affected by the condition need support to better access vital support services to live well. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-02821-1.
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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 Lion
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Maria Mackowiak
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Rabih Chattat
- Department of Psychology, University of Bologna, Bologna, Italy
| | | | - Monica Cations
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
| | - Mark Gabbay
- Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK.,NIHR ARC NWC, Liverpool, UK
| | - Wendy Moyle
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | | | | | | | - Dorota Szczesniak
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | | | - Elzbieta Trypka
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Marco Valente
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Ilaria Chirico
- Department of Psychology, University of Bologna, Bologna, Italy
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15
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Helmert C, Siegels D, Haufe E, Abraham S, Heratizadeh A, Kleinheinz A, Harder I, Schäkel K, Effendy I, Wollenberg A, Sticherling M, Stahl M, Worm M, Schwichtenberg U, Schwarz B, Rossbacher J, Buck PM, Schenck F, Werfel T, Weidinger S, Schmitt J. Wahrnehmung der Corona‐Pandemie durch Neurodermitispatienten – Ergebnisse aus dem Neurodermitisregister TREATgermany. J Dtsch Dermatol Ges 2022; 20:45-58. [PMID: 35040570 DOI: 10.1111/ddg.14655_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 09/12/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Claudia Helmert
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der Technischen Universität Dresden
| | - Doreen Siegels
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der Technischen Universität Dresden
| | - Eva Haufe
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der Technischen Universität Dresden
| | - Susanne Abraham
- Klinik und Poliklinik für Dermatologie, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der Technischen Universität Dresden
| | - Annice Heratizadeh
- Abteilung Immundermatologie und experimentelle Allergologie, Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover
| | | | - Inken Harder
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | - Knut Schäkel
- Hautklinik, Universitätsklinikum Heidelberg, Ruprecht-Karls Universität Heidelberg
| | - Isaak Effendy
- Hautklinik, Universitätsklinikum OWL der Universität Bielefeld, Campus Klinikum Bielefeld
| | | | | | | | - Margitta Worm
- Klinik für Dermatologie, Venerologie und Allergologie am Campus Mitte (CCM), Charité - Universitätsmedizin Berlin
| | - Uwe Schwichtenberg
- Hautpraxen Derma-nord, Derma-nord Hautarztpraxen Dr. Schwichtenberg, Bremen-Nord
| | | | | | | | | | - Thomas Werfel
- Exzellenzcluster RESIST (EXC 2155), Hannover Medizinische Hochschule Hannover
| | - Stephan Weidinger
- Abteilung Immundermatologie und experimentelle Allergologie, Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover
| | - Jochen Schmitt
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der Technischen Universität Dresden
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- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der Technischen Universität Dresden
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16
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Sabatini S, Bennett HQ, Martyr A, Collins R, Gamble LD, Matthews FE, Pentecost C, Dawson E, Hunt A, Parker S, Allan L, Burns A, Litherland R, Quinn C, Clare L. 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. Front Psychiatry 2022; 13:849808. [PMID: 35370851 PMCID: PMC8965515 DOI: 10.3389/fpsyt.2022.849808] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 02/14/2022] [Indexed: 12/23/2022] Open
Abstract
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.
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Affiliation(s)
- Serena Sabatini
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Holly Q Bennett
- Faculty of Medical Sciences, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Anthony Martyr
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Rachel Collins
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Laura D Gamble
- Faculty of Medical Sciences, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Fiona E Matthews
- Faculty of Medical Sciences, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Claire Pentecost
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Eleanor Dawson
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Anna Hunt
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Sophie Parker
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Louise Allan
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Alistair Burns
- School of Social Sciences, Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, United Kingdom
| | - Rachael Litherland
- Innovations in Dementia Community Interest Company (CIC), Exeter, United Kingdom
| | - Catherine Quinn
- Centre for Applied Dementia Studies, Bradford University, Bradford, United Kingdom
| | - Linda Clare
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom.,National Institute for Health Research (NIHR) Applied Research Collaboration South-West Peninsula, London, United Kingdom
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17
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Biswas A, Mukherjee R, Bhattacharyya B, Mukherjee A, Das G, Das S. Exploring caregiver burden and health condition of dementia patients during lockdown due to COVID-19 pandemic. Ann Indian Acad Neurol 2022; 25:235-238. [PMID: 35693668 PMCID: PMC9175442 DOI: 10.4103/aian.aian_439_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 09/05/2021] [Accepted: 10/15/2021] [Indexed: 01/10/2023] Open
Abstract
Background: To combat the COVID-19 pandemic, several countries imposed strict lockdown to ensure social distancing to limit the spread of the virus. This caused difficulties in the management and care of patients with various chronic disorders including dementia. Objectives: The objective of the study was to explore the health condition of patients with dementia and assess their caregivers’ burden during the lockdown. Methods: A total of 57 caregivers of patients with dementia who had attended the cognitive clinic of the institute for a follow-up within 1 year preceding the lockdown were assessed through telephonic interviews. Caregivers’ details were noted following an interview related to the patients’ health condition during lockdown and caregiver concerns. Results: Findings showed a deterioration in memory in 66.7% of patients with dementia and an increase in symptoms like agitation, sleeplessness, low mood, restlessness, aggression, etc., Caregivers felt helpless and had to manage new concerns and they were not sure as to how to deal with the situation. Conclusion: The lockdown situation disrupted the health conditions of dementia patients and caregivers faced novel challenges while managing them.
