Dementia and Mental Health During the COVID-19 Pandemic: A Systematic Review

Abstract

ObjectivesThe COVID-19 pandemic raised significant concerns related to the management of care for people with dementia, but few studies have examined the mental health of older adults with dementia and their caregivers during the pandemic, when compared to other populations. This systematic review thus aims to compare and discuss the impact of the COVID-19 pandemic on people with dementia and on their caregivers' mental health.MethodsA search was performed in the PubMed/Medline and ISI databases according to the PRISMA methodology. We included studies published in 2020 and 2021 with the following combinations of keywords: “COVID-19 and mental health and elderly,” “COVID-19 and mental health and dementia;” “COVID-19 and dementia and caregivers,” “pandemic and mental health and elderly,” and “pandemic and anxiety.”ResultsTwenty-two studies were included. Technology has proven to be an essential ally during the pandemic, since all 22 studies performed remote data collection. Nearly all the studies emphasized that social isolation and withdrawal can lead to the emergence or increase of neuropsychiatric symptoms and motor difficulties. However, the findings were mixed concerning the pandemic's impact on the cognition of people with dementia. Caregivers also suffered from the pandemic's impact, experiencing an increase in the burden of care and symptoms of stress, depression, and anxiety. Few studies suggested measures to alleviate the difficulties of people with dementia and their caregivers. There are reports of the benefits of technology in communication and treatment through teleconsultations, however, not everyone has access to such technology, making it difficult to disseminate this tool to the target population.ConclusionsThe studies generally showed that social isolation can increase motor deficits and neuropsychiatric symptoms and caregivers' burden and anxiety. New avenues for care and intervention are thus needed for older adults with cognitive deficits and their caregivers to avoid the intensification of physical and psychological suffering. Technological initiatives and support should consider people with cognitive impairment and different levels of technology literacy.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/.

‘I am proud of how I handled it’. Exploring the impact of the COVID‐19 pandemic and related restrictions on well‐being of adults with severe mental illness using qualitative methods

“…The outcomes of our in‐depth qualitative approach align well with quantitative findings as reviewed by Ahmed et al 23 ; they observed a lack of a clear exacerbation in symptoms of various psychiatric disorders. Participants in our study reported a fairly stable mental health situation, but also a negative impact of the COVID‐19 pandemic and associated restrictions on their overall well‐being.…”

“…In contrast to these negative effects of the COVID‐19 pandemic, a recent quantitative review found no clear pattern of change in mental health symptom severity and associated outcomes in adults with pre‐existing mental health conditions 23 . This systematic review included 37 quantitative studies reporting on one or more of the following outcome measurements: symptom severity, social functioning (assessed through self‐administered questionnaires on social participation and loneliness), quality of life, suicide behaviours and self‐harm in people with pre‐existing mental health conditions.…”

2023 Alzheimer's disease facts and figures

“…Existing reports indicate that the COVID-19 pandemic has posed significant social, psychological, emotional, and physical challenges to family members and friends who provide care for people with dementia. [604][605][606][607][608][609] Fatigue and burnout among dementia caregivers and their lack of access to services and supports for themselves and for the people for whom they provide care are common themes in research on the wide-ranging effects of the COVID-19 pandemic. For these reasons the pandemic has created a crisis for dementia caregivers.…”

The impact of social isolation from COVID-19-related public health measures on cognitive function and mental health among older adults: A systematic review and meta-analysis

“…Recent systematic reviews and meta-analyses reported an association between dementia and mortality of COVID-19 ( Dadras et al, 2022 , Hariyanto et al, 2021 , July and Pranata, 2021 , Liu et al, 2020 , Saragih et al, 2021 , Tahira et al, 2021 ), or loneliness during isolation associated with increased risk of dementia ( Lazzari and Rabottini, 2021 ). Other reviews addressed the impact of the COVID-19 pandemic and isolation on older adults with Alzheimer’s and other types of dementia, including physical deterioration and accelerated ageing ( Lebrasseur et al, 2021 ), changes in neuropsychiatric symptoms of dementia ( Gaigher et al, 2022 , Lebrasseur et al, 2021 , Manca et al, 2020 , Numbers and Brodaty, 2021 , Sánchez-García et al, 2022 , Simonetti et al, 2020 , Suárez-González et al, 2021 ), worsening cognitive health ( Giebel et al, 2022 , Suárez-González et al, 2021 ), as well as new-onset dementia during the first year of COVID-19 isolation ( Suárez-González et al, 2021 ). Although, worsening or new-onset cognitive impairment and subjective mental health deterioration are considered a precursor to dementia, proportions of older adults with dementia and HC experiencing these symptoms for the two-year-and-a-half pandemic period is not well understood.…”