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Nichols E, Petrosyan S, Lee J. Mental Health Impacts of COVID-19: Does Prepandemic Cognition and Dementia Status Matter? J Gerontol A Biol Sci Med Sci 2024; 79:glae028. [PMID: 38267562 PMCID: PMC10972580 DOI: 10.1093/gerona/glae028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic disrupted daily life and led to sharp shocks in trends for various health outcomes. Although substantial evidence exists linking the pandemic and mental health outcomes and linking dementia and mental health outcomes, little evidence exists on how cognitive status may alter the impact of COVID-19 on mental health. METHODS We used prepandemic data from the Longitudinal Aging Study in India-Diagnostic Assessment of Dementia study and 9 waves of data from the Real-Time Insights of COVID-19 in India study (N = 1 182). We estimated associations between measures of prepandemic cognition (continuous cognition based on 22 cognitive tests, dementia status) and mental health measures during the pandemic (Patient Health Questionnaire [PHQ]-4 [9 time points], PHQ-9 [2 time points], Beck Anxiety Inventory [3 time points]), adjusting for age, gender, rural/urban residence, state, education, and prepandemic mental health. RESULTS Summarizing across time points, PHQ-9 score was marginally or significantly associated with prepandemic cognition (PHQ-9 difference: -0.38 [-0.78 to 0.14] points per SD higher cognition; p = .06), and prepandemic dementia (PHQ-9 difference: 0.61 [0.11-1.13] points for those with dementia compared to no dementia; p = .02). Associations with BAI were null, whereas associations with PHQ-4 varied over time (p value for interaction = .02) and were strongest during the delta wave, when pandemic burden was highest. CONCLUSIONS We present initial evidence that mental health impacts of COVID-19 or other acute stressors may be unequally distributed across strata of cognitive outcomes. In dynamically changing environments, those with cognitive impairment or dementia may be more vulnerable to adverse mental health outcomes.
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Affiliation(s)
- Emma Nichols
- Center for Economic and Social Research, University of Southern California, Los Angeles, California, USA
| | - Sarah Petrosyan
- Center for Economic and Social Research, University of Southern California, Los Angeles, California, USA
| | - Jinkook Lee
- Center for Economic and Social Research, University of Southern California, Los Angeles, California, USA
- Department of Economics, University of Southern California, Los Angeles, California, USA
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2
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Du J, Burger H, Kupers T, Sulim K, Homburg MT, Muris JWM, Olde Hartman TC, Zuidema SU, Peters LL, Janus SIM. Patterns of psychotropic drug prescriptions and general practice consultations among community-dwelling older people with dementia during the first two years of the COVID-19 pandemic. BMC Geriatr 2024; 24:120. [PMID: 38297202 PMCID: PMC10832125 DOI: 10.1186/s12877-024-04708-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 01/14/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic and subsequent lockdown measures had serious implications for community-dwelling older people with dementia. While the short-term impacts of the pandemic on this population have been well studied, there is limited research on its long-term impacts. Quantifying the long-term impacts may provide insights into whether healthcare adaptations are needed after the acute phase of the pandemic to balance infection prevention measures with healthcare provision. This study aims to examine patterns of psychotropic drug prescriptions and general practice consultations in community-dwelling older people with dementia during the first two years of the pandemic. METHODS We utilised routine electronic health records from three Dutch academic general practice research networks located in the North, East, and South, between 2019 and 2021. We (1) compared the weekly prescription rates of five groups of psychotropic drugs and two groups of tracer drugs, and weekly general practice consultation rates per 1000 participants, between the first two years of the pandemic and the pre-pandemic phase, (2) calculated changes in these rates during three lockdowns and two relaxation phases relative to the corresponding weeks in 2019, and (3) employed interrupted time series analyses for the prescription rates. Analyses were performed for each region separately. RESULTS The study population sizes in the North, East, and South between 2019 and 2021 were 1726 to 1916, 93 to 117, and 904 to 960, respectively. Data from the East was excluded from the statistical analyses due to the limited sample size. During the first two years of the pandemic, the prescription rates of psychotropic drugs were either lower or similar to those in the pre-pandemic phase, with differences varying from -2.6‰ to -10.2‰. In contrast, consultation rates during the pandemic were higher than in the pre-pandemic phase, increasing by around 38‰. CONCLUSIONS This study demonstrates a decrease in psychotropic drug prescriptions, but an increase in general practice consultations among community-dwelling older people with dementia during the first two years of the pandemic. However, reasons for the decrease in psychotropic drug prescriptions are unclear due to limited information on the presence of neuropsychiatric symptoms and the appropriateness of prescribing.
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Affiliation(s)
- Jiamin Du
- Department of Primary and Long-Term Care, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - Huibert Burger
- Department of Primary and Long-Term Care, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - Thijmen Kupers
- Department of Primary and Long-Term Care, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - Karina Sulim
- Department of Primary and Long-Term Care, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - Maarten T Homburg
- Department of Primary and Long-Term Care, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - Jean W M Muris
- Department of Family Medicine, Maastricht University Medical Centre, CAPHRI Care and Public Health Research Institute, Maastricht, the Netherlands
| | - Tim C Olde Hartman
- Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
| | - Sytse U Zuidema
- Department of Primary and Long-Term Care, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
- Alzheimer Centre Groningen, Groningen, the Netherlands
| | - Lilian L Peters
- Department of Primary and Long-Term Care, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
- Amsterdam University Medical Centre, Vrije Universiteit Amsterdam, Midwifery Science, AVAG, Amsterdam Public Health, Amsterdam, the Netherlands
| | - Sarah I M Janus
- Department of Primary and Long-Term Care, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands.
- Alzheimer Centre Groningen, Groningen, the Netherlands.
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Harding E, Rossi-Harries S, Gerritzen EV, Zimmerman N, Hoare Z, Proctor D, Brotherhood E, Crutch S, Suárez-González A. "I felt like I had been put on the shelf and forgotten about" - lasting lessons about the impact of COVID-19 on people affected by rarer dementias. BMC Geriatr 2023; 23:392. [PMID: 37370011 DOI: 10.1186/s12877-023-03992-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 04/23/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND The public health measures imposed in many countries to contain the spread of COVID-19 resulted in significant suspensions in the provision of support and care for people with dementia. The negative effects of these measures have been extensively reported. However, little is known about the specific impact on people with young onset, non-memory-led and inherited dementias. This group may have experienced different challenges compared to those with late onset dementia given their non-memory phenotypes and younger age. We explored the impact of the first COVID-19 lockdown on people living with familial Alzheimer's disease, behavioural variant frontotemporal dementia, familial frontotemporal dementia, dementia with Lewy bodies, posterior cortical atrophy and primary progressive aphasia and their carers in the UK and their self-reported strategies for coping. METHODS This was a mixed methods study. An online survey was administered to people with dementia and family carers recruited via Rare Dementia Support. Free-text responses were analysed using framework analysis to identify key issues and themes. RESULTS 184 carers and 24 people with dementia completed the survey. Overall, people with dementia experienced worsening of cognitive symptoms (70%), ability to do things (62%), well-being (57%) and changes to medication (26%) during lockdown. Carers reported a reduction in the support they received (55%) which impacted their own mental health negatively. Qualitative analysis of free-text responses shed light on how the disruption to routines, changes to roles and responsibilities, and widespread disconnection from friends, family and health and social care support varied according to phenotype. These impacts were exacerbated by a more general sense that precious time was being lost, given the progressive nature of dementia. Despite significant challenges, respondents demonstrated resilience and resourcefulness in reporting unexpected positives and strategies for adapting to confinement. CONCLUSIONS This study has highlighted the specific impacts of the COVID-19 restrictions on people with young onset, non-memory-led and inherited dementias, including behavioural variant frontotemporal dementia, primary progressive aphasia and posterior cortical atrophy, and their carers. The specific challenges faced according to diagnosis and the self-reported strategies speak to the importance of - and may inform the development of - tailored support for these underrepresented groups more generally.
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Affiliation(s)
- Emma Harding
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, 8-11 Queen Square, London, WC1N 3BG, UK
| | - Sam Rossi-Harries
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, 8-11 Queen Square, London, WC1N 3BG, UK
| | - Esther Vera Gerritzen
- Institute of Mental Health, Mental Health and Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
| | - Nikki Zimmerman
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, 8-11 Queen Square, London, WC1N 3BG, UK
| | - Zoe Hoare
- NWORTH Clinical Trials Unit, School of Health Sciences, Bangor University, Bangor, UK
| | - Danielle Proctor
- Department of Clinical, Educational, and Health Psychology, UCL Division of Psychology and Language Sciences, UCL, London, UK
| | - Emilie Brotherhood
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, 8-11 Queen Square, London, WC1N 3BG, UK
| | - Sebastian Crutch
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, 8-11 Queen Square, London, WC1N 3BG, UK
| | - Aida Suárez-González
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, 8-11 Queen Square, London, WC1N 3BG, UK.
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Wang HJ, Kusumo RW, Kiss A, Tennen G, Marotta G, Viaje S, Lanctôt KL. Characterizing PRN Use of Psychotropic Medications for Acute Agitation in Canadian Long-Term Care Residents with Dementia Before and During COVID-19. J Alzheimers Dis Rep 2023; 7:575-587. [PMID: 37313488 PMCID: PMC10259051 DOI: 10.3233/adr-230009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 05/15/2023] [Indexed: 06/15/2023] Open
Abstract
Background Agitation is a disabling neuropsychiatric symptom of dementia. Pro re nata (PRN) injections of psychotropics can be administered for severe acute agitation, but little is known about the frequency of their actual use. Objective Characterize actual use of injectable PRN psychotropics for severe acute agitation in Canadian long-term care (LTC) residents with dementia and compare use before and during the COVID-19 pandemic. Methods Residents from two Canadian LTC facilities with orders for PRN haloperidol, olanzapine, or lorazepam between January 1, 2018- May 1, 2019 (i.e., pre-COVID-19) and January 1, 2020- May 1, 2021 (i.e., COVID-19) were identified. Electronic medical records were reviewed to document PRN injections of psychotropic medications and collect data on reason and demographic characteristics. Descriptive statistics were used to characterize frequency, dose, and indications of use, and multivariate regression models were used to compare use between time periods. Results Of the 250 residents, 45 of 103 (44%) people in the pre-COVID-19 period and 85 of 147 (58%) people in the COVID-19 period with standing orders for PRN psychotropics received ≥1 injections. Haloperidol was the most frequently used agent in both time periods (74% (155/209 injections) pre-COVID-19; 81% (323/398 injections) during COVID-19). Residents in the COVID-19 period were almost two times more likely to receive injections compared with those in the pre-COVID-19 period (odds ratio = 1.96; 95% CI = 1.15-3.34; p = 0.01). Conclusion Our results suggest that use of PRN injections increased in LTC during the pandemic and contribute to the mounting evidence that agitation worsened during that time.
