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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
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
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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