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18
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Helmert C, Siegels D, Haufe E, Abraham S, Heratizadeh A, Kleinheinz A, Harder I, Schäkel K, Effendy I, Wollenberg A, Sticherling M, Stahl M, Worm M, Schwichtenberg U, Schwarz B, Rossbacher J, Buck PM, Schenck F, Werfel T, Weidinger S, Schmitt J. Perception of the coronavirus pandemic by patients with atopic dermatitis - Results from the TREATgermany registry. J Dtsch Dermatol Ges 2021; 20:45-57. [PMID: 34958179 DOI: 10.1111/ddg.14655] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 09/12/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND TREATgermany, a registry for patients with moderate to severe atopic dermatitis (AD), established an additional questionnaire in spring 2020 to investigate the effects of the coronavirus pandemic on the daily life of patients with AD. MATERIAL AND METHODS A questionnaire was used to analyze general information regarding a patient's experience of the coronavirus pandemic and, using the Inventory of Life-Changing Events, the resulting personal burden. To analyze possible associations between disease severity (EASI score, oSCORAD, IGA, PGA, POEM), quality of life (DLQI) and personal burden, t-tests, analyses of variance and correlations were evaluated, controlled for sex and age. RESULTS 58 % (n = 233) of the included 400 registry patients reported high burden scores caused by the coronavirus pandemic, regardless of an actual infection. Men showed significantly higher burden scores than women, and younger than older respondents (both P = 0.03). There were no differences in burden scores related to the physician's assessment of disease severity. However, patients with higher quality of life impairments and higher disease severity perceived the burden of the coronavirus pandemic as less severe (DLQI P = 0.019, PGA P = 0.044). CONCLUSIONS Our data show that registry patients considered the coronavirus pandemic as a life-changing event and perceived the burden differently. This should be taken into account in the treatment of patients with moderate to severe AD as well as in further studies.
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Affiliation(s)
- Claudia Helmert
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Doreen Siegels
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Eva Haufe
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Susanne Abraham
- Department of Dermatology, University Allergy Center, Carl Gustav Carus Faculty of Medicine, Technische Universitaet Dresden, Dresden, Germany
| | - Annice Heratizadeh
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | | | - Inken Harder
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Knut Schäkel
- Department of Dermatology, University Hospital, Heidelberg, Ruprecht-Karls University of Heidelberg, Heidelberg, Germany
| | - Isaak Effendy
- Department of Dermatology, OWL University Hospital of Bielefeld University, Campus Clinic Bielefeld, Germany
| | - Andreas Wollenberg
- Clinics and Outpatient Clinics for Dermatology and Allergy, LMU Munich, Munich, Germany
| | - Michael Sticherling
- Department of Dermatology, University, German Center for Immunotherapy, Erlangen, Germany
| | | | - Margitta Worm
- Department of Dermatology, Allergy and Venereology, Charité Berlin, Berlin, Germany
| | | | | | - Jens Rossbacher
- Practice Jens Rossbacher/Dr. med. Klaus Spickermann, Hautzentrum, Friedrichshain, Germany
| | | | | | - Thomas Werfel
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany.,Cluster of Excellence RESIST (EXC 2155), Hannover Medical School, Hannover, Germany
| | - Stephan Weidinger
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Jochen Schmitt
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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19
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The Experiences of People with Dementia and Informal Carers Related to the Closure of Social and Medical Services in Poland during the COVID-19 Pandemic-A Qualitative Study. Healthcare (Basel) 2021; 9:healthcare9121677. [PMID: 34946403 PMCID: PMC8702134 DOI: 10.3390/healthcare9121677] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/27/2021] [Accepted: 11/30/2021] [Indexed: 02/07/2023] Open
Abstract
Older people with dementia are particularly at risk of COVID-19; however, relatively little is known about the indirect impact of the pandemic on the lives of those living with, and/or caring for someone with, dementia. The aim of this study was to investigate the experiences of people with dementia and informal carers during the closure of available social and medical services in Poland during the COVID-19 pandemic. A qualitative thematic analysis of semi-structured interviews with people with dementia (n = 5) and informal carers (n = 21) was performed between June and August 2020 after the first wave of COVID-19 in Poland. Three overarching themes were identified: (1) care re-organization; (2) psychological responses; (3) emerging needs. The factor underlying all these elements was reliance on other people. Social support and engagement are vital to the ongoing health and well-being of people living with dementia and their informal carers. Services need to be strengthened to provide ongoing provision to those living with dementia to reach pre-pandemic levels, if not better. Within the post-pandemic environment, people with dementia and their informal carers need reassurance that they can rely on external institutional and social support able to meet their needs.