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Affiliation(s)
- Hui Jue Wang
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Raphael W. Kusumo
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Alex Kiss
- Department of Research Design and Biostatistics, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Gayla Tennen
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON Canada
| | - Giovanni Marotta
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, ON, Canada
- Division of Geriatrics, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Villa Colombo Homes for the Aged Inc, North York, ON, Canada
| | - Shirley Viaje
- Villa Colombo Homes for the Aged Inc, North York, ON, Canada
| | - Krista L. Lanctôt
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON Canada
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Prommas P, Lwin KS, Chen YC, Hyakutake M, Ghaznavi C, Sakamoto H, Miyata H, Nomura S. The impact of social isolation from COVID-19-related public health measures on cognitive function and mental health among older adults: A systematic review and meta-analysis. Ageing Res Rev 2023; 85:101839. [PMID: 36596396 PMCID: PMC9804967 DOI: 10.1016/j.arr.2022.101839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 11/24/2022] [Accepted: 12/30/2022] [Indexed: 01/01/2023]
Abstract
We aimed to estimate the impact of social isolation on cognitive function and mental health among older adults during the two-year-and-a-half COVID-19 period. Pubmed Central, Medline, CINAHL Plus and PsychINFO were searched between March 1, 2020, and September 30, 2022. We included all studies that assessed proportions of older adults with the mean or the median with a minimum age above 60 reporting worsening cognitive function and mental health. Thirty-two studies from 18 countries met the eligibility criteria for meta-analyses. We found that the proportions of older adults with dementia who experienced worsening cognitive impairment and exacerbation or new onset of behavioral and psychological symptoms of dementia (BPSD) were approximately twice larger than that of older adults with HC experiencing SCD and worsening mental health. Stage of dementia, care options, and severity of mobility restriction measures did not yield significant differences in the number of older adults with dementia reporting worsening cognitive impairment and BPSD, while the length of isolation did for BPSD but not cognitive impairment. Our study highlights the impact of social isolation on cognitive function and mental health among older adults. Public health strategies should prioritize efforts to promote healthy lifestyles and proactive assessments.
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Affiliation(s)
- Prapichaya Prommas
- Department of Health Policy and Management, Keio University School of Medicine, Tokyo, Japan.
| | - Kaung Suu Lwin
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yi Chi Chen
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Division of Health Medical Intelligence, Human Genome Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Misa Hyakutake
- Medical Education Center, Keio University School of Medicine, Tokyo, Japan
| | - Cyrus Ghaznavi
- Department of Health Policy and Management, Keio University School of Medicine, Tokyo, Japan; Medical Education Program, Washington University School of Medicine in St Louis, Saint Louis, USA
| | - Haruka Sakamoto
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Tokyo Foundation for Policy Research, Tokyo, Japan; Department of Hygiene and Public Health, Tokyo Women's Medical University, Tokyo, Japan
| | - Hiroaki Miyata
- Department of Health Policy and Management, Keio University School of Medicine, Tokyo, Japan; Tokyo Foundation for Policy Research, Tokyo, Japan
| | - Shuhei Nomura
- Department of Health Policy and Management, Keio University School of Medicine, Tokyo, Japan; Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Tokyo Foundation for Policy Research, Tokyo, Japan
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6
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Giebel C, Talbot CV, Wharton E, Lorenz-Dant K, Suárez-González A, Cannon J, Tetlow H, Lion KM, Thyrian JR. The early impacts of COVID-19 on unpaid carers of people living with dementia: part II of a mixed-methods systematic review. Aging Ment Health 2023; 27:547-562. [PMID: 35818800 DOI: 10.1080/13607863.2022.2084510] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 05/14/2022] [Indexed: 11/01/2022]
Abstract
OBJECTIVES With a lack of existing comprehensive reviews, the aim of this mixed-method systematic review was to synthesise the evidence on the early impacts of the pandemic on unpaid dementia carers across the globe. METHODS This review was registered on PROSPERO [CDR42021248050]. PubMed, CINAHL, Embase, Scopus and Web of Science were searched from 2020 to July 2021. Studies were included if they reported on the different impacts of the pandemic on unpaid dementia carers aged 18+, with papers published in English, German, Polish, or Spanish. A number of research team members were involved in the selection of studies following PRISMA guidance. RESULTS Thirty-six studies (43 papers) from 18 countries reported on the early impact of the pandemic on unpaid dementia carers. Impacts were noted on accessing care and support; carer burden; and well-being. Studies found that carers had limited access to care and support services, increased workload, enhanced feelings of social isolation, and reduced wellbeing. Specifically, reductions in access to care and support increased carer's unpaid caring tasks, removing any opportunities for temporary respite, and thus further increasing carer burden and reducing mental well-being in many. CONCLUSIONS The needs of unpaid dementia carers appear to have increased during the pandemic, without adequate support provided. Policy initiatives need to enable better mental health support and formal care provision for unpaid carers and their relatives with dementia, whilst future research needs to explore the long-term implications of carer needs in light of care home restrictions and care delivery.
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Affiliation(s)
- Clarissa Giebel
- Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK
- NIHR ARC NWC, Liverpool, UK
| | | | - Emily Wharton
- NIHR ARC NWC, Liverpool, UK
- School for Sport and Exercise Science, Liverpool John Moore's University, Liverpool, UK
| | - Klara Lorenz-Dant
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | | | | | - Hilary Tetlow
- NIHR ARC NWC, Liverpool, UK
- SURF Liverpool, Liverpool, UK
| | - Katarzyna M Lion
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Jochen René Thyrian
- German Centre for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
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Luo H, Lau WCY, Chai Y, Torre CO, Howard R, Liu KY, Lin X, Yin C, Fortin S, Kern DM, Lee DY, Park RW, Jang JW, Chui CSL, Li J, Reich C, Man KKC, Wong ICK. Rates of Antipsychotic Drug Prescribing Among People Living With Dementia During the COVID-19 Pandemic. JAMA Psychiatry 2023; 80:211-219. [PMID: 36696128 PMCID: PMC9878427 DOI: 10.1001/jamapsychiatry.2022.4448] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Importance Concerns have been raised that the use of antipsychotic medication for people living with dementia might have increased during the COVID-19 pandemic. Objective To examine multinational trends in antipsychotic drug prescribing for people living with dementia before and during the COVID-19 pandemic. Design, Setting, and Participants This multinational network cohort study used electronic health records and claims data from 8 databases in 6 countries (France, Germany, Italy, South Korea, the UK, and the US) for individuals aged 65 years or older between January 1, 2016, and November 30, 2021. Two databases each were included for South Korea and the US. Exposures The introduction of population-wide COVID-19 restrictions from April 2020 to the latest available date of each database. Main Outcomes and Measures The main outcomes were yearly and monthly incidence of dementia diagnosis and prevalence of people living with dementia who were prescribed antipsychotic drugs in each database. Interrupted time series analyses were used to quantify changes in prescribing rates before and after the introduction of population-wide COVID-19 restrictions. Results A total of 857 238 people with dementia aged 65 years or older (58.0% female) were identified in 2016. Reductions in the incidence of dementia were observed in 7 databases in the early phase of the pandemic (April, May, and June 2020), with the most pronounced reduction observed in 1 of the 2 US databases (rate ratio [RR], 0.30; 95% CI, 0.27-0.32); reductions were also observed in the total number of people with dementia prescribed antipsychotic drugs in France, Italy, South Korea, the UK, and the US. Rates of antipsychotic drug prescribing for people with dementia increased in 6 databases representing all countries. Compared with the corresponding month in 2019, the most pronounced increase in 2020 was observed in May in South Korea (Kangwon National University database) (RR, 2.11; 95% CI, 1.47-3.02) and June in the UK (RR, 1.96; 95% CI, 1.24-3.09). The rates of antipsychotic drug prescribing in these 6 databases remained high in 2021. Interrupted time series analyses revealed immediate increases in the prescribing rate in Italy (RR, 1.31; 95% CI, 1.08-1.58) and in the US Medicare database (RR, 1.43; 95% CI, 1.20-1.71) after the introduction of COVID-19 restrictions. Conclusions and Relevance This cohort study found converging evidence that the rate of antipsychotic drug prescribing to people with dementia increased in the initial months of the COVID-19 pandemic in the 6 countries studied and did not decrease to prepandemic levels after the acute phase of the pandemic had ended. These findings suggest that the pandemic disrupted the care of people living with dementia and that the development of intervention strategies is needed to ensure the quality of care.
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Affiliation(s)
- Hao Luo
- Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong
- Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong
| | - Wallis C. Y. Lau
- Research Department of Practice and Policy, UCL School of Pharmacy, London, England
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
- Laboratory of Data Discovery for Health, Hong Kong Science Park, Hong Kong
| | - Yi Chai
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Carmen Olga Torre
- Real World Data Enabling Platform, Roche, Welwyn Garden City, England
- School of Science and Engineering, University of Groningen, Groningen, the Netherlands
- Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Robert Howard
- Division of Psychiatry, Faculty of Brain Science, University College London, London, England
| | - Kathy Y. Liu
- Division of Psychiatry, Faculty of Brain Science, University College London, London, England
| | - Xiaoyu Lin
- Real-World Solutions, IQVIA, Durham, North Carolina
| | - Can Yin
- Real-World Solutions, IQVIA, Durham, North Carolina
| | | | - David M. Kern
- Janssen Research & Development, LLC, Horsham, Pennsylvania
| | - Dong Yun Lee
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, South Korea
| | - Rae Woong Park
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, South Korea
| | - Jae-Won Jang
- Department of Neurology, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, South Korea
| | - Celine S. L. Chui
- Laboratory of Data Discovery for Health, Hong Kong Science Park, Hong Kong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Jing Li
- Real-World Solutions, IQVIA, Durham, North Carolina
| | | | - Kenneth K. C. Man
- Research Department of Practice and Policy, UCL School of Pharmacy, London, England
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
- Laboratory of Data Discovery for Health, Hong Kong Science Park, Hong Kong
| | - Ian C. K. Wong
- Research Department of Practice and Policy, UCL School of Pharmacy, London, England
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine and Musketeers Foundation Institute of Data Science, The University of Hong Kong, Hong Kong
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8
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Giebel C, Lion KM, Lorenz-Dant K, Suárez-González A, Talbot C, Wharton E, Cannon J, Tetlow H, Thyrian JR. The early impacts of COVID-19 on people living with dementia: part I of a mixed-methods systematic review. Aging Ment Health 2023; 27:533-546. [PMID: 35763444 DOI: 10.1080/13607863.2022.2084509] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 05/14/2022] [Indexed: 11/01/2022]
Abstract
Objectives: The aim of this Part I systematic review was to understand the impact of the COVID-19 pandemic on the lives of people with dementia living in the community or in residential care. Part II focused on unpaid carers.Methods: This review was registered on PROSPERO [CRD42021248050]. Five data bases (PubMed, CINAHL, Embase, Scopus, Web of Science) were searched in July 2021. Studies were included if they reported on the impacts of the pandemic on people living with dementia, either in the community or residential settings, and published in English, German, Polish, or Spanish. Risk of bias was assessed using the Standard Quality Assessment QualSyst.Results: Forty papers from 33 studies reported on the effects of COVID-19 on people with dementia. Included studies were conducted across 15 countries, focusing on single-country evaluations except in one study. Three studies focused on care homes, whilst the remainder reported on the community. Studies were categorised into five impacts: Cognition; Independence and physical functioning; Behavioural symptoms; Well-being; and Access to care. All studies evidenced the negative pandemic impacts, including faster cognitive, physical, and behavioural deterioration, limited access to care, and poorer mental and social health.Conclusions: Future restrictions need to consider the need for people with dementia to stay cognitively, physically, and socially stimulated to live well, and this review provides a call for a future pandemic strategy for dementia. Longitudinal research is required on the long-term impacts of the pandemic on the lives of people with dementia, including time to care home entry.
