The silent deaths of the elderly in long-term care facilities during the Covid-19 pandemic: The role of forensic pathology

Cordasco, Fabrizio; Scalise, Carmen; Sacco, Matteo Antonio; Bonetta, Carlo Filippo; Zibetti, Angelica; Cacciatore, Giulia; Caputo, Fiorella; Ricci, Pietrantonio; Aquila, Isabella

doi:10.1177/0025817220930552

Cited by 11 publications

(10 citation statements)

References 12 publications

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“…Most COVID-19-related deaths have occurred in long-term care facilities, where patients with dementia are a significant part of the residents and require close contact for assistance in their daily care (Blackman et al, 2020;Cordasco et al, 2020). Blackman et al (2020) reported the rapid evolution of COVID-19 in a longterm care facility with 150 beds for individuals with dementia, where despite the preventive measures developed, within 3 weeks of the first confirmed COVID-19 case, 30 residents had died and more than 50 were confirmed cases or were having symptoms compatible for the disease.…”

Section: Covid-19 Indirect Effects In Patients With Dementiamentioning

confidence: 99%

Cognitive and Neuropsychiatric Manifestations of COVID-19 and Effects on Elderly Individuals With Dementia

Alonso‐Lana

Marquié

Ruiz

et al. 2020

Front. Aging Neurosci.

150

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The coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly spread worldwide and has had unprecedented effects in healthcare systems, economies and society. COVID-19 clinical presentation primarily affects the respiratory system causing bilateral pneumonia, but it is increasingly being recognized as a systemic disease, with neurologic manifestations reported in patients with mild symptoms but, most frequently, in those in a severe condition. Elderly individuals are at high risk of developing severe forms of COVID-19 due to factors associated with aging and a higher prevalence of medical comorbidities and, therefore, they are more vulnerable to possible lasting neuropsychiatric and cognitive impairments. Several reports have described insomnia, depressed mood, anxiety, post-traumatic stress disorder and cognitive impairment in a proportion of patients after discharge from the hospital. The potential mechanisms underlying these symptoms are not fully understood but are probably multifactorial, involving direct neurotrophic effect of SARS-CoV-2, consequences of long intensive care unit stays, the use of mechanical ventilation and sedative drugs, brain hypoxia, systemic inflammation, secondary effects of medications used to treat COVID-19 and dysfunction of peripheral organs. Chronic diseases such as dementia are a particular concern not only because they are associated with higher rates of hospitalization and mortality but also because COVID-19 further exacerbates the vulnerability of those with cognitive impairment. In patients with dementia, COVID-19 frequently has an atypical presentation with mental status changes complicating the early identification of cases. COVID-19 has had a dramatical impact in long-term care facilities, where rates of infection and mortality have been very high. Community measures implemented to slow the spread of the virus have forced to social distancing and cancelation of cognitive stimulation programs, which may have contributed to generate loneliness, behavioral symptoms and worsening of cognition in patients with dementia. COVID-19 has impacted the functioning of Memory Clinics, research programs and clinical trials in the Alzheimer's field, triggering the

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Section: Covid-19 Indirect Effects In Patients With Dementiamentioning

confidence: 99%

Cognitive and Neuropsychiatric Manifestations of COVID-19 and Effects on Elderly Individuals With Dementia

Alonso‐Lana

Marquié

Ruiz

et al. 2020

Front. Aging Neurosci.

150

View full text Add to dashboard Cite

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“…The 149 publications came from the following 26 countries: 52 from the USA [ 16 , 18 , 24 , 30 , 31 , 39 , 42 , 49 , 51 , 52 , 56 , 57 , 59–62 , 73 , 77–80 , 83 , 85 , 91–93 , 95–98 , 100 , 103 , 104 , 107–112 , 115 , 117–119 , 123 , 135 , 143 , 144 , 149 , 152 , 157 , 160 , 162 ], 13 from China [ 36 , 72 , 102 , 105 , 120 , 137–139 , 147 , 153 , 154 , 163 , 164 ], 13 from Italy [ 26 , 33 , 34 , 40 , 41 , 43 , 55 , 58 , 121 , 131 , 141 , 146 , 148 ], ten from the United Kingdom [ 21 , 29 , 44 , 48 , 63 , 89 , 113 , 130 , …”