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Giebel C, Robertson S, Beaulen A, Zwakhalen S, Allen D, Verbeek H. "Nobody Seems to Know Where to Even Turn To": Barriers in Accessing and Utilising Dementia Care Services in England and The Netherlands. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212233. [PMID: 34831989 PMCID: PMC8622725 DOI: 10.3390/ijerph182212233] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/08/2021] [Accepted: 11/09/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Accessing post-diagnostic care can be difficult for people with dementia and their informal carers. Little is known, however, about the determinants of barriers to access, and how these might vary between countries. The aim of this study was to explore potential inequalities in access to formal dementia care services between England and the Netherlands, specifically from more disadvantaged areas. METHODS This was a mixed-methods study, involving semi-structured qualitative interviews and a carer questionnaire. People with dementia and informal carers were recruited by clinicians. The postal survey was co-produced with people with dementia, informal carers, and health care professionals. The survey asked carers about their own and their relatives with dementia's, social support service usage and financing; as well as how they were made aware of services and whether they required more support. Qualitative transcripts were analysed by two researchers in each country using thematic analysis. RESULTS A total of 103 carer questionnaires were received by post and 13 interviews were conducted with people with dementia and family carers between January 2020 and April 2020. Many services were accessed via self-funding. Thematic analysis generated five core themes: Health literacy; Having faith and lack of faith; Service suitability; Structural issues surrounding service provision; and Financing care. One major difference between both country's systems of care were the case manager and network support which people with dementia and carers benefitted from in the Netherlands, which was rarely the case in the UK. CONCLUSIONS People with dementia and informal carers need to be supported better in accessing formal dementia care services in both the UK and the Netherlands, whilst some learning can be taken to improve access.
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Affiliation(s)
- Clarissa Giebel
- Institute of Population Health Sciences, University of Liverpool, Liverpool L69 3GL, UK
- NIHR ARC NWC, Liverpool L69 3GL, UK;
- Correspondence:
| | | | - Audrey Beaulen
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, 6200 MD Maastricht, The Netherlands; (A.B.); (S.Z.); (H.V.)
| | - Sandra Zwakhalen
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, 6200 MD Maastricht, The Netherlands; (A.B.); (S.Z.); (H.V.)
| | | | - Hilde Verbeek
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, 6200 MD Maastricht, The Netherlands; (A.B.); (S.Z.); (H.V.)
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21
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Clare L, Martyr A, Gamble LD, Pentecost C, Collins R, Dawson E, Hunt A, Parker S, Allan L, Burns A, Hillman A, Litherland R, Quinn C, Matthews FE, Victor C. Impact of COVID-19 on 'Living Well' with Mild-to-Moderate Dementia in the Community: Findings from the IDEAL Cohort. J Alzheimers Dis 2021; 85:925-940. [PMID: 34776448 DOI: 10.3233/jad-215095] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
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.