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Affiliation(s)
- Clarissa Giebel
- Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK
- NIHR ARC NWC, Liverpool, UK
| | - Katarzyna M Lion
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Klara Lorenz-Dant
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | | | - Catherine Talbot
- Faculty of Science & Technology, Bournemouth University, Poole, UK
| | - Emily Wharton
- NIHR ARC NWC, Liverpool, UK
- School of Sport and Exercise Sciences, Liverpool John Moore's University, Liverpool, UK
| | - Jacqueline Cannon
- School of Sport and Exercise Sciences, Liverpool John Moore's University, Liverpool, UK
| | - Hilary Tetlow
- NIHR ARC NWC, Liverpool, UK
- Lewy Body Society, Wigan, UK
| | - Jochen René Thyrian
- Lewy Body Society, Wigan, UK
- SURF Liverpool, Liverpool, UK
- German Centre for Neurodegenerative Diseases (DZNE), Greifswald, Germany
- Institute for Community Medicine, University of Greifswald, Greifswald, Germany
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Huang P, Zhang LY, Tan YY, Chen SD. Links between COVID-19 and Parkinson's disease/Alzheimer's disease: reciprocal impacts, medical care strategies and underlying mechanisms. Transl Neurodegener 2023; 12:5. [PMID: 36717892 PMCID: PMC9885419 DOI: 10.1186/s40035-023-00337-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 01/12/2023] [Indexed: 01/31/2023] Open
Abstract
The impact of coronavirus disease 2019 (COVID-19) pandemic on patients with neurodegenerative diseases and the specific neurological manifestations of COVID-19 have aroused great interest. However, there are still many issues of concern to be clarified. Therefore, we review the current literature on the complex relationship between COVID-19 and neurodegenerative diseases with an emphasis on Parkinson's disease (PD) and Alzheimer's disease (AD). We summarize the impact of COVID-19 infection on symptom severity, disease progression, and mortality rate of PD and AD, and discuss whether COVID-19 infection could trigger PD and AD. In addition, the susceptibility to and the prognosis of COVID-19 in PD patients and AD patients are also included. In order to achieve better management of PD and AD patients, modifications of care strategies, specific drug therapies, and vaccines during the pandemic are also listed. At last, mechanisms underlying the link of COVID-19 with PD and AD are reviewed.
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Affiliation(s)
- Pei Huang
- grid.16821.3c0000 0004 0368 8293Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025 China
| | - Lin-Yuan Zhang
- grid.412478.c0000 0004 1760 4628Department of Neurology, Shanghai General Hospital, Shanghai, 200080 China
| | - Yu-Yan Tan
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
| | - Sheng-Di Chen
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China. .,Lab for Translational Research of Neurodegenerative Diseases, Shanghai Institute for Advanced Immunochemical Studies (SIAIS), Shanghai Tech University, Shanghai, 201210, China.
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10
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Telehealth Support for Dementia Caregivers During the COVID-19 Pandemic: Lessons Learned From the NYU Family Support Program. Am J Geriatr Psychiatry 2023; 31:14-21. [PMID: 36167652 PMCID: PMC9424119 DOI: 10.1016/j.jagp.2022.08.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 08/15/2022] [Accepted: 08/24/2022] [Indexed: 01/25/2023]
Abstract
OBJECTIVES In response to the needs of dementia caregivers during the COVID-19 pandemic, the NYU Langone Alzheimer's Disease and Related Disorders Family Support Program (FSP) quickly transitioned to providing most services online. To understand how dementia caregivers experienced FSP services after the switch to video telehealth, we conducted qualitative interviews of spouse or partner dementia caregivers. PARTICIPANTS Ten participants were recruited from a convenience sample of dementia spouse or partner caregivers who used one or more online FSP services offered during the pandemic. DESIGN Caregivers engaged in semi-structured interviews held via videoconference between May and June 2020. Qualitative analysis of interviews was conducted according to the principles of framework analysis. RESULTS Caregivers reported high satisfaction with the FSP pre-pandemic and continued to feel supported when services were provided online. They transitioned to video telehealth services with little difficulty. CONCLUSIONS While video telehealth is frequently cited as beneficial for those in rural communities, socioeconomically disadvantaged groups, or homebound individuals, our findings suggest that video telehealth is also advantageous for dementia caregivers, given their unique barriers, including lack of time due to caregiving responsibilities, lack of respite care for the person with dementia, and the additional burdens of travel time to access in-person services.
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11
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Pentecost C, Collins R, Stapley S, Victor C, Quinn C, Hillman A, Litherland R, Allan L, Clare L. Effects of social restrictions on people with dementia and carers during the pre-vaccine phase of the COVID-19 pandemic: Experiences of IDEAL cohort participants. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e4594-e4604. [PMID: 35695217 PMCID: PMC9349761 DOI: 10.1111/hsc.13863] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 04/25/2022] [Accepted: 05/28/2022] [Indexed: 06/07/2023]
Abstract
This qualitative study was designed to understand the impact of social distancing measures on people with dementia and carers living in the community in England and Wales during a period of social restrictions before the COVID-19 vaccination roll-out. We conducted 12 semi-structured interviews with people with dementia aged 50-88 years, living alone or with a partner, and 10 carers aged 61-78 years, all living with the person with dementia. Three of the interviews were with dyads. Participants were recruited during November and December 2020. We used framework analysis to identify themes and elicit suggestions for potential solutions. We identified three interrelated themes. People with dementia experienced a fear of decline in capabilities or mood and attempted to mitigate this. Carers noticed changes in the person with dementia and increased caring responsibilities, and for some, a change in the relationship. Subsequently, reduced confidence in capabilities to navigate a new and hostile environment created a cyclical dilemma of re-engaging where an inability to access usual activities made things worse. People with dementia and carers experienced neglect and being alone in their struggle, alongside feeling socially excluded during the pandemic, and there was little optimism associated with the upcoming vaccine programme. People found their own solutions to reduce the effects of isolation by keeping busy and being socially active, and practising skills deemed to help reduce the progression of dementia. This and some limited local public initiatives for the general public facilitated feelings of social inclusion. This study adds understanding to existing evidence about the longer-term experience of social isolation several months into the pandemic. It highlights the importance of health and community groups and suggests how services can find ways to support, include, and interact with people with dementia and carers during and after social restrictions.
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Affiliation(s)
- Claire Pentecost
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter Medical SchoolUniversity of ExeterExeterUnited Kingdom
| | - Rachel Collins
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter Medical SchoolUniversity of ExeterExeterUnited Kingdom
| | - Sally Stapley
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter Medical SchoolUniversity of ExeterExeterUnited Kingdom
| | - Christina Victor
- College of Health, Medicine and Life Sciences, Department of Health SciencesBrunel University LondonLondonUK
| | - Catherine Quinn
- Centre for Applied Dementia StudiesUniversity of BradfordBradfordUK
- Wolfson Centre for Applied Health ResearchBradfordUnited Kingdom
| | | | | | - Louise Allan
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter Medical SchoolUniversity of ExeterExeterUnited Kingdom
| | - Linda Clare
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter Medical SchoolUniversity of ExeterExeterUnited Kingdom
- NIHR Applied Research Collaboration South‐West PeninsulaExeterUK
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12
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Khoreva MA. Postcovid Syndrome – The New Reality. NEUROSCIENCE AND BEHAVIORAL PHYSIOLOGY 2022; 52:619-624. [PMID: 36119648 PMCID: PMC9468516 DOI: 10.1007/s11055-022-01286-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 09/30/2021] [Indexed: 10/13/2023]
Abstract
The second year of the COVID-19 pandemic has demonstrated the need for detection and assessment of the long-term consequences SARS-CoV-2 infection, including adequate cognitive functioning. This review addresses our current understanding of the direct and indirect mechanisms of nervous system infection in COVID-19, paying special attention to cause-effect relationships between SARS-CoV-2 infection and long-term neuropsychological disorders. Understanding the pathogenesis of neurological impairments in COVID-19 is important for studies of the long-term sequelae of the disease and for identifying preventive and therapeutic possibilities in relation to brain damage. Further studies of nervous system lesions in COVID-19 are clearly needed to expand existing knowledge. Early initiation of therapeutic measures for emerging disorders will probably have decisive importance for improving quality of life for many COVID-19 survivors.
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13
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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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14
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Quinn C, Gamble LD, Parker S, Martyr A, Collins R, Victor C, Dawson E, Hunt A, Pentecost C, Allan L, Clare L. Impact of COVID-19 on carers of people with dementia in the community: Findings from the British IDEAL cohort. Int J Geriatr Psychiatry 2022; 37:10.1002/gps.5708. [PMID: 35394090 PMCID: PMC9087398 DOI: 10.1002/gps.5708] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 03/21/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Unpaid carers for people with dementia play a crucial role in society. Emerging evidence suggests the COVID-19 pandemic has negatively impacted on carers. This study sought to explore the impact of the COVID-19 pandemic on carers for community-dwelling people with dementia and compare responses with pre-pandemic data. METHODS Data were collected between September 2020 and April 2021 in England and Wales. Carers were identified from the Improving the experience of Dementia and Enhancing Active Life (IDEAL) cohort and data were collected either through the telephone, video conferencing, or an online questionnaire. Responses from 242 carers were compared against benchmark data from the IDEAL cohort collected pre-pandemic. Analyses were conducted for the full sample of carers and spousal/partner carers only. RESULTS In total 48.8% of carers thought their healthcare needs were negatively affected during the pandemic. Compared with pre-pandemic data carers were more lonely and experienced less life satisfaction. There was little impact on carers' experience of caregiving, although carers felt trapped in their caregiving role. Carers were more optimistic and had higher social contact with relatives. There were changes in the methods carers used for contacting relatives and friends. Most carers coped very or fairly well during the pandemic. There was little difference in the experiences of spousal/partner carers and the full sample. CONCLUSIONS After a long period of providing care under pandemic conditions carers require additional support. This support needs to be focused on alleviating feelings of loneliness and increasing life satisfaction. Services need to consider how to improve access to health care, particularly resuming face-to-face appointments.
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Affiliation(s)
- Catherine Quinn
- Centre for Applied Dementia Studies, Faculty of Health StudiesBradford UniversityBradfordUK
- Wolfson Centre for Applied Health ResearchBradfordUK
| | - Laura D. Gamble
- Population Health Sciences InstituteNewcastle UniversityNewcastle upon TyneUK
| | - Sophie Parker
- College of Medicine and HealthUniversity of ExeterExeterUK
| | - Anthony Martyr
- College of Medicine and HealthUniversity of ExeterExeterUK
| | - Rachel Collins
- College of Medicine and HealthUniversity of ExeterExeterUK
| | - Christina Victor
- College of Health, Medicine and Life SciencesBrunel University LondonLondonUK
| | - Eleanor Dawson
- College of Medicine and HealthUniversity of ExeterExeterUK
| | - Anna Hunt
- College of Medicine and HealthUniversity of ExeterExeterUK
| | | | - Louise Allan
- College of Medicine and HealthUniversity of ExeterExeterUK
- NIHR Applied Research Collaboration South‐West PeninsulaExeterUK
| | - Linda Clare
- College of Medicine and HealthUniversity of ExeterExeterUK
- NIHR Applied Research Collaboration South‐West PeninsulaExeterUK
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15
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Vernuccio L, Sarà D, Inzerillo F, Catanese G, Catania A, Vesco M, Cacioppo F, Dominguez LJ, Veronese N, Barbagallo M. Effect of COVID-19 quarantine on cognitive, functional and neuropsychiatric symptoms in patients with mild cognitive impairment and dementia. Aging Clin Exp Res 2022; 34:1187-1194. [PMID: 35325450 PMCID: PMC8943360 DOI: 10.1007/s40520-022-02113-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 03/09/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND During the last two years, COVID-19 affected older people with dementia or mild cognitive impairment (MCI), but conflicting and sparse results are still present. The objective of this study was to investigate the frequency and type of changes in functional, cognitive and behavioral and psychological symptoms of dementia (BPSD), and caregiver's stress during the period of quarantine in 2020 in patients affected by dementia/MCI living in Palermo, Sicily. METHODS Outpatients affected by MCI/dementia were evaluated before and after COVID-19 quarantine. Functional status was investigated using basic and instrumental activities of daily living (ADL); cognitive performance with the mini-mental state examination; BPSD through the neuropsychiatric inventory (NPI). All scales were reported as pre/post-COVID-19 quarantine and a logistic regression analysis was performed for investigating the factors associated with worsening in NPI in patients and their caregivers. RESULTS One hundred patients (mean age 77.1; females = 59%) were evaluated over a median of 10 months. In the sample as whole, a significant decline in functional and cognitive status was observed (p < 0.001 for both comparisons). The NPI significantly increased by 3.56 ± 8.96 points after the COVID-19 quarantine (p < 0.0001), while the caregivers' stress increased by 1.39 ± 3.46 points between the two evaluations (p < 0.0001). The decline was more evident in people with milder dementia. Higher values of instrumental ADL at baseline were associated with a significant lower worsening in NPI and caregiver's stress. CONCLUSIONS COVID-19 quarantine negatively affected functional, cognitive, and neuropsychiatric symptoms in older people affected by dementia/MCI, highlighting the impact of COVID-19 quarantine for this population.
