Background COVID-19 forced the implementation of restrictive measures in Spain, such as lockdown, home confinement, social distancing, and isolation. It is necessary to study whether limited access to basic services and decreased family and social support could have deleterious effects on cognition, quality of life, and mental health in vulnerable older people. Objective This study aims to explore the impact of the COVID-19 outbreak on cognition in older adults with mild cognitive impairment or dementia as the main outcome and the quality of life, perceived health status, and depression as secondary outcomes and to analyze the association of living alone and a change in living arrangements with those outcomes and other variables related with the use of technology and health services. Likewise, this study aims to analyze the association of high and low technophilia with those variables, to explore the access and use of health care and social support services, and, finally, to explore the informative-, cognitive-, entertainment-, and socialization-related uses of information and communications technologies (ICTs) during the COVID-19 outbreak. Methods This cohort study was conducted in Málaga (Spain). In total, 151 participants with mild cognitive impairment or mild dementia, from the SMART4MD (n=75, 49.7%) and TV-AssistDem (n=76, 50.3%) randomized clinical trials, were interviewed by telephone between May 11 and June 26, 2020. All participants had undergone 1-3 assessments (in 6-month intervals) on cognition, quality of life, and mood prior to the COVID-19 breakout. Results The outbreak did not significantly impact the cognition, quality of life, and mood of our study population when making comparisons with baseline assessments prior to the outbreak. Perceived stress was reported as moderate during the outbreak. After correction for multiple comparisons, living alone, a change in living arrangements, and technophilia were not associated with negative mental health outcomes. However, being alone was nominally associated with self-perceived fear and depression, and higher technophilia with better quality of life, less boredom, perceived stress and depression, and also less calmness. Overall, health care and social support service access and utilization were high. The most used ICTs during the COVID-19 outbreak were the television for informative, cognitive, and entertainment-related uses and the smartphone for socialization. Conclusions Our findings show that the first months of the outbreak did not significantly impact the cognition, quality of life, perceived health status, and depression of our study population when making comparisons with baseline assessments prior to the outbreak. Living alone and low technophilia require further research to establish whether they are risk factors of mental health problems during lockdowns in vulnerable populations. Moreover, although ICTs have proven to be useful for informative-, cognitive-, entertainment-, and socialization-related uses during the pandemic, more evidence is needed to support these interventions. Trial Registration ClinicalTrials.gov NCT04385797; https://clinicaltrials.gov/ct2/show/NCT04385797 International Registered Report Identifier (IRRID) RR2-10.2196/26431
Bipolar disorder (BD) is a multifactorial chronic psychiatric disease highly defined by genetic, clinical, environmental and social risk factors. The present systematic review and meta-analysis aimed to examine the relationship between inflammatory and neurotrophic factors and clinical, social and environmental factors involved in the development and the characterization of BD. Web of Science, PubMed, PsycINFO, Scopus and Science Direct were searched by two independent reviewers. The systematic review was registered in PROSPERO (CRD42020180626). A total of 51 studies with 4547 patients with a diagnosis of BD were selected for systematic review. Among them, 18 articles were included for meta-analysis. The study found some evidence of associations between BDNF and/or inflammatory factors and different stressors and functional and cognitive impairment, but limitations prevented firm conclusions. The main finding of the meta-analysis was a negative correlation between circulating levels of BDNF and depression severity score (standardized mean difference = −0.22, Confidence Interval 95% = −0.38, −0.05, p = 0.01). Evidence indicates that BDNF has a role in the depressive component of BD. However, the poor consistency found for other inflammatory mediators clearly indicates that highly controlled studies are needed to identity precise biomarkers of this disorder.
Background The COVID-19 pandemic has led to worldwide implementation of unprecedented restrictions to control its rapid spread and mitigate its impact. The Spanish government has enforced social distancing, quarantine, and home confinement measures. Such restrictions on activities of daily life and separation from loved ones may lead to social isolation and loneliness with health-related consequences among community-dwelling older adults with mild cognitive impairment or mild dementia and their caregivers. Additionally, inadequate access to health care and social support services may aggravate chronic conditions. Home-based technological interventions have emerged for combating social isolation and loneliness, while simultaneously preventing the risk of virus exposure. Objective The aim of this cohort study is to explore, analyze, and determine the impact of social isolation on (1) cognition, quality of life, mood, technophilia, and perceived stress among community-dwelling older adults with mild cognitive impairment or mild dementia and on the caregiver burden; (2) access to and utilization of health and social care services; and (3) cognitive, social, and entertainment-related uses of information and communication technologies. Methods This study will be conducted in Málaga (Andalucía, Spain). In total 200 dyads, consisting of a person with mild cognitive impairment or mild dementia and his/her informal caregiver, will be contacted by telephone. Potential respondents will be participants of the following clinical trials: support, monitoring, and reminder technology for mild dementia (n=100) and television-based assistive integrated service to support European adults living with mild dementia or mild cognitive impairment (n=100). Results As of May 2021, a total of 153 participants have been enrolled and assessed during COVID-19 confinement, of whom 67 have been assessed at 6 months of enrollment. Changes in the mean values of the variables will be analyzed relative to baseline findings of previous studies with those during and after confinement, using repeated-measures analysis of variance or the nonparametric Friedman test, as appropriate. The performance of multivariate analysis of covariance (ANCOVA) to introduce potential covariates will also be considered. Values of 95% CI will be used. Conclusions If our hypothesis is accepted, these findings will demonstrate the negative impact of social isolation owing to COVID-19 confinement on cognition, quality of life, mood, and perceived stress among community-dwelling older adults with mild cognitive impairment and mild dementia, the impact on technophilia, caregiver burden, the access to and utilization of health and social care services, and the cognitive, social, and entertainment-related use of information and communication technologies during and after COVID-19 confinement. Trial Registration ClinicalTrials.gov NCT04385797; https://clinicaltrials.gov/ct2/show/NCT04385797 International Registered Report Identifier (IRRID) DERR1-10.2196/26431