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Affiliation(s)
- Linda Clare
- College of Medicine and Health, University of Exeter, Exeter, UK.,NIHR Applied Research Collaboration South-West Peninsula, Exeter, UK
| | - Anthony Martyr
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Laura D Gamble
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Claire Pentecost
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Rachel Collins
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Eleanor Dawson
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Anna Hunt
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Sophie Parker
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Louise Allan
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Alistair Burns
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - Alexandra Hillman
- Department of Public Health Policy and Social Sciences, Swansea University, Swansea, Wales, UK
| | | | - Catherine Quinn
- Centre for Applied Dementia Studies, Bradford University, Bradford, UK.,Wolfson Centre for Applied Health Research, Bradford, UK
| | - Fiona E Matthews
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Christina Victor
- College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK
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22
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Liu KY, Howard R, Banerjee S, Comas‐Herrera A, Goddard J, Knapp M, Livingston G, Manthorpe J, O'Brien JT, Paterson RW, Robinson L, Rossor M, Rowe JB, Sharp DJ, Sommerlad A, Suárez‐González A, Burns A. Dementia wellbeing and COVID-19: Review and expert consensus on current research and knowledge gaps. Int J Geriatr Psychiatry 2021; 36:1597-1639. [PMID: 34043836 PMCID: PMC8237017 DOI: 10.1002/gps.5567] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 05/06/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVES In response to a commissioned research update on dementia during the COVID-19 pandemic, a UK-based working group, comprising dementia researchers from a range of fields and disciplines, aimed to describe the impact of the pandemic on dementia wellbeing and identify priorities for future research. METHODS We supplemented a rapid literature search (including unpublished, non-peer reviewed and ongoing studies/reports) on dementia wellbeing in the context of COVID-19 with expert group members' consensus about future research needs. From this we generated potential research questions the group judged to be relevant that were not covered by the existing literature. RESULTS Themes emerged from 141 studies within the six domains of the NHS England COVID-19 Dementia Wellbeing Pathway: Preventing Well, Diagnosing Well, Treating Well, Supporting Well, Living Well and Dying Well. We describe current research findings and knowledge gaps relating to the impact on people affected by dementia (individuals with a diagnosis, their carers and social contacts, health and social care practitioners and volunteers), services, research activities and organisations. Broad themes included the potential benefits and risks of new models of working including remote healthcare, the need for population-representative longitudinal studies to monitor longer-term impacts, and the importance of reporting dementia-related findings within broader health and care studies. CONCLUSIONS The COVID-19 pandemic has had a disproportionately negative impact on people affected by dementia. Researchers and funding organisations have responded rapidly to try to understand the impacts. Future research should highlight and resolve outstanding questions to develop evidence-based measures to improve the quality of life of people affected by dementia.
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Affiliation(s)
- Kathy Y. Liu
- Division of PsychiatryUniversity College LondonLondonUK
| | - Robert Howard
- Division of PsychiatryUniversity College LondonLondonUK
| | | | - Adelina Comas‐Herrera
- Department of Health PolicyLondon School of Economics and Political ScienceCare Policy and Evaluation CentreLondonUK
| | - Joanne Goddard
- Economic and Social Research CouncilUK Research and InnovationSwindonUK
| | - Martin Knapp
- Department of Health PolicyLondon School of Economics and Political ScienceCare Policy and Evaluation CentreLondonUK
| | | | - Jill Manthorpe
- NIHR Policy Research Unit in Health and Social Care WorkforceKing's College LondonLondonUK
| | - John T. O'Brien
- Department of PsychiatryUniversity of Cambridge School of Clinical MedicineCambridgeUK
| | - Ross W. Paterson
- Dementia Research CentreQueen Square UCL Institute of NeurologyUniversity College LondonLondonUK
| | - Louise Robinson
- Population Health Sciences InstituteFaculty of Medical SciencesNewcastle UniversityNewcastleUK
| | - Martin Rossor
- Dementia Research CentreQueen Square UCL Institute of NeurologyUniversity College LondonLondonUK
| | - James B. Rowe
- Medical Research Council Cognition and Brain Sciences UnitUniversity of CambridgeCambridgeUK,Department of Clinical NeurosciencesUniversity of CambridgeCambridgeUK
| | - David J. Sharp
- Department of Brain SciencesImperial College LondonLondonUK,UK Dementia Research InstituteCare Research and Technology Centre, Imperial College LondonLondonUK
| | | | - Aida Suárez‐González
- Dementia Research CentreQueen Square UCL Institute of NeurologyUniversity College LondonLondonUK
| | - Alistair Burns
- Division of Neuroscience and Experimental PsychologyThe University of ManchesterManchesterUK
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23
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Schroeter ML, Kynast J, Villringer A, Baron-Cohen S. Face Masks Protect From Infection but May Impair Social Cognition in Older Adults and People With Dementia. Front Psychol 2021; 12:640548. [PMID: 34489776 PMCID: PMC8418138 DOI: 10.3389/fpsyg.2021.640548] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 05/21/2021] [Indexed: 11/27/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic will have a high impact on older adults and people with Alzheimer's disease and other dementias. Social cognition enables the understanding of another individual's feelings, intentions, desires and mental states, which is particularly important during the COVID-19 pandemic. To prevent further spread of the disease face masks have been recommended. Although justified for prevention of this potentially devastating disease, they partly cover the face and hamper emotion recognition and probably mindreading. As social cognition is already affected by aging and dementia, strategies must be developed to cope with these profound changes of communication. Face masking even could accelerate cognitive decline in the long run. Further studies are of uppermost importance to address face masks' impact on social cognition in aging and dementia, for instance by longitudinally investigating decline before and in the pandemic, and to design compensatory strategies. These issues are also relevant for face masking in general, such as in medical surroundings—beyond the COVID-19 pandemic.