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Affiliation(s)
- Laura Vernuccio
- Geriatric Unit, Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone, Palermo, Italy
| | - Davide Sarà
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Via del Vespro, 127, 90127, Palermo, Italy
| | - Florenza Inzerillo
- Geriatric Unit, Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone, Palermo, Italy
| | - Giuseppina Catanese
- Geriatric Unit, Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone, Palermo, Italy
| | - Angela Catania
- Geriatric Unit, Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone, Palermo, Italy
| | - Miriam Vesco
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Via del Vespro, 127, 90127, Palermo, Italy
| | - Federica Cacioppo
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Via del Vespro, 127, 90127, Palermo, Italy
| | - Ligia J Dominguez
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Via del Vespro, 127, 90127, Palermo, Italy
- School of Medicine, "Kore" University of Enna, Enna, Italy
| | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Via del Vespro, 127, 90127, Palermo, Italy.
| | - Mario Barbagallo
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Via del Vespro, 127, 90127, Palermo, Italy
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16
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Altieri M, Capuano R, Bisecco A, d'Ambrosio A, Buonanno D, Tedeschi G, Santangelo G, Gallo A. The psychological impact of Covid-19 pandemic on people with Multiple Sclerosis: a meta-analysis. Mult Scler Relat Disord 2022; 61:103774. [PMID: 35381533 PMCID: PMC8956358 DOI: 10.1016/j.msard.2022.103774] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/24/2021] [Accepted: 03/24/2022] [Indexed: 12/22/2022]
Abstract
Background Covid-19 pandemic caused relevant psychological consequences in the general population. Since people with Multiple Sclerosis (pwMS) are usually at higher risk of psychological distress than age-matched healthy controls (HC), a meta-analytic study was conducted, aimed at evaluating i) differences between pwMS and HC in the psychological variables during the pandemic, ii) differences in the levels of anxiety, depression, stress, sleep disturbances and quality of life before and during the Covid-19 pandemic in pwMS. Methods The literature search on three electronic databases yielded 196 studies (113 after the duplicates removal). Seven studies compared psychological variables between pwMS and HC during the pandemic, while seven studies evaluated the pre- vs during the pandemic differences in pwMS. The following outcomes were selected: depression, anxiety, physical QoL, mental QoL, stress, sleep quality/disturbances. Mean weighted effect sizes (ES) were calculated using Hedges'g, via Prometa3 software. Results During the pandemic, pwMS showed higher levels of depression (g = 0.51, p=.001), anxiety (g = 0.41, p=.032), and stress (g = 0.51, p=.016) compared to HC. The comparison on psychological outcomes before and during the pandemic in pwMS revealed no significant increase during the pandemic on levels of anxiety (g = 0.08, p=.380), depression (g = 0.02, p=.772), mental QoL (g= -0.14, p=.060), physical QoL (g = 0.00, p=.986), whereas sleep quality deteriorated during the pandemic (g = 0.52, p<.001). Conclusions In agreement with pre-pandemic literature, pwMS showed higher levels of psychological distress than HC also during the Covid-19 pandemic. Contrariwise, longitudinal studies revealed that, in pwMS, the only psychological-associated variable that worsened significantly was the sleep quality, but this outcome was evaluated only in two studies. Future studies will have to assess/evaluate the long-term psychological consequences of the pandemic on pwMS.
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Affiliation(s)
- Manuela Altieri
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, (NA), Italy; Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta (CE), Italy.
| | - Rocco Capuano
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, (NA), Italy
| | - Alvino Bisecco
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, (NA), Italy
| | - Alessandro d'Ambrosio
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, (NA), Italy
| | - Daniela Buonanno
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, (NA), Italy
| | - Gioacchino Tedeschi
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, (NA), Italy
| | - Gabriella Santangelo
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta (CE), Italy
| | - Antonio Gallo
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, (NA), Italy.
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Rolland Y, Baziard M, De Mauleon A, Dubus E, Saidlitz P, Soto ME. COVID-19 in older people with cognitive impairment. Clin Geriatr Med 2022; 38:501-517. [PMID: 35868669 PMCID: PMC8934719 DOI: 10.1016/j.cger.2022.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Yves Rolland
- Gerontopole of Toulouse, Institute on Aging, Toulouse University Hospital (CHU Toulouse), 20 rue du Pont Saint-Pierre, Cité de la Santé, CHU de Toulouse, Toulouse 31059, France; CERPOP Centre d'Epidémiologie et de Recherche en santé des POPulations UPS/INSERM UMR 1295, Toulouse, France.
| | - Marion Baziard
- Gerontopole of Toulouse, Institute on Aging, Toulouse University Hospital (CHU Toulouse), 20 rue du Pont Saint-Pierre, Cité de la Santé, CHU de Toulouse, Toulouse 31059, France
| | - Adelaide De Mauleon
- Gerontopole of Toulouse, Institute on Aging, Toulouse University Hospital (CHU Toulouse), 20 rue du Pont Saint-Pierre, Cité de la Santé, CHU de Toulouse, Toulouse 31059, France
| | - Estelle Dubus
- Gerontopole of Toulouse, Institute on Aging, Toulouse University Hospital (CHU Toulouse), 20 rue du Pont Saint-Pierre, Cité de la Santé, CHU de Toulouse, Toulouse 31059, France
| | - Pascal Saidlitz
- Gerontopole of Toulouse, Institute on Aging, Toulouse University Hospital (CHU Toulouse), 20 rue du Pont Saint-Pierre, Cité de la Santé, CHU de Toulouse, Toulouse 31059, France
| | - Maria Eugenia Soto
- Gerontopole of Toulouse, Institute on Aging, Toulouse University Hospital (CHU Toulouse), 20 rue du Pont Saint-Pierre, Cité de la Santé, CHU de Toulouse, Toulouse 31059, France; CERPOP Centre d'Epidémiologie et de Recherche en santé des POPulations UPS/INSERM UMR 1295, Toulouse, France
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18
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Rajagopalan J, Arshad F, Thomas PT, Varghese F, Hurzuk S, Hoskeri RM, Ramappa RB, Nair VS, Paplikar A, Mekala S, Manae TS, Ramanna DBP, Rakesh G, Ganeshbhai PV, Dhiren SR, Komaravolu S, Kammammettu C, Rao GN, Alladi S. Cognition, Behavior, and Caregiver Stress in Dementia during the COVID-19 Pandemic: An Indian Perspective. Dement Geriatr Cogn Disord 2022; 51:90-100. [PMID: 35184061 PMCID: PMC9059024 DOI: 10.1159/000519616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 09/10/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Little is known regarding the cognitive and behavioral status of patients with dementia and their caregivers in lower middle-income countries during the COVID-19 pandemic. This study aimed to understand the impact of the pandemic on persons with dementia and their caregivers in India. METHODS This was an observational study. A cohort of 66 persons with dementia and their caregivers were evaluated during the COVID-19 pandemic in 2 specialist hospitals in South India. Caregivers were interviewed at 2 distinct time points of the pandemic: during the national lockdown and 5 months after during later periods of the "cluster of cases" transmission phase. Participants were assessed via telephone utilizing validated instruments (Neuropsychiatric Inventory [NPI], Clinical Dementia Rating [CDR] Scale, and Depression, Anxiety and Stress Scale [DASS-21]) and a semi-structured questionnaire. The questionnaire documented sociodemographic information, clinical history, infection measures adopted, changes in caregiving routines, involvement in functional rehabilitation activities, and access to medical and long-term care support services. RESULTS The 2-phase follow-up study found a significant worsening of behavior in dementia patients, demonstrated by a difference in the NPI sub-domain scores for anxiety (mean difference [standard deviation, SD] = -0.552 [1.993], t58 = -2.109, p = 0.039) and eating disturbances (mean difference [SD] = -1.121 [2.493], t59 = -3.424, p = 0.001). A relatively high proportion of patients developed anxiety (cumulative incidence = 24.53%) and eating disturbances (cumulative incidence = 26.92%), without having these symptoms at baseline. There was a trend toward an increase in proportion of persons with severe dementia (19.7% vs. 39.4%) on follow-up. Caregiver distress reported was significantly associated with neuropsychiatric symptoms (r = 0.712, p < 0.001) and dementia severity (ρ = 0.365, p = 0.004). In addition, difficulties in accessing medical care persisted between the 2 assessments, and there were statistically significant differences between functional rehabilitation activities such as indoor activities (p < 0.001), outdoor activities (p = 0.013), and physical exercises (p = 0.003) between baseline and follow-up. CONCLUSION Findings suggest interruption of functional rehabilitation activities and disruption in medical care services are likely to have had an adverse impact on patients with dementia and contributed toward caregiver distress.
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Affiliation(s)
- Jayeeta Rajagopalan
- Strengthening Responses to Dementia in Developing Countries (STRiDE) India, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Faheem Arshad
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India,*Faheem Arshad,
| | - Priya Treesa Thomas
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Feba Varghese
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Saadiya Hurzuk
- Strengthening Responses to Dementia in Developing Countries (STRiDE) India, Alzheimer's and Related Disorders Society of India, Hyderabad, India
| | | | - Renuka Bavikatti Ramappa
- Dementia Science Programme, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Vasundharaa S. Nair
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Avanthi Paplikar
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Shailaja Mekala
- Department of Neurology, Nizam's Institute of Medical Sciences India, Hyderabad, India
| | - Tejaswini S. Manae
- Dementia Science Programme, National Institute of Mental Health and Neurosciences, Bangalore, India
| | | | - Gurrapu Rakesh
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Patel Vishal Ganeshbhai
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Shah Rutul Dhiren
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Shashidhar Komaravolu
- Alzheimer's and Related Disorders Society of India Hyderabad Deccan Chapter, Hyderabad, India
| | | | - Girish N. Rao
- Department of Epidemiology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Suvarna Alladi
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India
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19
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Sizoo EM, Thunnissen JA, van Loon AM, Brederveld CL, Timmer H, Hendriks S, Smalbrugge M. The course of neuropsychiatric symptoms and psychotropic drug use in Dutch nursing home patients with dementia during the first wave of COVID-19: A longitudinal cohort study. Int J Geriatr Psychiatry 2022; 37:10.1002/gps.5693. [PMID: 35191093 PMCID: PMC9087381 DOI: 10.1002/gps.5693] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 02/03/2022] [Indexed: 12/02/2022]
Abstract
OBJECTIVE To describe the course of neuropsychiatric symptoms in nursing home residents with dementia during the step-by-step lifting of restrictions after the first wave of the COVID-19 pandemic in the Netherlands, and to describe psychotropic drug use (PDU) throughout the whole first wave. METHODS Longitudinal cohort study of nursing home residents with dementia. We measured neuropsychiatric symptoms using the Neuropsychiatric Inventory-Questionnaire (NPI-Q). From May to August 2020, the NPI-Q was filled in monthly. Psychotropic drug use was retrieved from the electronic prescription system, retrospectively for the months February to April and prospectively for the months May to August. RESULTS We followed 252 residents with dementia in 19 Dutch nursing homes. Agitation was the most prevalent type of neuropsychiatric symptom at each assessment. Overall, the prevalence and severity of agitation and depression significantly decreased over time. When considering more in detail, we observed that in some residents specific neuropsychiatric symptoms resolved (resolution) while in others specific neuropsychiatric symptoms developed (incidence) during the study period. For the majority of the residents, neuropsychiatric symptoms persisted over time. Psychotropic drug use remained stable over time throughout the whole first wave of the pandemic. CONCLUSIONS At group level, lifting the measures appeared to have beneficial effects on the prevalence and severity of agitation and depression in residents with dementia. Nevertheless, on an individual level we observed high heterogeneity in the course of neuropsychiatric symptoms over time. Despite the pressure of the pandemic and the restrictions in social contact imposed, PDU remained stable.