BACKGROUND Coronavirus disease 2019 has forced worldwide the implementation of unprecedented restrictions to control its rapid spread and mitigate its impact. The Spanish government has enforced social distancing, quarantine and home confinement. This restriction of daily life activities and separation from loved ones may lead to social isolation and loneliness with health-related consequences in community-dwelling older adults with mild cognitive impairment or mild dementia and their caregivers. Additionally, an inadequate access to healthcare and social support services may aggravate chronic conditions. Technology home-based interventions emerge for combating social isolation and loneliness preventing the risk of viral exposure. OBJECTIVE The aim of this cohort study is to explore, analyze and determine the impact of social isolation on: 1) cognition, quality of life, mood, technophilia and perceived stress of community-dwelling older adults with mild cognitive impairment or mild dementia, and on caregiver burden; 2) health and social care services access and utilization, and 3) cognitive, social and entertainment use of ICTs. METHODS This study will be conducted in the Spanish region of Andalucía (Málaga). In total 200 dyads, consisting of a person with mild cognitive impairment or mild dementia (PMCI/MD) and their informal caregiver will be contacted by telephone. Potential respondents will be participants of the SMART 4 MD (N=100) and TV-AssistDem (N=100) clinical trials. RESULTS The change in means in the variables will be analyzed comparing baseline results in the previous studies with those during and after confinement using the ANOVA test of repeated measures or the non-parametric Friedman test if appropriate. The performance of a multivariate analysis of variance (ANCOVA) to introduce possible covariates will also be contemplated. A 95% confidence level will be used. CONCLUSIONS If the hypothesis is proven, these findings will demonstrate the negative impact of social isolation due to the COVID-19 confinement on cognition, quality of life, mood, and perceived stress of community-dwelling older adults with mild cognitive impairment and mild dementia, the impact on technophilia, caregiver burden, and health and social care services access and utilization; and the cognitive, social and entertainment use of ICTs during the COVID-19 confinement and afterwards. CLINICALTRIAL NCT: 04385797
BACKGROUND Coronavirus disease 2019 has forced the implementation of restrictive measures to control its viral spread and avoid the serious collapse of health systems worldwide. The Spanish government enforced lockdown, home confinement, social distancing and isolation. Limited access to basic services, and decreased family and social support have deleterious effects on physical and mental health, quality of life and cognition. Technology home-based interventions reduce the risk of viral exposure and prevent the health-related negative outcomes of social isolation through: healthcare delivery, cognitive stimulation, social connection, information sharing, and leisure entertainment. OBJECTIVE The aims of this cohort study were: 1) to explore the impact of social isolation resulting from restrictive measures on cognition, quality of life, mood and perceived stress on community-dwelling older adults with mild cognitive impairment or mild dementia; 2) to analyze how living alone and attitude towards technologies affect mental health; 3) to determine healthcare and social support services access and utilization; and finally; 3) to explore the informative, cognitive, entertainment, and social related uses of ICTs during the COVID-19 outbreak . METHODS This cohort study was conducted in the Spanish region of Andalucía (Málaga). In total 151 participants with mild cognitive impairment or mild dementia (PMCI/MD), from the SMART 4 MD (n=75) and TV-AssistDem (n=76) randomized clinical trial, were interviewed by telephone between May 11 and June 26 2020. The R version 4.0.4 program was used for all statistical analysis. RESULTS Of the respondents, 97/151 (64.2%) were women. The mean age was 74.31 years (SD 6.48), and 36/151 (23.8%) lived alone. Our findings show that the first months of the outbreak did not significantly impact the cognition, quality of life and mood of our study population when making comparisons with baseline assessments prior to the outbreak, and perceived stress was reported as moderate during the outbreak. Living alone was found a risk factor for fear, and higher technophilia was associated with less negative mental health outcomes. Overall, healthcare and social support services access and utilization was high. The most used ICTs during the COVID-19 outbreak were the Television for informative, cognitive, and entertainment related uses; and the SmartPhone for socialization. CONCLUSIONS While COVID-19 restrictions have demonstrated being effective in viral spread prevention, they have had negative effects in health and well-being and have changed lifestyles worldwide. Our study shows how a presumably vulnerable population of elderly with cognitive impairment has shown more resilience to restrictive measures than expected, experiencing no decline in cognition, quality of life or mood during the period of the COVID-19 outbreak. They reported overall well-being, maintained sleep quality, moderate perceived stress and low depression. Furthermore, findings show how a positive attitude towards technology is associated with less perceived stress, depression and boredom. CLINICALTRIAL NCT 04385797 May 13, 2020 INTERNATIONAL REGISTERED REPORT RR2-10.2196/26431
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