Section: Resultsmentioning

confidence: 99%

Older people at the beginning of the COVID-19 pandemic: A scoping review

Gaertner¹,

Fuchs²,

Mohler³

et al. 2021

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This scoping review focuses on evidence gaps regarding the effects on health, social participation and life contexts of older people at the beginning of the COVID-19 pandemic. It is based on a systematic search strategy of the international literature covering a period between December 2019 and June 2020. The review is supplemented by a search of the websites of selected organisations in Germany (cut-off date: 29 June 2020). Search hits were differentiated by types of publication (empirical study, review, discussion paper). The contents were summarised in tabular form according to topic. The publications mainly discussed the high risks of suffering severe courses of COVID-19 faced by older people, specifically those belonging to certain subgroups. In addition, further main topics were the pandemic’s indirect impacts on physical and mental health, physical and cognitive functions and participation in society. Social isolation, loneliness, reduced levels of physical activity and difficulties in maintaining care were discussed as major health risks. Ageism was an issue that was addressed across all of the identified topics. The publications highlighted the need, but also the opportunity, for raising public awareness of the needs of older people in various life contexts. Publications pointed to the urgent need for research into the biological and social causes of older peoples’ high infection risk and how measures could be adapted in a differentiated manner (infection prevention and control measures, social support, medical and nursing care).

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“…Of relevance here, rapidly changing information and public health measures in relation to COVID-19 can heighten feelings of uncertainty about the future. Carers of people with dementia living in long-term care facilities may also experience increased uncertainty about the future as a result of visitation bans and disproportionately high rates of infection and death in long-term care residents worldwide 25 , 42 . Worsened carer mental health since the outbreak of COVID-19 was also associated with greater loneliness.…”

Section: Discussionmentioning

confidence: 99%

The effects of the COVID-19 pandemic on neuropsychiatric symptoms in dementia and carer mental health: an international multicentre study

Wei

Diehl‐Schmid

Matías‐Guiu

et al. 2022

Sci Rep

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As a global health emergency, the rapid spread of the novel coronavirus disease (COVID-19) led to the implementation of widespread restrictions (e.g., quarantine, physical/social distancing measures). However, while these restrictions reduce the viral spread of COVID-19, they may exacerbate behavioural and cognitive symptoms in dementia patients and increase pressure on caregiving. Here, we aimed to assess the impact of COVID-19 and related restrictions on both carers and people living with dementia across the world. We conducted an international survey (Australia, Germany, Spain, and the Netherlands) to assess the impact of COVID-19 on carers and people living with dementia. People with dementia experienced worsened neuropsychiatric symptoms since the outbreak of COVID-19, most commonly, depression, apathy, delusions, anxiety, irritability, and agitation. Regression analyses revealed that limited understanding of the COVID-19 situation and not living with the carer was associated with worsened neuropsychiatric symptoms. Carers also reported a decline in their own mental health, increased stress and reduced social networks as a result of COVID-19 and related restrictions. Regression analyses revealed uncertainty about the future and loneliness were associated with worsened carer mental health. Findings from this study will inform strategies for the development of support services and compassionate protocols that meet the evolving needs of those living with dementia and their carers.

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The silent deaths of the elderly in long-term care facilities during the Covid-19 pandemic: The role of forensic pathology

Cited by 11 publications

References 12 publications

Cognitive and Neuropsychiatric Manifestations of COVID-19 and Effects on Elderly Individuals With Dementia

Cognitive and Neuropsychiatric Manifestations of COVID-19 and Effects on Elderly Individuals With Dementia

Older people at the beginning of the COVID-19 pandemic: A scoping review

The effects of the COVID-19 pandemic on neuropsychiatric symptoms in dementia and carer mental health: an international multicentre study

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