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Affiliation(s)
- Eefje M. Sizoo
- Department of Medicine for Older PeopleAmsterdam Public Health Research Institute, Amsterdam University Medical Centers, Location VUmcAmsterdamthe Netherlands
| | - Josi A. Thunnissen
- Department of Medicine for Older PeopleAmsterdam Public Health Research Institute, Amsterdam University Medical Centers, Location VUmcAmsterdamthe Netherlands
| | - Anouk M. van Loon
- Department of Medicine for Older PeopleAmsterdam Public Health Research Institute, Amsterdam University Medical Centers, Location VUmcAmsterdamthe Netherlands
| | - Claire L. Brederveld
- Department of Medicine for Older PeopleAmsterdam Public Health Research Institute, Amsterdam University Medical Centers, Location VUmcAmsterdamthe Netherlands
| | - Helma Timmer
- Department of Medicine for Older PeopleAmsterdam Public Health Research Institute, Amsterdam University Medical Centers, Location VUmcAmsterdamthe Netherlands
| | - Simone Hendriks
- Department of Medicine for Older PeopleAmsterdam Public Health Research Institute, Amsterdam University Medical Centers, Location VUmcAmsterdamthe Netherlands
| | - Martin Smalbrugge
- Department of Medicine for Older PeopleAmsterdam Public Health Research Institute, Amsterdam University Medical Centers, Location VUmcAmsterdamthe Netherlands
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20
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Manchia M, Gathier AW, Yapici-Eser H, Schmidt MV, de Quervain D, van Amelsvoort T, Bisson JI, Cryan JF, Howes OD, Pinto L, van der Wee NJ, Domschke K, Branchi I, Vinkers CH. The impact of the prolonged COVID-19 pandemic on stress resilience and mental health: A critical review across waves. Eur Neuropsychopharmacol 2022; 55:22-83. [PMID: 34818601 PMCID: PMC8554139 DOI: 10.1016/j.euroneuro.2021.10.864] [Citation(s) in RCA: 166] [Impact Index Per Article: 83.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 10/15/2021] [Accepted: 10/20/2021] [Indexed: 12/19/2022]
Abstract
The global public health crisis caused by COVID-19 has lasted longer than many of us would have hoped and expected. With its high uncertainty and limited control, the COVID-19 pandemic has undoubtedly asked a lot from all of us. One important central question is: how resilient have we proved in face of the unprecedented and prolonged coronavirus pandemic? There is a vast and rapidly growing literature that has examined the impact of the pandemic on mental health both on the shorter (2020) and longer (2021) term. This not only concerns pandemic-related effects on resilience in the general population, but also how the pandemic has challenged stress resilience and mental health outcomes across more specific vulnerable population groups: patients with a psychiatric disorder, COVID-19 diagnosed patients, health care workers, children and adolescents, pregnant women, and elderly people. It is challenging to keep up to date with, and interpret, this rapidly increasing scientific literature. In this review, we provide a critical overview on how the COVID-19 pandemic has impacted mental health and how human stress resilience has been shaped by the pandemic on the shorter and longer term. The vast literature is dominated by a wealth of data which are, however, not always of the highest quality and heavily depend on online and self-report surveys. Nevertheless, it appears that we have proven surprisingly resilient over time, with fast recovery from COVID-19 measures. Still, vulnerable groups such as adolescents and health care personnel that have been severely impacted by the COVID-19 pandemic do exist. Large interindividual differences exist, and for future pandemics there is a clear need to comprehensively and integratively assess resilience from the start to provide personalized help and interventions tailored to the specific needs for vulnerable groups.
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Affiliation(s)
- Mirko Manchia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy; Department of Pharmacology, Dalhousie University, Halifax, NS, Abbreviation
| | - Anouk W Gathier
- Department of Psychiatry (GGZ inGeest), Amsterdam UMC (location VUmc), Vrije University, Amsterdam Public Health and Amsterdam Neuroscience research institutes, Amsterdam, Netherlands
| | - Hale Yapici-Eser
- Department of Psychiatry, Koç University School of Medicine, Istanbul, Turkey; Research Center for Translational Medicine, Koç University, Istanbul, Turkey
| | - Mathias V Schmidt
- Research Group Neurobiology of Stress Resilience, Max Planck Institute of Psychiatry, Munich, Germany
| | - Dominique de Quervain
- Division of Cognitive Neuroscience, Department of Psychology, Department of Medicine, University of Basel, Switzerland
| | - Therese van Amelsvoort
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, Netherlands
| | - Jonathan I Bisson
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - John F Cryan
- Dept Anatomy & Neuroscience, University College Cork, Cork, Ireland & APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - Oliver D Howes
- King's College London, London, SE5 8AF Imperial College London, London, W12 0NN Lundbeck A/v, Valby, Denmark
| | - Luisa Pinto
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal; Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
| | - Nic J van der Wee
- Department of Psychiatry, Leiden University Medical Center, LUMC Neuroscience and Leiden Institute for Brain and Cognition, Leiden, Netherlands
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Center for Basics in NeuroModulation, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Igor Branchi
- Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Christiaan H Vinkers
- Department of Psychiatry (GGZ inGeest), Amsterdam UMC (location VUmc), Vrije University, Amsterdam Public Health and Amsterdam Neuroscience research institutes, Amsterdam, Netherlands; Department of Anatomy and Neurosciences, Amsterdam UMC (location VUmc), Vrije University, Amsterdam, Netherlands.
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21
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Paplikar A, Rajagopalan J, Alladi S. Care for dementia patients and caregivers amid COVID-19 pandemic. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2022; 3:100040. [PMID: 35072119 PMCID: PMC8763414 DOI: 10.1016/j.cccb.2022.100040] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 11/13/2021] [Accepted: 01/16/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND Multiple efforts have been taken across the world to bridge gaps in evidence and provide recommendations for dementia care and caregiver support during the COVID-19 pandemic. We aimed to review the available literature on measures used to alleviate the negative impacts of the pandemic on dementia care. METHODS We searched three databases: PubMed, CINAHL and PsycINFO to identify studies that described strategies that were recommended or taken to provide care and support to persons with dementia and their caregivers during the COVID-19 pandemic. RESULTS We included a total of 37 papers, originating from high, middle and low-income countries. We also included 6 papers exploring safety of COVID-19 vaccinations. Infection prevention recommendations predominantly involved providing consistent reminders to persons with dementia to engage in infection prevention measures and included measures to restrict wandering in long-term care settings to reduce spread of infection. Medical care included tele and video consultations to maintain and monitor clinical stability. Guidance for continuing rehabilitation activities for persons with dementia through remotely conducted cognitive stimulating activities, physical exercises and environmental modifications were further highlighted by multiple studies/articles. In addition, strategies to support caregivers were also advised and included teleconsultations and psycho-educational programs. CONCLUSION The COVID-19 pandemic has exposed gaps in health and social care systems across the world, but has also revealed the enduring dedication of clinicians, expert groups and dementia support organizations to modify and adapt existing dementia care services to meet the needs of persons with dementia and their caregivers during periods of emergency.
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Affiliation(s)
- Avanthi Paplikar
- Dr. S.R.Chandrasekhar Institute of Speech and Hearing, Bengaluru, India, 560084.,Department of Neurology, National Institute of Mental Health and Neurosciences [NIMHANS], Bengaluru, India, 560029
| | - Jayeeta Rajagopalan
- Department of Neurology, National Institute of Mental Health and Neurosciences [NIMHANS], Bengaluru, India, 560029
| | - Suvarna Alladi
- Department of Neurology, National Institute of Mental Health and Neurosciences [NIMHANS], Bengaluru, India, 560029
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22
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Gedde MH, Husebo BS, Vahia IV, Mannseth J, Vislapuu M, Naik M, Berge LI. Impact of COVID-19 restrictions on behavioural and psychological symptoms in home-dwelling people with dementia: a prospective cohort study (PAN.DEM). BMJ Open 2022; 12:e050628. [PMID: 35074810 PMCID: PMC8787843 DOI: 10.1136/bmjopen-2021-050628] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVES To investigate the impact of the COVID-19 restrictions on behavioural and psychological symptoms of dementia (BPSD). DESIGN Prospective cohort study (PAN.DEM) nested within the halted parent trial (LIVE@Home.Path). SETTING Households in Norway immediate before and 6-9 weeks into the COVID-19 restrictions. PARTICIPANTS 104 dyads (persons with mild to moderate dementia aged ≥65 and their informal carers) completed both prepandemic and pandemic assessments, among 237 in the parent trial. Mini-Mental Status Examination score 15-26 or Functional Assessment Staging score 3-7 covered dementia severity. MAIN OUTCOME MEASURES Neuropsychiatric Inventory (NPI-12) total (range 0-144), psychosis (range 0-24), hyperactive behaviour (range 0-60) and mood subsyndrome (range 0-48) scores; Cornell Scale for Depression in Dementia (CSDD) total score (range 0-38). RESULTS We found an overall increase in BPSD by NPI-12 total score comparing prepandemic to pandemic levels (median 16 IQR (4.5-29) to 20 (7-32.5), p=0.03) over a mean of 86 days (SD 19). NPI-12 total score worsened in 57 (55%) of people with dementia and was associated with postponed or averted contacts with healthcare professionals (logistic regression, OR 3.96, 95% CI 1.05 to 14.95). Psychosis subsyndrome levels increased (0 (0-3) to 0.5 (0-6), p=0.01) in 37 (36%) persons; this worsening was associated with partial insight (9.57, 1.14 to 80.71) and reduced informal carer contact (4.45, 1.01 to 19.71). Moreover, depressive symptoms increased as assessed by CSDD total score (5 (3-9) to 7 (4-12), p=0.01) and worsened for 56 (54%), which was inversely associated with psychotropic drugs on-demand (0.16, 0.03 to 0.75). CONCLUSIONS BPSD worsened during the first months of the COVID-19 restrictions, most pronounced for psychosis and depression. These BPSD exacerbations have implications for pandemic policies, emphasising that restrictions must balance COVID-19 morbidity and mortality against dementia deterioration. TRIAL REGISTRATION NUMBER NCT04043364; Results.
