Cognitive, Functional, and Emotional Changes During the COVID-19 Pandemic in Greek Patients with Neurocognitive Disorders

Abstract

Background: Prolonged periods of social deprivation, such as COVID-19-related lockdowns, are associated with deleterious effects on cognitive functions. Objective: The aim of this study was to gauge the effect of prolonged social isolation on the cognitive function of older adults with neurocognitive disorders. Methods: We recruited 125 older adults with minor or major neurocognitive disorders divided into two groups. The control group was tested at the first period of the study (October 2018–May 2019), whereas the experimental group was evaluated at the second chronological period of the study (October 2020–May 2021) during the second wave of COVID-19. Neuropsychological tests were performed at baseline and six months after baseline. Results: In the control group, significant changes in the scores from the Montreal Cognitive Assessment (MoCA; p = 0.049) and the Functional Rating Scale for Symptoms of Dementia (FRSSD; p = 0.005) were found between baseline and follow-up assessments, whereas no changes were identified in Mini-Mental State Examination (MMSE; p = 0.229) and Geriatric Depression Scale (GDS; p = 0.619) scores. In the experimental group, the scores from all neuropsychological tests (MoCA, MMSE, GDS, and FRSSD; p < 0.001 for all) were significantly different at follow-up when compared with those at baseline measurements. Moreover, significant deterioration of specific functions assessed in MMSE and FRSSD was detected, especially in the experimental group. Conclusion: This study highlights cognitive functions directly affected by social deprivation of individuals with neurocognitive disorders. The findings can be used in the rehabilitation from confinement and its negative consequences.

The Impact of COVID-19 Lockdown Measures and COVID-19 Infection on Cognitive Functions: A Review in Healthy and Neurological Populations

“…Thus, it was expected that it would immediately impact the population as a whole with severe psychological and cognitive implications. Indeed, our findings are in line with previous literature on COVID-19 which report the presence of cognitive decline in the short [ 20 , 42 , 53 ], medium [ 49 , 52 , 61 ], and long-term periods [ 50 , 92 ].…”

“…During the medium and long period of COVID-19 lockdown measures, all groups of neurological patients exhibited a significant decline in functional and cognitive status compared to the pre-COVID period. During the medium period (5 to 8 months), three out of four studies showed adverse effects of COVID-19 lockdown measures on attention [ 46 ], and on the overall patients’ cognitive status [ 48 , 49 ], except for Ref. [ 47 ].…”

Links between COVID-19 and Parkinson’s disease/Alzheimer’s disease: reciprocal impacts, medical care strategies and underlying mechanisms

“…Numerous cross-sectional studies in different countries have investigated the impact of the COVID-19 pandemic and social-distancing measures on neuropsychiatric symptoms of AD. They consistently demonstrated that the COVID-19 pandemic and related restrictions lead to the worsening of neuropsychiatric symptoms in AD patients [ 5 , 7 , 114 , 115 ], with most pronounced neuropsychiatric symptoms being agitation, anxiety, and depression. The worsening of irritability, sleep disturbance, apathy, aberrant motor activity, appetite disturbances, and delusion were also reported in some of these studies.…”

“…These data are consistent with another longitudinal 1-year follow-up study [ 7 ], which reported that the decline of MMSE scores in AD patients during the pandemic was similar to the rate of yearly decline in previous studies before the pandemic [ 7 ]. On the contrary, Tsiakiri et al longitudinally assessed the cognitive performance of 21 AD patients during 7-month follow-up that corresponded to the strict lockdown period in Greece [ 115 ]. They found significantly greater worsening of MMSE and MoCA scores in AD patients during the COVID-19 pandemic lockdown compared to the AD controls who completed follow-up before the lockdown.…”

Post–Intensive Care Syndrome in Neurocritical Care Patients

“…There is a strong relationship between depression and physical and emotional quality of life in stroke survivor–caregiver dyads. 141 Better caregiver preparedness can reduce the likelihood of depression and overall improve the quality of life of the stroke survivor–caregiver dyad. 142 Caregivers who have better caregiver preparedness are less likely to suffer from mood disturbances, experience lower burden of care, and perform better self-care.…”