COVID-19 and the forgotten pandemic: follow-up of neurocognitive disorders during lockdown in Argentina

Abstract

Introduction Health systems in numerous countries around the world are suffering a serious burden as a consequence of the COVID-19 pandemic. As a result of this situation, the follow-up of such chronic diseases as dementia may be at risk. Similarly, neuropsychiatric complications related to lockdown measures may also be neglected; Argentina’s lockdown has been the longest implemented in Latin America. This study aims to determine the frequency of the different types of medical consultations for neurocognitive disorders and the predictors for requiring consultation since the beginning of the lockdown. Methods We performed a descriptive, observational, cross-sectional study based on data collected through an online survey. Results Data were collected on 324 participants, with 165 (50.9%) having had at least one medical consultation. Consultations were held by telephone in 109 cases (33.6%), by e-mail in 62 (19.1%), by video conference in 30 (9.3%), and at the emergency department in 23 (7.1%). Predictors of requiring consultation were Clinical Dementia Rating scores ≥1 ( P < .001) and diagnosis of Alzheimer disease ( P = .017). Higher Neuropsychiatric Inventory scores were found in the group of respondents who did require medical consultation ( P < .001), but no significant differences were found between groups for Zarit Burden Interview scores. Conclusion We identified a high prevalence of behavioural disorders and caregiver burden during lockdown. Nevertheless, only 50% of respondents had sought medical consultation (by telephone or email in 52.7% of cases). Care of people with dementia must be emphasised, guaranteeing follow-up of these patients.

Impact of Social Isolation on People with Dementia and Their Family Caregivers

“…Several behavioral and psychological changes due to deprivation or reduced social contact during the pandemic period have also been reported, such as increased anxiety, agitation, and depression [16][17][18]. However, few studies have addressed these impacts on the population with dementia [19][20][21]. A recent study conducted in Italy evaluated neuropsychiatric changes among individuals with dementia and their caregivers during the lockdown period and found that there had been large increases in complaints of these symptoms in about two-thirds of both the patients and the caregivers [22].…”

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

“…The majority of the studies (n = 16) were conducted in the European continent, [13][14][15][23][24][25][26][27][28][29][30][31][32][33][34][35] and the remainder (n = 5) in the Americas. 5,12,[36][37][38] Eight of these studies were cohort studies, and 13 were cross-sectional studies (Table 1). Three studies did not specify the type of dementia.…”

“…1) with 21 articles meeting the inclusion criteria (composite sample: N = 7139, range 18–4913, 4.0% MCI, mean age 75.6 ± 7.9 years, 60.0% female). The majority of the studies ( n = 16) were conducted in the European continent, 13–15,23–35 and the remainder ( n = 5) in the Americas 5,12,36–38 . Eight of these studies were cohort studies, and 13 were cross‐sectional studies (Table 1).…”

“…15 Based on the results of 12 other studies, the most common aggravated reported NPS were depression, anxiety, agitation, irritability, and apathy during lockdown. 5,[12][13][14][15][30][31][32][33][34][36][37][38] The rate of incidence was not specified in three studies, only pre-and post-COVID-19 crisis outbreak values were compared. 13,30,33 The two studies including different populations and conducted by El Haj et al determined that higher levels of depression and anxiety were recorded during compared to before the pandemic.…”

“…5,12,14,31,34,[36][37][38] Seven studies showed that incidence of depression was very common during lockdown (23.3%-61.5%). 12,14,31,32,34,36,38 Four studies showed an increase in agitation and aggression (20.7%-36.4%) and showed an increase in irritability (20.7%-49.4%), 5,31,36,38 while four studies similarly revealed that apathy increased (24.1%-48.1%) compared to pre-lockdown. 31,34,36,38 Unlike the aforementioned studies, Cagnin et al examined the frequency of new onset NPS with aggravated NPS and showed that aggravated and new-onset NPS were similar, but sleep disorder was one of the most commonly observed new onset NPS.…”