The Effects of Confinement on Neuropsychiatric Symptoms in Alzheimer’s Disease During the COVID-19 Crisis

Abstract

Background: Neuropsychiatric symptoms, such as depression, anxiety, apathy, agitation, and hallucinations, are frequent in Alzheimer's disease (AD) and their prevalence tends to increase with external stressors. Objective: We offer the first investigation of the effects of confinement during the COVID-19 crisis on neuropsychiatric symptoms in patients with AD. Methods: We contacted caregivers of 38 patients with AD who were confined to their homes for nearly two months and asked them to report whether patients experienced any change in neuropsychiatric symptoms during, compared to before, the confinement and rate its severity and impact on themselves using the Neuropsychiatric Inventory-Questionnaire. Results: Among the 38 patients, only 10 demonstrated neuropsychiatric changes during the confinement. Cognitive function of these 10 patients, assessed with the Mini-Mental State Examination, was worse than that of patients who did not demonstrate neuropsychiatric changes. Interestingly, among the 10 patients with neuropsychiatric changes, the duration of confinement significantly correlated with the severity of symptoms as well as with their caregivers' distress. Discussion: The confinement seems to impact neuropsychiatric symptomatology in AD patients with low baseline cognitive function.

Impact of COVID-19 related social support service closures on people with dementia and unpaid carers: a qualitative study

“…This is likely to be due to the lack of mental stimulation, which is linked with levels of cognition in dementia (Woods, Aguirre, Spector, & Orrell, 2012). Recent early evidence into cognitive and behavioural symptomatology in dementia since the pandemic supports this notion (Boutoleau-Bretonni ere et al, 2020;Canevelli et al, 2020), posing a large concern for the increased care needs of PLWD. Increased levels of dependency became particularly difficult for those unpaid carers who suddenly had to take over care that was usually provided by paid carers.…”

Coping with Dementia in the Middle of the COVID-19 Pandemic

“…However, reduced social contact and physical activity during isolation may have also induced these changes. 55 Also, AD patients are more vulnerable to infection because it is difficult to restrict physical contact with others in situations that require physical care.…”

“… 77 Tele-counselling hotlines can aid in relieving suffering related to BPSD symptoms. In addition, family members often feel tired and stressed due to long-term care of dementia patients 55 66 ; thus, it is important to share the burden of care with other family members or caregivers. This can be accomplished by making “care and rest” schedules.…”

“…In addition to neuropsychiatric symptom severity in dementia patients, longer confinement durations have also been correlated with caregiver distress. 55 Family caregivers of patients with AD are sometimes referred to as “invisible second patients,” 90 and as a medical community, we need to be aware of their stress as well. Moreover, financial problems, such as sudden job loss due to the economic shutdown, may compound stress among caregivers.…”

The Effects of COVID-19 and Quarantine Measures on the Lifestyles and Mental Health of People Over 60 at Increased Risk of Dementia

“…On the other hand, these researches enrolled seniors without cognitive impairment. It was observed that the COVID-19 related confinement aggravated the behavioral and psychological symptoms of community-dwelling older adults with mild cognitive impairment (MCI) or mild dementia, with agitation, apathy, and aberrant motor activity being the most affected symptoms ( 29 , 30 ). A phone-based survey conducted by Goodman-Casanova et al ( 31 ) in order to explore the well-being and the physical and mental health impact in community-dwelling older adults with MCI or mild dementia during the quarantine also showed that 46.1% participants reported negative experiences, such as fear of become infected or infecting family members, frustration and boredom involving not being able to take part in daily activities, loss of usual routine and social isolation.…”