COVID-19 Epidemic in Argentina: Worsening of Behavioral Symptoms in Elderly Subjects With Dementia Living in the Community

Cohen, Gabriela; Russo, María Julieta; Campos, Jorge; Allegri, Ricardo

doi:10.3389/fpsyt.2020.00866

Cited by 66 publications

(118 citation statements)

References 30 publications

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“…Changes in medication were reported in 26% of the cases. This is close to the 27% increase reported by Cagnin et al, (Cagnin et al, 2020), the 20% increase reported by Cohen et al (Cohen et al, 2020) and far higher than the 7% reported by Canevelli et al (Cavenelli et al, 2020). As in previous studies, many of the changes had to do with commencement or increase in the use of antipsychotics, benzodiazepines and antidepressants.…”

Section: Discussionsupporting

confidence: 85%

“…The questions were informed by emerging evidence from research in the field (Lara et al, 2020; Canevelli et al, 2020; Cohen et al, 2020; Boutoleau-Bretonniere et al, 2020; Cagning et al, 2020) and feedback from the experience of the Direct Support Team at RDS and clinical experience. Three variations in the survey questions were produced to suit the three types of respondents approached:…”

Section: Methodsmentioning

confidence: 99%

“…The lockdown and the first wave of Covid-19, in general, has had a detrimental impact on people with dementia, both for those living in the community and care homes. The main changes reported in people living with dementia under lockdown are worsening of behavioural and psychological symptoms (including apathy, depression, agitation, anxiety and irritability and walking with purpose), followed by decline in functional abilities for daily living (Lara et al, 2020; Canevelli et al, 2020; Cohen et al, 2020; Boutoleau-Bretonniere et al, 2020; Cagning et al, 2020) and increased used of antipsychotics (Howard et al, 2020). For those in care homes (usually in later stages of the disease and with more severe symptoms) a decline in cognition and ability to perform activities of daily living and an increase in depression and anxiety have been reported (El Haj et al, 2020; O’Caoimh et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The impact of the first UK Covid-19 lockdown on carers and people living with low prevalence dementia: results from the Rare Dementia Support survey

González

Harding

Zimmerman

et al. 2020

Preprint

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IntroductionThe public health measures imposed to contain Covid-19 during the first UK lockdown resulted in significant changes in the provision of community support and care for people with dementia. People with low prevalence and young-onset dementias often experience non-memory, behavioural or neuropsychiatric symptoms that require specialised support.ObjectiveWe explored the impact of the first Covid-19 lockdown on people living with low prevalence and young-onset dementia and their carers in the UK.MethodAn online survey, including eleven questions about the impact of the lockdown on both the person with dementia and their family caregivers was conducted. Participants were people living with dementia and caregivers who are members of the UK national-reach organisation Rare Dementia Support.Results184 carers and 24 people with dementia completed the survey. People with dementia experienced worsening of cognitive symptoms (70%), ability to do things (62%) and well-being (57%) according to their carers. Carers also reported a reduction in the support received for caring (55%). 93% of carers of people living in care homes reported a reduction in their ability to provide care. 26% of carers reported changes in the medication of the person with dementia during the lockdown. 74% of people with dementia reported decreased ability to connect with people socially.ConclusionsPeople with dementia experienced a worsening of dementia symptoms, removal of support and increased difficulty to connect with other people socially during the 1st wave of Covid-19. Carers encountered barriers to both receiving and providing support and a decline in their own mental health and well-being.Key points70 % of carers reported cognitive symptoms getting worse during the lockdown (e.g., the person with dementia being more disoriented and finding it more difficult to communicate).26 % of carers reported a change (initiation or increase) in medication in the person with dementia during the lockdown.79 % carers reported their own physical or mental health getting worse due to the lockdown. This increased to 93% when considering responses only from family carers of people living in care homes.93 % of family carers of people living in care homes found it harder to continue providing care and support for their relative due to Covid-19.

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Section: Discussionsupporting

confidence: 85%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The impact of the first UK Covid-19 lockdown on carers and people living with low prevalence dementia: results from the Rare Dementia Support survey

González

Harding

Zimmerman

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Moreover, the social restrictions and increased isolation may lead to increased negative effects on memory disorders and neuropsychiatric symptoms of older people with NCD (18,19). In fact, recent data on this topic reported an increase of behavioral symptoms in elderly with dementia (8)(9)(10). It is also possible that there may be an increased need for assessment of new patients in geriatric psychiatry settings as a result of the negative consequence of quarantine and social distancing measures.…”

Section: Discussionmentioning

confidence: 99%

“…Many countries have employed similar restrictive measures (2-4) and have made changes to the routine management of patients with non-communicable diseases [e.g., canceling "so-called" non-urgent appointments, which have important implications for the identification and treatment, and therefore for the progression of these chronic conditions (5)]. Although the focus on procedures to urgently slow SARS-CoV-2 infection rates and minimize the number of infected individuals has extreme importance, it has short-and long-term negative consequences on health and well-being of patients with non-communicable diseases, including neurocognitive disorders (NCD) (6)(7)(8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

Effects of COVID-19 Infection Control Measures on Appointment Cancelation in an Italian Outpatient Memory Clinic

et al. 2020

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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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Rates of Antipsychotic Drug Prescribing Among People Living With Dementia During the COVID-19 Pandemic

et al. 2023

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ImportanceConcerns have been raised that the use of antipsychotic medication for people living with dementia might have increased during the COVID-19 pandemic.ObjectiveTo examine multinational trends in antipsychotic drug prescribing for people living with dementia before and during the COVID-19 pandemic.Design, Setting, and ParticipantsThis 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.ExposuresThe introduction of population-wide COVID-19 restrictions from April 2020 to the latest available date of each database.Main Outcomes and MeasuresThe 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.ResultsA 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 RelevanceThis 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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COVID-19 Epidemic in Argentina: Worsening of Behavioral Symptoms in Elderly Subjects With Dementia Living in the Community

Abstract: necessary to develop a plan of action to help dementia subjects deal with the increased stress that this epidemic imposed on them.

Cited by 66 publications

References 30 publications

The impact of the first UK Covid-19 lockdown on carers and people living with low prevalence dementia: results from the Rare Dementia Support survey

The impact of the first UK Covid-19 lockdown on carers and people living with low prevalence dementia: results from the Rare Dementia Support survey

Effects of COVID-19 Infection Control Measures on Appointment Cancelation in an Italian Outpatient Memory Clinic

Rates of Antipsychotic Drug Prescribing Among People Living With Dementia During the COVID-19 Pandemic

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