The Impact of the COVID-19 Pandemic and Lockdown on Mild Cognitive Impairment, Alzheimer's Disease and Dementia With Lewy Bodies in China: A 1-Year Follow-Up Study

Abstract

Background: While the lockdown strategies taken by many countries effectively limited the spread of COVID-19, those were thought to have a negative impact on older people. This study aimed to investigate the impact of lockdown on cognitive function and neuropsychiatric symptoms over a 1-year follow-up period in patients with mild cognitive impairment (MCI), Alzheimer's disease (AD) and dementia with Lewy bodies (DLB).Methods: We enrolled consecutive patients with MCI, probable AD or DLB who were receiving outpatient memory care before the COVID-19 pandemic and followed-up with them after 1 year by face-to-face during the COVID-19 pandemic to assess changes in physical activity, social contact, cognitive function and neuropsychiatric symptoms (NPS).Results: Total 105 probable AD, 50 MCI and 22 probable DLB patients were included and completed the 1-year follow-up between October 31 and November 30, 2020. Among the respondents, 42% of MCI, 54.3% of AD and 72.7% of DLB patients had a decline in MMSE scores and 54.4% of DLB patients had worsening Neuropsychiatric inventory (NPI) scores. Patients with DLB showed a more rapid decline of MMSE than those with AD. Diminished physical activity and social contact might have hastened the deterioration of cognition and the worsening of NPS.Conclusion: Social isolation and physical inactivity even after strict lockdown for at least 6 months were correlated with accelerated decline of cognitive function and NPS in patients with AD and DLB.

New Recovery Strategies in Motor and Cognitive Functions, before, during and after Home-Confinement COVID-19, for Healthy Adults and Patients with Neurodegenerative Diseases: Review

“…Other tools can assess signs and symptoms of neurodegenerative diseases related to motor and cognitive dysfunctions well as their changes during the period of social isolation imposed by the spread of SARS infection-Cov-2: for Alzheimer' Disease; these include the Consortium to Establish a Registry for Alzheimer's Disease (CERAD-Plus) [19], the Clinical Dementia Rating Scale (CDR) [34], Hamilton Depression Rating (HAMD), Epworth Sleepiness Scale (ESS), Activities Daily Living (ADL) and Neuropsychiatric Inventory (NPI) [35].…”

“…For 177 older adults with mild cognitive impairment (50), Alzheimer' disease (105) and dementia with Lewy bodies, which performed activities daily living (ADL) stimulated by caregivers, demonstrated delayed mental and physical deterioration. Monitoring was demonstrated by evaluation of the scores of MOCA, NPI, HAMD, and ESS tools [35]. Another study investigated by telephone semi-structured interview, 4710 patients of which 2809 female and 1901 male, split in 2355 pairs with caregivers, with Alzheimer' disease, Dementia with Lewy body disease, Frontotemporal dementia and Vascular dementia, which performed activities daily living (ADL).…”

“…Physical activity (PA) has been studied in terms of types of physical activity and is presented in Figure 3. [9,13,26,[30][31][32][33][34][35]38,39,41].…”

“…Table 2 presents the tools discussed, the characteristics, physical activities performed, interventions and conclusions derived from the studies on patients with neurodegenerative diseases. [9,13,26,[30][31][32][33][34][35]38,39,41].…”

“…Chen [35] took into consideration the relationship between PA and cognitive, neuropsychiatric symptoms and observed that PA had the most important decrease during one year with a DLB group of patients (p ≤ 0.001). At the same time, the PA level showed a sudden decrease and was correlated with the MMSE score.…”