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Affiliation(s)
- Matthias L Schroeter
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, University Hospital Leipzig, Clinic for Cognitive Neurology, Leipzig, Germany
| | - Jana Kynast
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, University Hospital Leipzig, Clinic for Cognitive Neurology, Leipzig, Germany
| | - Arno Villringer
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, University Hospital Leipzig, Clinic for Cognitive Neurology, Leipzig, Germany
| | - Simon Baron-Cohen
- Department of Psychiatry, Autism Research Centre, University of Cambridge, Cambridge, United Kingdom
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24
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Dellazizzo L, Léveillé N, Landry C, Dumais A. Systematic Review on the Mental Health and Treatment Impacts of COVID-19 on Neurocognitive Disorders. J Pers Med 2021; 11:jpm11080746. [PMID: 34442390 PMCID: PMC8401453 DOI: 10.3390/jpm11080746] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/27/2021] [Accepted: 07/28/2021] [Indexed: 01/10/2023] Open
Abstract
Objectives. The COVID-19 pandemic has had many public health impacts, especially on vulnerable individuals including adults with neurocognitive disorders (NCD). With increasing literature, this systematic literature review aimed to address the mental health effects of COVID-19 on people with NCD in addition to examine the impact of the pandemic on treatments/resources for NCD. Methods. A literature search was conducted in the electronic databases of PubMed, PsycINFO, Web of Science and Google Scholar. Studies were included so long as they assessed the mental health or therapeutic effects of COVID-19 on NCD. Results. Among the retrieved articles, 59 met eligibility criteria. First, the pandemic and resulting self-isolation led to many detrimental effects on psychological well-being. Exacerbation and relapses of neurocognitive and behavioral symptoms were observed, as well as emergences of new psychological symptoms (i.e., depression, anxiety). Second, therapeutic and community services for individuals suffering from NCD, such as social support services and outpatient clinics, were disrupted or reduced leading to postponed appointments and evaluations, as well as reduced access to medications. These issues were somewhat palliated with the growth of telemedicine. Conclusions. This systematic review highlights the extent of the effects of the pandemic, and the topics addressed should be taken into consideration by healthcare practitioners, institutions, and policymakers to ensure that proper measures are employed to protect this population from additional harm.
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Affiliation(s)
- Laura Dellazizzo
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, 7331 Hochelaga, Montreal, QC H1N 3V2, Canada; (L.D.); (N.L.); (C.L.)
- Faculty of Medicine, Université de Montréal, 2900 Edouard Montpetit Blvd, Montreal, QC H3T 1J4, Canada
| | - Nayla Léveillé
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, 7331 Hochelaga, Montreal, QC H1N 3V2, Canada; (L.D.); (N.L.); (C.L.)
- Faculty of Medicine, Université de Montréal, 2900 Edouard Montpetit Blvd, Montreal, QC H3T 1J4, Canada
| | - Clara Landry
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, 7331 Hochelaga, Montreal, QC H1N 3V2, Canada; (L.D.); (N.L.); (C.L.)
- Faculty of Medicine, Université de Montréal, 2900 Edouard Montpetit Blvd, Montreal, QC H3T 1J4, Canada
| | - Alexandre Dumais
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, 7331 Hochelaga, Montreal, QC H1N 3V2, Canada; (L.D.); (N.L.); (C.L.)
- Faculty of Medicine, Université de Montréal, 2900 Edouard Montpetit Blvd, Montreal, QC H3T 1J4, Canada
- Institut National de Psychiatrie Légale Philippe-Pinel, 10905 Blvd Henri-Bourassa E, Montreal, QC H1C 1H1, Canada
- Correspondence:
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25
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Weitzel EC, Löbner M, Röhr S, Pabst A, Reininghaus U, Riedel-Heller SG. Prevalence of High Resilience in Old Age and Association with Perceived Threat of COVID-19-Results from a Representative Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18137173. [PMID: 34281110 PMCID: PMC8296883 DOI: 10.3390/ijerph18137173] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/24/2021] [Accepted: 06/28/2021] [Indexed: 11/16/2022]
Abstract
Little is known about resilience in old age and its manifestation during the COVID-19 pandemic. This study aims to estimate the prevalence of high resilience in the German old age population. We further examine the socio-demographic correlates and whether high resilience reflects on older adults’ perception of the threat posed by COVID-19. The data were derived from a representative telephone survey of n = 1005 older adults (≥65 years) during the first COVID-19 lockdown. Assessments included socio-demographic variables, the perceived threat of COVID-19, and high resilience (Brief Resilience Scale; cutoff: ≥4.31). The association between high resilience and threat from COVID-19 was analyzed using ordinal logistic regression. The study sample had a mean age (SD) of 75.5 (7.1) years, and n = 566 (56.3%) were female. The estimated prevalence of high resilience was 18.7% (95% CI = [16.3; 21.2]). High resilience was more prevalent in the younger age group and participants with higher education levels. High resilience was significantly associated with a lower perception of threat from COVID-19. The results of the representative survey in the German old age population showed that one out of five adults aged 65 years and older had high resilience. Older adults with high resilience tended to feel less threatened by COVID-19. Further research on resilience in old age is needed to support vulnerable groups in the context of care.