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Affiliation(s)
- Marie H Gedde
- Haraldsplass Deaconess Hospital, Bergen, Norway
- Centre for Elderly and Nursing Home Medicine, Department of Global Public Health Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Bettina S Husebo
- Centre for Elderly and Nursing Home Medicine, Department of Global Public Health Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
- Bergen Municipality, Bergen, Norway
| | - Ipsit V Vahia
- McLean Hospital, Belmont, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Janne Mannseth
- Section for Epidemiology and Medical Statistic, Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Maarja Vislapuu
- Centre for Elderly and Nursing Home Medicine, Department of Global Public Health Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Mala Naik
- Haraldsplass Deaconess Hospital, Bergen, Norway
- Department of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Line I Berge
- Centre for Elderly and Nursing Home Medicine, Department of Global Public Health Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
- NKS Olaviken Gerontopsychiatric Hospital, Askøy, Norway
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23
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Aragón I, Flores I, Dorman G, Rojas G, Sierra Sanjurjo N, O’Neill S. Quality of life, mood, and cognitive performance in older adults with cognitive impairment during the first wave of COVID 19 in Argentina. Int J Geriatr Psychiatry 2022; 37:10.1002/gps.5650. [PMID: 34755917 PMCID: PMC8646356 DOI: 10.1002/gps.5650] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 10/31/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND OBJECTIVES In Argentina, government has established lockdown on 19 March 2020 to decrease SARS-COV-2 infection. The study aim was to understand how mandatory quarantine imposed due to COVID-19 pandemic has affected quality of life, mood, and cognitive performance of older adults with cognitive impairment. DESIGN Longitudinal descriptive-observational study. PARTICIPANTS Patients with cognitive impairment attending to online cognitive training sessions. MEASUREMENTS Participants have completed by themselves Quality of Life in Alzheimer's Disease scale (QOL-AD), Beck Depression Inventory (BDI-II), Test your Memory (TYM), and an attention and executive task created by our institution. Same assessments were done at the beginning of the lockdown and 7 months later. RESULTS Fifty-one adults were included. An increase in BDI-II score (p = 0.049) and worse performance in one of the executive attention tests (p = 0.012) have been found. No significant differences in QOL-AD, TYM, verbal fluency, or memory tests total scores have been observed. Reviewing scales subitems, differences in changes in sleep habits (p = 0.021), energy level decrease (p = 0.004), worse subjective record of memory capacity (p = 0.028), and decrease in ability to do housework (p = 0.007) have been shown. In those who lived alone, BDI and TYM higher scores in BDI-II (p = 0.030) (p = 0.022) have been found. CONCLUSION Mandatory quarantine imposed due to COVID-19 pandemic was associated with worsening of mood, some quality-of-life variables, and decrease in attention in older adults with cognitive impairment in Argentina.
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Affiliation(s)
- Irina Aragón
- Neuroscience InstituteFavaloro Foundation University HospitalBuenos AiresArgentina
| | - Ignacio Flores
- Neuroscience InstituteFavaloro Foundation University HospitalBuenos AiresArgentina
| | - Guido Dorman
- Neuroscience InstituteFavaloro Foundation University HospitalBuenos AiresArgentina
| | - Galeno Rojas
- Neuroscience InstituteFavaloro Foundation University HospitalBuenos AiresArgentina
| | - Natalia Sierra Sanjurjo
- Neuroscience InstituteFavaloro Foundation University HospitalBuenos AiresArgentina,Neuropsychology LaboratoryINCYT‐CONICETBuenos AiresArgentina
| | - Santiago O’Neill
- Neuroscience InstituteFavaloro Foundation University HospitalBuenos AiresArgentina
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24
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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: 9] [Impact Index Per Article: 4.5] [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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25
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Gaigher JM, Lacerda IB, Dourado MCN. Dementia and Mental Health During the COVID-19 Pandemic: A Systematic Review. Front Psychiatry 2022; 13:879598. [PMID: 35873228 PMCID: PMC9301378 DOI: 10.3389/fpsyt.2022.879598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 06/17/2022] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES The COVID-19 pandemic raised significant concerns related to the management of care for people with dementia, but few studies have examined the mental health of older adults with dementia and their caregivers during the pandemic, when compared to other populations. This systematic review thus aims to compare and discuss the impact of the COVID-19 pandemic on people with dementia and on their caregivers' mental health. METHODS A search was performed in the PubMed/Medline and ISI databases according to the PRISMA methodology. We included studies published in 2020 and 2021 with the following combinations of keywords: "COVID-19 and mental health and elderly," "COVID-19 and mental health and dementia;" "COVID-19 and dementia and caregivers," "pandemic and mental health and elderly," and "pandemic and anxiety." RESULTS Twenty-two studies were included. Technology has proven to be an essential ally during the pandemic, since all 22 studies performed remote data collection. Nearly all the studies emphasized that social isolation and withdrawal can lead to the emergence or increase of neuropsychiatric symptoms and motor difficulties. However, the findings were mixed concerning the pandemic's impact on the cognition of people with dementia. Caregivers also suffered from the pandemic's impact, experiencing an increase in the burden of care and symptoms of stress, depression, and anxiety. Few studies suggested measures to alleviate the difficulties of people with dementia and their caregivers. There are reports of the benefits of technology in communication and treatment through teleconsultations, however, not everyone has access to such technology, making it difficult to disseminate this tool to the target population. CONCLUSIONS The studies generally showed that social isolation can increase motor deficits and neuropsychiatric symptoms and caregivers' burden and anxiety. New avenues for care and intervention are thus needed for older adults with cognitive deficits and their caregivers to avoid the intensification of physical and psychological suffering. Technological initiatives and support should consider people with cognitive impairment and different levels of technology literacy. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/prospero/.
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Affiliation(s)
- Julia Mariano Gaigher
- Center for Alzheimer's Disease, Institute of Psychiatry, Universidade Federal Do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Isabel Barbeito Lacerda
- Center for Alzheimer's Disease, Institute of Psychiatry, Universidade Federal Do Rio de Janeiro, Rio de Janeiro, Brazil
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26
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Abstract
The second year of the COVID-19 (Coronavirus Disease 2019) pandemic has seen the need to identify and assess the long-term consequences of a SARS-CoV-2 (Severe acute respiratory syndrome coronavirus-2) infection on an individual's, including adequate cognitive functioning. This review is attempting to highlight the current understanding of the various direct and indirect mechanisms of nervous system damage, describing the causality of similar symptoms following SARS-CoV-2 infection. This understanding is essential to establish the long-term consequences from the disease (including the potential for increased risk of dementia in some cases) and to identify means of preventing or ameliorating the brain damage. There is urgent need for research to better understand the pathogenesis of neurological disturbances in COVID-19, some of which have probably been covert and the prevalence of which may be considerably underestimated. Neuropsychiatric monitoring follow-up of COVID-19 patients will be important in determining the extent and prevalence of long-term neurological and psychiatric consequences of COVID-19. Early intervention for emerging these problems will be critical for improving quality of life for many COVID-19 survivors.
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Affiliation(s)
- M A Khoreva
- Altai State Medical University, Barnaul, Russia
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27
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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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28
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Masterson-Algar P, Allen MC, Hyde M, Keating N, Windle G. Exploring the impact of Covid-19 on the care and quality of life of people with dementia and their carers: A scoping review. DEMENTIA 2021. [PMCID: PMC8811334 DOI: 10.1177/14713012211053971] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
This article reports on findings of a scoping review aimed to map the published literature concerning the impact of Covid-19 on the care and quality of life of people living with dementia and their carers. Twenty-nine articles were included in the review. Three overarching themes were identified: (1) Impact on people with dementia – unmet and increased care needs; (2) Impact on carers – increased stress and burden and (3) Impact according to demographics. Overall, findings show that Covid-19 has led to a reduction in support from health and social services and to a move towards technology-based support. Furthermore, Covid-19 has had a negative impact on the care and quality of life of people living with dementia and their carers, and that this impact was influenced by the severity of dementia.
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Affiliation(s)
| | | | - Martin Hyde
- Centre for Innovative Ageing, Swansea University, Swansea, United Kingdom
| | - Norah Keating
- Centre for Innovative Ageing, Swansea University, Swansea, United Kingdom; North-West University, Gauteng, South Africa
| | - Gill Windle
- School of Health Sciences, Bangor University, Bangor, United Kingdom
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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: 45] [Impact Index Per Article: 15.0] [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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Vislapuu M, Angeles RC, Berge LI, Kjerstad E, Gedde MH, Husebo BS. The consequences of COVID-19 lockdown for formal and informal resource utilization among home-dwelling people with dementia: results from the prospective PAN.DEM study. BMC Health Serv Res 2021; 21:1003. [PMID: 34551783 PMCID: PMC8457031 DOI: 10.1186/s12913-021-07041-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 09/13/2021] [Indexed: 11/10/2022] Open
Abstract
Background COVID-19 isolated home-dwelling people with dementia (PwD) from home care services, respite care, and daytime activities. We aimed to investigate the consequences of these restrictions on informal (family, friends) and formal (homecare staff) resource utilization among co-residing (e.g., spouses) and visiting caregivers (e.g., children). Methods 105 PwD (≥65 years old) and their caregivers were included in the prospective PANdemic in DEMentia (PAN.DEM) study, which was initiated when the ongoing stepped-wedge, cluster randomized LIVE@Home.Path trial (N = 438) was temporarily halted due to the pandemic. Primary outcome was change in resource utilization assessed by the Resource Utilization in Dementia Care (RUD) instrument in pre- (12 Dec. 2019 to 11 Mar. 2020) and during the lockdown periods (20 April 2020 to 15 May 2020). Degree of cognitive impairment was assessed by Mini-Mental Status Examination (MMSE), and physical functioning and independent living skills by Physical Self-Maintenance Scale and Lawton Instrumental Activities of Daily Living Scale. Associations between informal and formal care utilization, socio-demographics, and clinical variables were assessed by descriptive statistics and Ordinary Least Squares models (OLS). Results Mean age for PwD was 81.8 years; 61% were female; 45.6% lived alone, and the mean MMSE score was 20.8 (SD ± 3.7). PwD with co-residents (44%) were younger (78.4 years) than those who were living alone (84.5 years; P < 0.001). During the first 2 months of lockdown, PwD missed on average 20.5 h of formal care in a month (P < 0.001) leading to an approximately 100% increase in informal care, which was particularly pronounced in personal hygiene (6.9 vs. 11.4 days in a month, P < 0.001) and supervision (9.2 vs. 17.6 days in a month; P < 0.001). Visiting caregivers increased by 1.9 days (SD ± 11.5), but co-residing caregivers increased their number of days providing ADL by approximately 7 days per month (β = 6.9; CI, 0.39–13.1, P < 0.05) after adjusting for PwD and caregiver demographics and clinical variables. Decrease in home nursing care was particularly visible for PwD living alone (− 6.1 vs. -1.3 h per month, P = 0.005). Higher cognitive function (β = − 0.64, CI, − 1.26 – 0.02, P = 0.044) was associated with reduction in home nursing service during the lockdown. Conclusion The care situation for PwD changed dramatically in the early phase of the COVID-19 pandemic, especially for those living alone who received less support from homecare services and visiting caregivers. For future crises and the forthcoming post-pandemic period, health authorities must plan better and identify and prioritize those in greatest need. Trial registration ClinicalTrials.gov; NCT04043364.
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Affiliation(s)
- Maarja Vislapuu
- Department of Global Public Health and Primary Care, Centre for Elderly and Nursing Home Medicine, University of Bergen, Årstadveien 17, 5009, Bergen, Norway.
| | | | - Line I Berge
- Department of Global Public Health and Primary Care, Centre for Elderly and Nursing Home Medicine, University of Bergen, Årstadveien 17, 5009, Bergen, Norway.,NKS Olaviken Gerontopsychiatric Hospital, Erdal, Norway
| | | | - Marie H Gedde
- Department of Global Public Health and Primary Care, Centre for Elderly and Nursing Home Medicine, University of Bergen, Årstadveien 17, 5009, Bergen, Norway.,Haraldsplass Deaconess Hospital, Bergen, Norway
| | - Bettina S Husebo
- Department of Global Public Health and Primary Care, Centre for Elderly and Nursing Home Medicine, University of Bergen, Årstadveien 17, 5009, Bergen, Norway.,Department of Nursing Home Medicine, Municipality of Bergen, Bergen, Norway
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Suárez-González A, Rajagopalan J, Livingston G, Alladi S. The effect of COVID-19 isolation measures on the cognition and mental health of people living with dementia: A rapid systematic review of one year of quantitative evidence. EClinicalMedicine 2021; 39:101047. [PMID: 34386758 PMCID: PMC8342894 DOI: 10.1016/j.eclinm.2021.101047] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 07/06/2021] [Accepted: 07/14/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND COVID-19 prevention and control policies have entailed lockdowns and confinement. This study aimed to summarize the global research evidence describing the effect of COVID-19 isolation measures on the health of people living with dementia. METHODS We searched Pubmed, PsycINFO and CINAHL up to 27th of February 2021 for peer-reviewed quantitative studies about the effects of isolation during COVID-19 on the cognitive, psychological and functional symptoms of people with dementia or mild cognitive impairment. The Joanna Briggs Institute critical appraisal tool was used to conduct the quality assessment. PROSPERO registration: CRD42021229259. FINDINGS 15 eligible papers were identified, examining a total of 6442 people with dementia. 13/15 studies investigated people living in the community and 2 in care homes. Out of 15 studies, 9 (60%) reported changes in cognition and 14 (93%) worsening or new onset of behavioral and psychological symptoms. Six studies (46%) reported a functional decline in daily activities in a variable proportion of the population analyzed. INTERPRETATION COVID-19 isolation measures have damaged the cognitive and mental health of people with dementia across the world. It is urgent to issue guidance that balances infection control measures against the principles of non-maleficence to guarantee fair and appropriate care during pandemic times for this population.
