COVID-19: challenges for dementia care and research

Abstract

ABSTRACT. The COVID-19 pandemic has raised significant concerns about the management and care for people with dementia and their caregivers. In this context, this work will discuss how social isolation or social distancing caused by the pandemic may impact the clinical management of people with dementia, caregivers’ health, and dementia research. The pandemic disrupts all forms of social interaction and may increase the behavioral impairment of people with dementia. Regarding pharmacological treatment, telemedicine is an option, but the context of social isolation raises questions about how to manage people with dementia with lack of cognitive stimulation and non-pharmacological treatment. In addition, the impact of the pandemic on caregivers should be considered. There is some evidence that telephone counseling can reduce depressive symptoms of caregivers of people with dementia. In dementia research, social isolation imposes researchers to modify their study protocols in order to continue collecting data by developing remote tools to assess the participants such as electronic informed consent and online questionnaires and tests. Thus, there is an urgent need for the evaluation and refinement of interventions to address several cognitive, behavioral, and clinical aspects of the long-term impact of the pandemic in dementia.

Systematic Review on the Mental Health and Treatment Impacts of COVID-19 on Neurocognitive Disorders

“…The use of telemedicine and its benefits, including reduced outpatient visits in crowded hospital, minimized travel time to clinics, reduced waiting lists and similar efficacy to face-to-face meetings or activities, were also discussed in 6 editorials [ 16 , 41 , 61 , 62 , 63 , 64 ]. Noteworthy, Cognitive Stimulation Therapy (CST), which is an evidence-based psychosocial group treatment for people with a diagnosis of mild to moderate NCD, has been adapted virtually since the pandemic.…”

“…Moreover, experience from practitioners have suggested the feasibility of connecting people with NCD virtually using information communication technology, without concerns of confusion or disengagement. There even appears to be additional benefits with the novelty and sense of empowerment associated with the use of virtual technologies in patients [ 62 , 63 ].…”

“…Besides, the observed effects may very well have been exacerbated by insufficient access to healthcare [ 2 , 12 , 14 , 42 ]. Notwithstanding, individuals with NCD depends on a variety of resources (e.g., community services, treatments) that help manage their condition, and maintain good quality of life [ 2 , 39 , 63 ]. However, our review highlighted that COVID-19 has caused a disruption and/or reduction of these resources [ 33 , 49 , 50 ], which could be explained by confinement measures aiming to limit social contacts by closing services and redeployment of medical staff from outpatient clinics to infectious wards [ 33 ].…”

“…Cross-sectional studies and reviews support that its efficacy could compare with that of in-person consultations [ 56 , 57 , 58 , 59 ]. Although telemedicine could bring additional benefits, such as feelings of pride [ 29 , 62 , 63 ], certain challenges need to be addressed, such as difficulties for these patients to adapt to technology, accessibility issues, and the adaptation of some interventions [ 2 , 64 ]. With these difficulties addressed, telemedicine could have major clinical implications and thus reform the care of patients with NCD.…”

COVID-19 pandemic and mental health of a sample of Brazilian caregivers of people with dementia

“…Online support groups for caregivers may also help them understand the sources of stress and suffering and encourage dialogue and sharing experiences during the pandemic. 20 Authors' contributions. AS: conceptualization, investigation, methodology, supervision, and writingreview and editing.…”