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Affiliation(s)
- Elena Caroline Weitzel
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany; (M.L.); (S.R.); (A.P.); (S.G.R.-H.)
- Correspondence: ; Tel.: +49-341-9724534
| | - Margrit Löbner
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany; (M.L.); (S.R.); (A.P.); (S.G.R.-H.)
| | - Susanne Röhr
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany; (M.L.); (S.R.); (A.P.); (S.G.R.-H.)
- Global Brain Health Institute (GBHI), Trinity College Dublin, D02 PN40 Dublin, Ireland
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany; (M.L.); (S.R.); (A.P.); (S.G.R.-H.)
| | - Ulrich Reininghaus
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159 Mannheim, Germany;
- Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London WC2R 2LS, UK
- ESRC Centre for Society and Mental Health, King’s College London, London WC2R 2LS, UK
| | - Steffi G. Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany; (M.L.); (S.R.); (A.P.); (S.G.R.-H.)
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26
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West E, Nair P, Barrado-Martin Y, Walters KR, Kupeli N, Sampson EL, Davies N. Exploration of the impact of the COVID-19 pandemic on people with dementia and carers from black and minority ethnic groups. BMJ Open 2021; 11:e050066. [PMID: 34006561 PMCID: PMC8136797 DOI: 10.1136/bmjopen-2021-050066] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
INTRODUCTION Despite community efforts to support and enable older and vulnerable people during the COVID-19 pandemic, many people with dementia and their family carers are still finding it difficult to adjust their daily living in light of the disruption that the pandemic has caused. There may be needs specific to black, Asian and minority ethnic (BAME) populations in these circumstances that remain thus far unexplored. OBJECTIVE The aim of the study was to explore the effects of the COVID-19 pandemic on people living with dementia and their family carers of BAME backgrounds, in relation to their experiences of community dementia care and the impact on their daily lives. DESIGN 15 participants (persons with dementia and carers) were recruited for semistructured qualitative interviews. Respondents were of South Asian and Afro-Caribbean backgrounds. We used thematic analysis to analyse our data from a constructivist perspective, which emphasises the importance of multiple perspectives, contexts and values. RESULTS There were a number of ways that the COVID-19 pandemic has impacted BAME persons with dementia and carers with regard to their experiences of dementia community care and the impact on their everyday lives. In particular we identified eight key themes, with subthemes: fear and anxiety, food and eating (encompassing food shopping and eating patterns), isolation and identity, community and social relationships, adapting to COVID-19, social isolation and support structures, and medical interactions. Fear and anxiety formed an overarching theme that encompassed all others. DISCUSSION This paper covers unique and underexplored topics in a COVID-19-vulnerable group. There is limited work with these groups in the UK and this is especially true in COVID-19. The results showed that such impacts were far-reaching and affected not only day-to-day concerns, but also care decisions with long-ranging consequences, and existential interests around fear, faith, death and identity.
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Affiliation(s)
- Emily West
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
| | - Pushpa Nair
- Department of Primary Care and Population Health, University College London, London, UK
| | | | - Kate R Walters
- Department of Primary Care and Population Health, University College London, London, UK
| | - Nuriye Kupeli
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
| | - Elizabeth L Sampson
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
- Division of Psychiatry, University College London, London, UK
| | - Nathan Davies
- Department of Primary Care and Population Health, University College London, London, UK
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27
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Tuijt R, Frost R, Wilcock J, Robinson L, Manthorpe J, Rait G, Walters K. Life under lockdown and social restrictions - the experiences of people living with dementia and their carers during the COVID-19 pandemic in England. BMC Geriatr 2021; 21:301. [PMID: 33971847 PMCID: PMC8107803 DOI: 10.1186/s12877-021-02257-z] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 04/30/2021] [Indexed: 01/22/2023] Open
Abstract
Background The impact of COVID-19 restrictions on people living with dementia and their carers is an emerging focus of recent research determining how we can best support this population. People living with dementia have faced service curtailment, increased risk for COVID-19, as well as potential heightened deterioration. This study reports the experiences of people living with dementia and their family carers during the early months of the COVID-19 pandemic in England and the impact on them. Methods We recruited and remotely interviewed 30 people living with dementia in their own homes and 31 family carers, via video or telephone call in mid-2020. Data were transcribed and analysed using thematic analysis. Results People living with dementia often had a basic understanding of COVID-19 restrictions but could have difficulty translating this into personalised risk-appraisal of their own actions. Managing COVID-19 risks facing people living with dementia at home was largely done by family carers, exemplified by changes to living arrangements, which could strain or sustain caring relationships. Well-established familial caring relationships contributed to the wellbeing of the person living with dementia and their carer, as well as keeping to simple routines that included leaving the home for exercise and stimulation. People living with dementia reported some negative psychological and cognitive effects due to the imposed restrictions, such as increased apathy, irritability, or anxiety, which were fuelled by lack of social engagement. Conclusions Structuring routine (remote) social interactions where possible could increase social engagement and improve wellbeing for people living with dementia, especially those with limited familial support in a post-COVID-19 context. As some care relationships had been restructured to manage COVID-19 risks, additional carer strain may emerge as a result of the impact on the independence of the person living with dementia and come to the attention of professionals in health and care services. People living with dementia and their carers highlighted the importance of maintaining or adapting routines which may be useful learning for professionals, although additional support may be necessary for those who are impacted by more severe or worsening symptoms of dementia. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02257-z.
