The impact of lockdown during SARS-CoV-2 outbreak on behavioral and psychological symptoms of dementia

Abstract

Background During Covid-19 pandemic, the Italian government adopted restrictive limitations and declared a national lockdown on March 9, which lasted until May 4 and produced dramatic consequences on people’s lives. The aim of our study was to assess the impact of prolonged lockdown on behavioral and psychological symptoms of dementia (BPSD). Methods Between April 30 and June 8, 2020, we interviewed with a telephone-based questionnaire the caregivers of the community-dwelling patients with dementia who had their follow-up visit scheduled from March 9 to May 15 and canceled due to lockdown. Among the information collected, patients’ BPSDs were assessed by the Neuropsychiatric Inventory (NPI). Non-parametric tests to compare differences between NPI scores over time and logistic regression models to explore the impact of different factors on BPSD worsening were performed. Results A total of 109 visits were canceled and 94/109 caregivers completed the interview. Apathy, irritability, agitation and aggression, and depression were the most common neuropsychiatric symptoms experienced by patients both at baseline and during Covid-19 pandemic. Changes in total NPI and caregiver distress scores between baseline and during lockdown, although statistically significant, were overall modest. The logistic regression model failed to determine predictors of BPSD worsening during lockdown. Conclusion This is one of the first studies to investigate the presence of BPSD during SARS-CoV-2 outbreak and related nationwide lockdown, showing only slight, likely not clinically relevant, differences in BPSD burden, concerning mostly agitation and aggression, anxiety, apathy and indifference, and irritability.

Neuropsychiatric Symptoms in Patients With Alzheimer’s Disease During SARS-COV-2 Pandemic in Peru

“…It is striking that no other study has so far reported sleep disorder as a worsening of a pre-existing neuropsychiatric symptom. 25,30 In contrast, agitation-aggression has been reported as a frequent symptom, similar to aberrant motor behavior in patients with AD and frequent neuropsychiatric symptoms when evaluating all dementias in general 25,30,33 (Table 4); however, a minor increase was observed in our study, but it was not significant. The new-onset neuropsychiatric symptoms during pandemic lockdown were reported as a higher frequency in AD (26.7%) than other dementias; in this same study from Cagnin A. et al, the most common symptoms reported were sleep disorders, irritability, and agitation-aggression.…”

Living with dementia under COVID-19 restrictions: coping and support needs among people with dementia and carers from the IDEAL cohort

“…Several surveys have documented increases in symptoms during similar COVID-19 restrictions among a signi cant proportion of people with dementia such as psychological distress (Giebel et al 2021, Manini et al 2021, cognitive worsening (Canavelli et al 2020) with impacts on communication and mood (Tsapanou et al 2021) and falls (Barguilla et al 2020). Stress has been observed among a signi cant proportion of carers (Altieri andSantangelo 2021, Caneyville et al 2020;Cagnino et al 2020).…”

Impact of COVID-19 on ‘living well’ with mild-to-moderate dementia in the community: findings from the IDEAL cohort

“…Where asked, people with dementia themselves were concerned about declining skills and abilities [10][11][12][13][14]. Increases in neuropsychiatric symptoms, behaviour problems, depression, anxiety, and loneliness were also reported by carers [11,[15][16][17][18][19][20][21][22][23], although some studies found only limited impacts in these areas [24,25]. For example, Thyrian, et al [24] observed rates of depression, anxiety, and loneliness that were comparable to or even lower than age-equivalent norms for the general population of older people recorded before the pandemic.…”