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Affiliation(s)
- Aida Suárez-González
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, box 16, 8-11 Queen Square, London WC1N 3BG, United Kingdom
| | - Jayeeta Rajagopalan
- Strengthening Responses to Dementia in Developing Countries (STRiDE) India, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Gill Livingston
- Division of Psychiatry, Maple House, University College London, United Kingdom
| | - Suvarna Alladi
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India
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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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Impact of the COVID-19 Pandemic on Family Carers of Older People Living with Dementia in Italy and Hungary. SUSTAINABILITY 2021. [DOI: 10.3390/su13137107] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The COVID-19 pandemic has had a major effect on both older people with dementia and families caring for them. This paper presents the results of an online survey carried out among Italian and Hungarian family carers of people with dementia during the first pandemic wave (May–July 2020, n = 370). The research questions were the following: (1) How has the pandemic changed the lives of family carers? (2) How did government restriction measures change the availability of care-related help? (3) What other changes did families experience? Results show that about one-quarter of both subsamples experienced a deterioration in their financial status. A decline in both general and mental health was also reported. Due to “lockdown”, family carers’ burden increased substantially. Utilization of care-related help decreased, and the share of those left with no help increased in both countries. Cross-country differences emerged in terms of dementia care system, severity of the first pandemic wave, and measures put in place by governments. Findings outline the weaknesses of support structures and their country-specific vulnerabilities to a worldwide pandemic. To better protect people with dementia in the future, it is essential to strengthen their family carers, and support structures need to be re-evaluated and re-designed.
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COVID-19: a novel risk factor for perioperative neurocognitive disorders. Br J Anaesth 2021; 127:e113-e115. [PMID: 34266660 PMCID: PMC8214172 DOI: 10.1016/j.bja.2021.06.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/08/2021] [Accepted: 06/08/2021] [Indexed: 11/21/2022] Open
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COVID-19 Recommendations for Assisted Living: Implications for the Future. J Am Med Dir Assoc 2021; 22:933-938.e5. [PMID: 33773962 PMCID: PMC7904515 DOI: 10.1016/j.jamda.2021.02.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/18/2021] [Accepted: 02/21/2021] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Assisted living (AL) emerged over 2 decades ago as a preferred residential care option for older adults who require supportive care; however, as resident acuity increased, concern has been expressed whether AL sufficiently addresses health care needs. COVID-19 amplified those concerns, and an examination of recommendations to manage COVID-19 may shed light on the future of AL. This review summarizes recommendations from 6 key organizations related to preparation for and response to COVID-19 in AL in relation to resident health and quality of life; compares recommendations for AL with those for nursing homes (NHs); and assesses implications for the future of AL. DESIGN Nonsystematic review involving search of gray literature. SETTING AND PARTICIPANTS Recommendations from key governmental bodies and professional societies regarding COVID-19 in AL, long-term care facilities (LTCFs) in general, and NHs. MEASURES We collected, categorized, and summarized these recommendations as they pertained to quality of life and health care. RESULTS Many recommendations for AL and NHs were similar, but differences provided insight into ways the pandemic was recognized and challenged AL communities in particular: recommending more flexible visitation and group activities for AL, providing screening by AL staff or an outside provider, and suggesting that AL staff access resources to facilitate advance care planning discussions. Recommendations were that AL integrate health care into offered services, including working with consulting clinicians who know both the residents and the LTC community. CONCLUSIONS AND IMPLICATIONS Long-term care providers and policy makers have recognized the need to modify current long-term care options. Because COVID-19 recommendations suggest AL communities would benefit from the services and expertise of social workers, licensed nurses, and physicians, it may accelerate the integration and closer coordination of psychosocial and medical care into AL. Future research should investigate different models of integrated, interdisciplinary health care in AL.
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Xia X, Wang Y, Zheng J. COVID-19 and Alzheimer's disease: how one crisis worsens the other. Transl Neurodegener 2021; 10:15. [PMID: 33941272 PMCID: PMC8090526 DOI: 10.1186/s40035-021-00237-2] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 04/05/2021] [Indexed: 02/06/2023] Open
Abstract
Alzheimer’s disease (AD) has emerged as a key comorbidity of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The morbidity and mortality of COVID-19 are elevated in AD due to multiple pathological changes in AD patients such as the excessive expression of viral receptor angiotensin converting enzyme 2 and pro-inflammatory molecules, various AD complications including diabetes, lifestyle alterations in AD, and drug-drug interactions. Meanwhile, COVID-19 has also been reported to cause various neurologic symptoms including cognitive impairment that may ultimately result in AD, probably through the invasion of SARS-CoV-2 into the central nervous system, COVID-19-induced inflammation, long-term hospitalization and delirium, and post-COVID-19 syndrome. In addition, the COVID-19 crisis also worsens behavioral symptoms in uninfected AD patients and poses new challenges for AD prevention. In this review, we first introduce the symptoms and pathogenesis of COVID-19 and AD. Next, we provide a comprehensive discussion on the aggravating effects of AD on COVID-19 and the underlying mechanisms from molecular to social levels. We also highlight the influence of COVID-19 on cognitive function, and propose possible routes of viral invasion into the brain and potential mechanisms underlying the COVID-19-induced cognitive impairment. Last, we summarize the negative impacts of COVID-19 pandemic on uninfected AD patients and dementia prevention.
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Affiliation(s)
- Xiaohuan Xia
- Center for Translational Neurodegeneration and Regenerative Therapy, Tenth People's Hospital of Tongji University, Shanghai, 200072, China. .,Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, 200434, China.
| | - Yi Wang
- Center for Translational Neurodegeneration and Regenerative Therapy, Tenth People's Hospital of Tongji University, Shanghai, 200072, China.,Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, 200434, China
| | - Jialin Zheng
- Center for Translational Neurodegeneration and Regenerative Therapy, Tenth People's Hospital of Tongji University, Shanghai, 200072, China. .,Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, 200434, China. .,Collaborative Innovation Center for Brain Science, Tongji University, Shanghai, 200092, China. .,Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE, 68198-5930, USA.
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Lebrasseur A, Fortin-Bédard N, Lettre J, Raymond E, Bussières EL, Lapierre N, Faieta J, Vincent C, Duchesne L, Ouellet MC, Gagnon E, Tourigny A, Lamontagne MÈ, Routhier F. Impact of the COVID-19 Pandemic on Older Adults: Rapid Review. JMIR Aging 2021; 4:e26474. [PMID: 33720839 PMCID: PMC8043147 DOI: 10.2196/26474] [Citation(s) in RCA: 153] [Impact Index Per Article: 51.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/07/2021] [Accepted: 03/10/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has drastically changed the lives of countless members of the general population. Older adults are known to experience loneliness, age discrimination, and excessive worry. It is therefore reasonable to anticipate that they would experience greater negative outcomes related to the COVID-19 pandemic given their increased isolation and risk for complications than younger adults. OBJECTIVE This study aims to synthesize the existing research on the impact of the COVID-19 pandemic, and associated isolation and protective measures, on older adults. The secondary objective is to investigate the impact of the COVID-19 pandemic, and associated isolation and protective measures, on older adults with Alzheimer disease and related dementias. METHODS A rapid review of the published literature was conducted on October 6, 2020, through a search of 6 online databases to synthesize results from published original studies regarding the impact of the COVID-19 pandemic on older adults. The Human Development Model conceptual framework-Disability Creation Process was used to describe and understand interactions between personal factors, environmental factors, and life habits. Methods and results are reported following the Preferred Reporting Items for Systematic Reviews and Meta-analyses Statement. RESULTS A total of 135 records were included from the initial search strategy of 13,452 individual studies. Of these, 113 (83.7%) studies were determined to be of level 4 according to the levels of evidence classification by the Centre for Evidence-Based Medicine. The presence of psychological symptoms, exacerbation of ageism, and physical deterioration of aged populations were reported in the included studies. Decreased social life and fewer in-person social interactions reported during the COVID-19 pandemic were occasionally associated with reduced quality of life and increased depression. Difficulties accessing services, sleep disturbances, and a reduction of physical activity were also noted. CONCLUSIONS Our results highlight the need for adequate isolation and protective measures. Older adults represent a heterogeneous group, which could explain the contradictory results found in the literature. Individual, organizational, and institutional strategies should be established to ensure that older adults are able to maintain social contacts, preserve family ties, and maintain the ability to give or receive help during the current pandemic. Future studies should focus on specific consequences and needs of more at-risk older adults to ensure their inclusion, both in public health recommendations and considerations made by policy makers.
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Affiliation(s)
- Audrey Lebrasseur
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, QC, Canada
- Department of Rehabilitation, Université Laval, Québec, QC, Canada
| | - Noémie Fortin-Bédard
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, QC, Canada
- School of Social Work and Criminology, Université Laval, Québec, QC, Canada
| | - Josiane Lettre
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, QC, Canada
| | - Emilie Raymond
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, QC, Canada
- School of Social Work and Criminology, Université Laval, Québec, QC, Canada
| | - Eve-Line Bussières
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, QC, Canada
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Nolwenn Lapierre
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, QC, Canada
- Department of Rehabilitation, Université Laval, Québec, QC, Canada
| | - Julie Faieta
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, QC, Canada
- Department of Rehabilitation, Université Laval, Québec, QC, Canada
| | - Claude Vincent
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, QC, Canada
- Department of Rehabilitation, Université Laval, Québec, QC, Canada
| | - Louise Duchesne
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, QC, Canada
- Department of Speech-Language Pathology, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Marie-Christine Ouellet
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, QC, Canada
- School of Psychology, Université Laval, Québec, QC, Canada
| | - Eric Gagnon
- VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, QC, Canada
- Department of Sociology, Université Laval, Québec, QC, Canada
| | - André Tourigny
- VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, QC, Canada
- Department of Social and Preventive Medicine, Université Laval, Québec, QC, Canada
| | - Marie-Ève Lamontagne
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, QC, Canada
- Department of Rehabilitation, Université Laval, Québec, QC, Canada
| | - François Routhier
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, QC, Canada
- Department of Rehabilitation, Université Laval, Québec, QC, Canada
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Werner P, Tur-Sinai A, AboJabel H. Examining Dementia Family Caregivers' Forgone Care for General Practitioners and Medical Specialists during a COVID-19 Lockdown. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3688. [PMID: 33916152 PMCID: PMC8036927 DOI: 10.3390/ijerph18073688] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 03/30/2021] [Accepted: 03/31/2021] [Indexed: 12/16/2022]
Abstract
The present study aimed to assess dementia caregivers' reports of the prevalence and correlates of forgone care regarding visits to a general practitioner (GP) and to a specialist during the COVID-19 lockdown in Israel, using Andersen's Behavioral Model of Healthcare Utilization. A cross-sectional study using an online survey was conducted with 73 Israeli family caregivers of persons with dementia residing in the community (81% Jews, 86% female, mean age = 54). Overall, one out of two participants reported having to delay seeking needed help from a GP or a specialist for themselves, as well as for their relatives with dementia, during the COVID-19 lockdown period. Among the predisposing factor, education was associated with caregivers' reports regarding forgone care for themselves as well as for their loved ones. Living with the care-receiver and income level were the enabling factors associated with forgone care for caregivers. Finally, feelings of burden were associated with caregivers' forgone care and feelings of loneliness and perceptions of the care-receiver's cognitive functioning were associated with care-receivers' forgone care. Our findings show that it is essential that this population receive appropriate practical and emotional support at times of distress and crisis to enable them to continue with their caregiving role.
