Effect of COVID-19 quarantine on cognitive, functional and neuropsychiatric symptoms in patients with mild cognitive impairment and dementia

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.

A Telehealth Home-Based Exercise Program for Community-Dwelling Older People with Dementia in Indonesia: A Feasibility Study

“…An important and less recognized, indirect consequence of the pandemic is that it has left many older people, including those with dementia, who are vulnerable to greater risk for severe illness from infection [ 18 ] restricted to home, with reduced opportunities and resources available to support their ongoing participation in physical activity or exercise in the community [ 19 ]. Ongoing impacts of this is the potential for increased risk for falls, a decline in their physical function and negative impact on the cognitive and neuropsychiatric symptoms of older people with dementia [ 20 ]. Therefore, an intervention designed to increase physical activity levels for people with dementia and address these challenges is necessary.…”

The Impact of COVID-19 Lockdown Measures and COVID-19 Infection on Cognitive Functions: A Review in Healthy and Neurological Populations

“…[ 47 ]. During the long period (9 to 12 months), three studies reported a decrease in the patients’ overall cognitive status [ 27 , 50 , 51 ].…”

Older People Hospitalized for COVID-19: Prognostic Role of Multidimensional Prognostic Index and Other Prognostic Scores

“…At the same time, there is still a paucity of prognostic tools based on CGA that evaluate the impact of COVID-19 in older subjects, even if some recent reports suggested that the impact of the COVID-19 pandemic on frailty condition is largely independent of the direct effect of the virus [ 33 ]. Consistently, growing evidence brings attention to the burden of the indirect effects of COVID-19 (i.e., psychological distress, cognitive impairment, malnutrition and physical inactivity), which are reflected in multidimensional well-being [ 34 ]. Therefore, it is reasonable to think, particularly during this pandemic, that only a CGA-based approach is qualified to really capture and track the changes in frailty condition.…”