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Affiliation(s)
- Remco Tuijt
- Research Department of Primary Care and Population Health, University College London, Royal Free Campus, Rowland Hill Street, London, NW3 2PF, UK.
| | - Rachael Frost
- Research Department of Primary Care and Population Health, University College London, Royal Free Campus, Rowland Hill Street, London, NW3 2PF, UK
| | - Jane Wilcock
- Research Department of Primary Care and Population Health, University College London, Royal Free Campus, Rowland Hill Street, London, NW3 2PF, UK
| | | | | | - Greta Rait
- Research Department of Primary Care and Population Health, University College London, Royal Free Campus, Rowland Hill Street, London, NW3 2PF, UK
| | - Kate Walters
- Research Department of Primary Care and Population Health, University College London, Royal Free Campus, Rowland Hill Street, London, NW3 2PF, UK
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28
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Berlit P, Frölich L, Förstl H. [The "Fourth Wave"? COVID-19 and consecutive cognitive impairment]. Dtsch Med Wochenschr 2021; 146:671-676. [PMID: 33957689 DOI: 10.1055/a-1468-1529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The COVID-19 pandemic poses new challenges for the healthcare systems world-wide which will go beyond prevention, acute and intensive care treatment of patients with severe illness. A large proportion of "COVID-survivors" - and not only elderly patients - suffers from "post-COVID-syndrome". Risk factors are preexisting somatic multimorbidity, cognitive and cerebral changes together with pneumonia and hypoxemia, intensive care treatment and confusional states during the acute phase of illness. Post-COVID cognitive deficits usually manifest as a frontal dysexecutive syndrome combined with fatigue and dysphoria and/or with attentional and memory deficits. Several pathogenetic mechanisms of COVID encephalopathy are understood, but no specific treatment strategies have been established so far. We assume that general practitioners, psychiatrists, neurologists and social workers will need to take care of the activation, reintegration and expert appraisals of patients with post-COVID fatigue and cognitive deficits during the years to come.
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Affiliation(s)
| | - Lutz Frölich
- Abteilung Gerontopsychiatrie, Zentralinstitut für Seelische Gesundheit, Mannheim
| | - Hans Förstl
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Technische Universität München
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29
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Tondo G, Sarasso B, Serra P, Tesser F, Comi C. The Impact of the COVID-19 Pandemic on the Cognition of People with Dementia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4285. [PMID: 33919491 PMCID: PMC8073614 DOI: 10.3390/ijerph18084285] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/06/2021] [Accepted: 04/15/2021] [Indexed: 01/07/2023]
Abstract
(1) Background: To limit the COVID-19 outbreak, the Italian government implemented social restrictions that may have had psychological and cognitive repercussions on people with dementia. We aimed to analyze cognitive decline during the pandemic year in people evaluated in a memory clinic in northern Italy, the epicenter of COVID-19 spread. (2) Methods: A single-center retrospective study was carried out, including individuals with annual follow-up evaluated in three different years (2020-GROUP, 2019-GROUP, 2018-GROUP). We performed an intergroup comparison of cognitive decline over a one-year follow-up, and an intragroup comparison in the 2020-GROUP to analyze the five-year cognitive decline trajectory, as measured by the MMSE. (3) Results: The 2020-GROUP showed a significant loss of MMSE points per year in the considered follow-up period compared with the 2019-GROUP and 2018-GROUP (p = 0.021). Demographics, clinical features, and the other analyzed variables, including rate of diagnosis, therapy, and comorbidities, did not significantly differ between groups. The five-year cognitive decline trajectory confirmed a significant worsening of cognitive decline between 2019 and 2020 (p < 0.001), while the decrease in MMSE scores was not statistically significant between previous time points. (4) Conclusions: COVID-19 pandemic measures have induced a significant worsening of cognitive decline in people with dementia, needing more careful assistance to minimize the adverse effects of social isolation in case of future lockdowns.