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Affiliation(s)
- Perla Werner
- Department of Community Mental Health, University of Haifa, Mt. Carmel, Haifa 3498838, Israel;
| | - Aviad Tur-Sinai
- Department of Health Systems Management, The Max Stern Yezreel Valley College, Yezreel Valley 1930600, Israel;
- School of Nursing, University of Rochester Medical Center, Rochester, NY 14627-0446, USA
| | - Hanan AboJabel
- Department of Community Mental Health, University of Haifa, Mt. Carmel, Haifa 3498838, Israel;
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Parish AL. Opportunities for the advanced practice nurse in improving the wellbeing of older adults during the COVID-19 pandemic. Geriatr Nurs 2021; 42:605-607. [PMID: 33632614 PMCID: PMC8021454 DOI: 10.1016/j.gerinurse.2021.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The prevalence of stress, anxiety, and depression have increased during the coronavirus disease (COVID-19) pandemic across age groups. Older adults may additionally be experiencing accelerated cognitive decline and increased behavioral and psychological symptoms of dementia related to the pandemic and associated isolation precautions. The advanced practice nurse has an opportunity to holistically intervene to mitigate the negative effects of isolation and promote older adults' wellbeing during challenging times.
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Affiliation(s)
- Abby Luck Parish
- Director of Education Innovation and Associate Professor at Vanderbilt University, School of Nursing, Nashville, TN, United States.
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Hwang Y, Connell LM, Rajpara AR, Hodgson NA. Impact of COVID-19 on Dementia Caregivers and Factors Associated With their Anxiety Symptoms. Am J Alzheimers Dis Other Demen 2021; 36:15333175211008768. [PMID: 33853394 PMCID: PMC8573819 DOI: 10.1177/15333175211008768] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Little is known about the family experience of caregiving for persons living with dementia (PLWD) at home during the COVID-19 pandemic. The purpose of this study was to examine the influence of COVID-19 on concerns of current family caregivers of PLWD. Study participants were recruited from the parent study, Healthy Patterns Clinical Trial (NCT03682185). Data was collected from 34 caregivers via semi-structured telephone interviews. Over 70% of the study participants reported worrying about spreading COVID-19 to the PLWD, 41% reported they had taken on additional caregiving duties for others in their family since COVID-19, and 62% reported one or more anxiety symptoms. Dementia caregivers who reported anxiety symptoms reported lower scores on functional independence of their care recipients compared to dementia caregivers who did not report anxiety symptoms (p=0.036). Health care professionals should be alert to the concerns expressed by dementia caregivers for their well-being during this unprecedented pandemic.
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Affiliation(s)
- Yeji Hwang
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | | | | | - Nancy A. Hodgson
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA
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Azevedo LVDS, Calandri IL, Slachevsky A, Graviotto HG, Vieira MCS, de Andrade CB, Rossetti AP, Generoso AB, Carmona KC, Pinto LAC, Sorbara M, Pinto A, Guajardo T, Olavarria L, Thumala D, Crivelli L, Vivas L, Allegri RF, Barbosa MT, Serrano CM, Miranda-Castillo C, Caramelli P. Impact of Social Isolation on People with Dementia and Their Family Caregivers. J Alzheimers Dis 2021; 81:607-617. [PMID: 33814446 PMCID: PMC11185189 DOI: 10.3233/jad-201580] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND People with dementia and their family caregivers may face a great burden through social isolation due to the COVID-19 pandemic, which can be manifested as various behavioral and clinical symptoms. OBJECTIVE To investigate the impacts of social isolation due to the COVID-19 pandemic on individuals with dementia and their family caregivers. METHODS Two semi-structured questionnaires were applied via telephone to family caregivers of people diagnosed with dementia in three cities in Argentina, Brazil, and Chile, in order to assess clinical and behavioral changes in people with dementia and in their caregivers. RESULTS In general, 321 interviews were conducted. A significant decline in memory function has been reported among 53.0%of people with dementia. In addition, 31.2%of individuals with dementia felt sadder and 37.4%had increased anxiety symptoms. These symptoms of anxiety were greater in individuals with mild to moderate dementia, while symptoms of agitation were greater in individuals with severe dementia. Moreover, compulsive-obsessive behavior, hallucinations, increased forgetfulness, altered appetite, and increased difficulty in activities of daily living were reported more frequently among individuals with moderate to severe dementia. Caregivers reported feeling more tired and overwhelmed during this period and these symptoms were also influenced by the severity of dementia. CONCLUSION Social isolation during the COVID-19 pandemic triggered a series of negative behavioral repercussions, both for people with dementia and for their family caregivers in these three South American countries.
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Affiliation(s)
- Lílian Viana dos Santos Azevedo
- Behavioral and Cognitive Research Group, Department of Internal Medicine, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte (MG), Brazil
| | - Ismael Luis Calandri
- Department of Cognitive Neurology, Neuropsychology and Neuropsychiatry, FLENI, Buenos Aires, Argentina
| | - Andrea Slachevsky
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Memory and Neuropsychiatric Clinic (CMYN) Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department – ICBM, Neurocience and East Neuroscience Departments, Faculty of Medicine, University of Chile, Santiago, Chile
- Servicio de Neuroloǵıa, Departamento de Medicina, Cĺınica Alemana-Universidad del Desarrollo, Santiago, Chile
| | - Héctor Gastón Graviotto
- Cognitive Neurology and Neuropsychology Department, César Milstein Hospital, Buenos Aires, Argentina
| | - Maria Carolina Santos Vieira
- Faculdade Ciências Médicas de Minas Gerais/FELUMA, Belo Horizonte (MG), Brazil
- Geriatric Medicine – Rede Mater Dei de Saúde e AURUS Ensino e Pesquisa do Envelhecimento, Belo Horizonte (MG), Brazil
| | - Caíssa Bezerra de Andrade
- Behavioral and Cognitive Research Group, Department of Internal Medicine, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte (MG), Brazil
| | - Adriana Peredo Rossetti
- Faculdade Ciências Médicas de Minas Gerais/FELUMA, Belo Horizonte (MG), Brazil
- Geriatric Medicine – Rede Mater Dei de Saúde e AURUS Ensino e Pesquisa do Envelhecimento, Belo Horizonte (MG), Brazil
| | - Alana Barroso Generoso
- Geriatric Medicine – Rede Mater Dei de Saúde e AURUS Ensino e Pesquisa do Envelhecimento, Belo Horizonte (MG), Brazil
| | - Karoline Carvalho Carmona
- Behavioral and Cognitive Research Group, Department of Internal Medicine, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte (MG), Brazil
| | - Ludmilla Aparecida Cardoso Pinto
- Behavioral and Cognitive Research Group, Department of Internal Medicine, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte (MG), Brazil
| | - Marcos Sorbara
- Cognitive Neurology and Neuropsychology Department, César Milstein Hospital, Buenos Aires, Argentina
| | - Alejandra Pinto
- Memory and Neuropsychiatric Clinic (CMYN) Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile
| | - Tania Guajardo
- Memory and Neuropsychiatric Clinic (CMYN) Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile
| | - Loreto Olavarria
- Memory and Neuropsychiatric Clinic (CMYN) Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile
| | - Daniela Thumala
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Department of Psychology, Social Sciences Faculty, University of Chile, Santiago, Chile
| | - Lucía Crivelli
- Department of Cognitive Neurology, Neuropsychology and Neuropsychiatry, FLENI, Buenos Aires, Argentina
| | - Ludmila Vivas
- Department of Cognitive Neurology, Neuropsychology and Neuropsychiatry, FLENI, Buenos Aires, Argentina
| | - Ricardo Francisco Allegri
- Department of Cognitive Neurology, Neuropsychology and Neuropsychiatry, FLENI, Buenos Aires, Argentina
| | - Maira Tonidandel Barbosa
- Behavioral and Cognitive Research Group, Department of Internal Medicine, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte (MG), Brazil
- Faculdade Ciências Médicas de Minas Gerais/FELUMA, Belo Horizonte (MG), Brazil
| | - Cecilia M. Serrano
- Cognitive Neurology and Neuropsychology Department, César Milstein Hospital, Buenos Aires, Argentina
| | - Claudia Miranda-Castillo
- Faculty of Nursing, Universidad Andres Bello, Santiago, Chile
- Millennium Institute for Research in Depression and Personality, Santiago, Chile
| | - Paulo Caramelli
- Behavioral and Cognitive Research Group, Department of Internal Medicine, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte (MG), Brazil
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Abstract
The World Health Organization has declared the COVID-19 outbreak a pandemic. The causative agent for COVID-19 is an RNA virus of the Coronaviridae family. In addition to the respiratory and other complications, a significant proportion of COVID-19 patients show neurological manifestations. Dementia is a neurocognitive disorder, the prevalence of which is projected to increase in the coming decades. This review provides an overview of the effects of COVID-19 on dementia patients.
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Spalletta G, Porcari DE, Banaj N, Ciullo V, Palmer K. Effects of COVID-19 Infection Control Measures on Appointment Cancelation in an Italian Outpatient Memory Clinic. Front Psychiatry 2020; 11:599844. [PMID: 33329152 PMCID: PMC7733990 DOI: 10.3389/fpsyt.2020.599844] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 11/02/2020] [Indexed: 12/31/2022] Open
Abstract
Background: In the first wave of the COVID-19 pandemic in 2020, many countries made changes to the routine management of patients with non-communicable diseases, including neurocognitive disorders. Therefore, many "so-called" non-urgent elective procedures and outpatient appointments have been canceled or postponed, possibly impacting negatively on health and well-being of patients in the short- and long-term. Aim: Here, we aimed at describing numbers and types of outpatient appointments canceled as a result of government's restrictive measures in our memory clinic. Methods: The scheduled appointments at the memory clinic of the Santa Lucia Foundation IRCCS, Rome, Italy, are recorded in a comprehensive dataset under strict administrative control. Here, we compared appointments (first-time and follow-up) that were canceled from January to April 2020 with those of the corresponding months in 2019. Results: We observed a substantial decrease in appointments during 2020. The majority of scheduled appointments were follow-up, and about a quarter were first-time appointments. We estimated that 66.7% and 77.4% of patients missed out respectively their first and follow-up appointments in our memory clinic due to government's restrictive measures in March-April 2020. Conclusions: A large number of patients with neurocognitive disorders missed crucial appointments due to government's restrictive measures, and many experienced a delay in initial diagnosis and initiation of treatment. This has relevant impact on their treatment and consequently has (is still having and potentially will have) an increase on the healthcare service burden of clinics. Furthermore, as a second wave of COVID-19 affects Europe, and with winter approaching, it is a compelling priority to ensure easy and rapid access to appropriate assessment, care and treatment in the event of a new outbreak and potential subsequent lockdowns, with particular attention to the development of specific healthcare technologies customized to older persons with cognitive impairment.
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Affiliation(s)
- Gianfranco Spalletta
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy.,Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
| | - Desirée Estela Porcari
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy.,Department of Neuroscience, University of Rome Tor Vergata, Rome, Italy
| | - Nerisa Banaj
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Valentina Ciullo
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Katie Palmer
- Department of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy
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