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Affiliation(s)
- Giacomo Tondo
- Neurology Unit, S. Andrea Hospital, Department of Translational Medicine, University of Piemonte Orientale, Corso Abbiate 21, 13100 Vercelli, Italy; (G.T.); (B.S.); (P.S.); (F.T.)
- School of Psychology, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Barbara Sarasso
- Neurology Unit, S. Andrea Hospital, Department of Translational Medicine, University of Piemonte Orientale, Corso Abbiate 21, 13100 Vercelli, Italy; (G.T.); (B.S.); (P.S.); (F.T.)
| | - Paola Serra
- Neurology Unit, S. Andrea Hospital, Department of Translational Medicine, University of Piemonte Orientale, Corso Abbiate 21, 13100 Vercelli, Italy; (G.T.); (B.S.); (P.S.); (F.T.)
| | - Fabiana Tesser
- Neurology Unit, S. Andrea Hospital, Department of Translational Medicine, University of Piemonte Orientale, Corso Abbiate 21, 13100 Vercelli, Italy; (G.T.); (B.S.); (P.S.); (F.T.)
| | - Cristoforo Comi
- Neurology Unit, S. Andrea Hospital, Department of Translational Medicine, University of Piemonte Orientale, Corso Abbiate 21, 13100 Vercelli, Italy; (G.T.); (B.S.); (P.S.); (F.T.)
- Interdisciplinary Research Center of Autoimmune Diseases (IRCAD), University of Piemonte Orientale, 28100 Novara, Italy
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["You have to take it that way." A study of the subjective experience of the corona pandemic by older people in need of help and care living at home]. Z Gerontol Geriatr 2021; 54:359-364. [PMID: 33856530 PMCID: PMC8047544 DOI: 10.1007/s00391-021-01888-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 03/18/2021] [Indexed: 11/26/2022]
Abstract
Hintergrund Da ältere Menschen ein erhöhtes Risiko für schwere und letale Verläufe einer SARS-CoV-2-Infektion aufweisen, erfahren sie besondere Aufmerksamkeit, die sich jedoch häufig einseitig auf ihre Schutzbedürftigkeit bezieht. Erforderlich ist eine Auseinandersetzung, die ihren subjektiven Wirklichkeiten Rechnung trägt und neben Risiken auch Ressourcen berücksichtigt. Ziel der Arbeit Die Studie stellt die Perspektiven älterer Menschen in den Mittelpunkt, und Ziel ist es, ihr subjektives Erleben der Coronapandemie zu beleuchten. Gefragt wird danach, wie sie die Pandemie, Risiken, Folgen und Schutzmaßnahmen erleben, inwiefern sich diese auf ihren Lebensalltag auswirken und wie sie damit umgehen. Material und Methoden Im Mai und Juni 2020 wurden 12 leitfadengestützte Telefoninterviews durchgeführt. Befragt wurden 9 Frauen und 3 Männer zwischen 77 und 91 Jahren, die in der eigenen Häuslichkeit leben, gesundheitlich beeinträchtigt, hilfe- und pflegebedürftig sind. Die Daten wurden mittels strukturierender Inhaltsanalyse ausgewertet. Ergebnisse Die Befragten machen sich i. Allg. Sorgen aufgrund der Coronapandemie, schätzen die eigene Gefährdung aber als gering ein. Sie sehen sich von den unmittelbaren Folgen der Krise kaum betroffen oder stark in ihrem Alltag eingeschränkt. Unsicherheiten erleben sie im sozialen Lebensbereich, wobei die Angst vor Einsamkeit zentral ist. Sie halten die Schutzmaßnahmen insgesamt für angemessen, kritisieren aber frühzeitige Lockerungen, familiäre Kontaktbeschränkungen und den Umgang mit Sterbenden. Diskussion Ein moderates Ausmaß unmittelbarer persönlicher Betroffenheit, Akzeptanz und Anpassungsfähigkeit prägen das Erleben und den Umgang älterer Menschen mit der Coronapandemie. Sichtbar werden Ressourcen und Kompetenzen im Umgang mit der Krise. Zusatzmaterial online Zusätzliche Informationen sind in der Online-Version dieses Artikels (10.1007/s00391-021-01888-6) enthalten.
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