Facing Dementia During the <scp>COVID</scp>‐19 Outbreak

Canevelli, Marco; Valletta, Martina; Blasi, Marco Toccaceli; Remoli, Giulia; Sarti, Giulia; Nuti, Filippo; Sciancalepore, Francesco; Ruberti, Enzo; Cesari, Matteo; Bruno, Giuseppe

doi:10.1111/jgs.16644

Cited by 160 publications

(189 citation statements)

References 3 publications

(5 reference statements)

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“…However, these results provide us with insights into how to care for patients with dementia and how to efficiently use of the time and support of our limited staff during the COVID-19 outbreak. A previous study demonstrated that the COVID-19 outbreak adversely affected not only cognition and neuropsychiatric symptoms but also the functional independence of patients with dementia [1]. Therefore, our results indicate that for patients with moderate to severe cognitive impairment, it may be useful to prioritize prevention of their cognitive decline and maintenance of their functional independence, whereas for those with mild cognitive impairment, it may be useful to prioritize reducing psychological stress and preventing neuropsychiatric symptoms, such as depression.…”

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confidence: 59%

“…Owing to the restrictive measures taken worldwide to block the spread of COVID-19 outbreaks (including the declaration of a state of emergency in Japan), patients with dementia and their caregivers have not been able to receive the usual support and care. Therefore, this is expected to lead to adverse effects on the patients and their caregivers, and many investigators have warned about the risks [1][2][3]. In fact, many scheduled appointments for routine outpatients' examinations and care services have been canceled and postponed owing to the COVID-19 outbreak.…”

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confidence: 99%

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Awareness of the COVID-19 Outbreak and Resultant Depressive Tendencies in Patients with Severe Alzheimer’s Disease

Tsugawa¹,

Sakurai²,

Inagawa³

et al. 2020

JAD

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The ongoing coronavirus disease 2019 (COVID-19) pandemic has substantially affected patients with dementia and their caregivers. However, we found not all Alzheimer’s disease (AD) patients were afraid of COVID-19 infection. Therefore, we investigated the association between rate of awareness of COVID-19 and depressive tendency in AD. 126 consecutive outpatients with AD were enrolled in this study from May 25, on the day when the declaration of emergency was lifted in Japan, through June 30, 2020. In addition to routine psychological tests, the participants were asked the following two questions: “Do you know COVID-19?” and “Why are you wearing a face mask?”. Moderate to severe AD patients were found to have a low COVID-19 recognition rate and did not fully understand why they were wearing face masks. In addition, because they did not understand the seriousness of the COVID-19 outbreak, their Geriatric Depression Scale scores were also substantially lower. These results may appear to simply indicate that people with severe dementia are unaware of current events. However, these results provide insights into how to care for patients with dementia and how to allocate the time and support of our limited staff during the COVID-19 outbreak.

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confidence: 59%

mentioning

confidence: 99%

Awareness of the COVID-19 Outbreak and Resultant Depressive Tendencies in Patients with Severe Alzheimer’s Disease

Tsugawa¹,

Sakurai²,

Inagawa³

et al. 2020

JAD

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“…Some authors provide recommendations aiming to reduce behavioral dyscontrol in subjects with dementia in accordance with recommendations from dementia association guidelines, accounting for limitations caused the pandemic ( 24 ). Such guidelines stress implementation of technology to improve mood; maintain daily activities at home (e.g., gardening, cooking, reading, listening to music, physical exercise) to treat apathy; and foster the development of simplified and sequential routines to treat anxiety.…”

Section: Resultsmentioning

confidence: 99%

“…Isolation may foster behavioral disturbances via several, partially overlapping mechanisms. Forced separation may interfere with caregiver support, whether the subject lives in his/her house or in nursing homes ( 24 ), and leads to poor health monitoring. Loss of interpersonal monitoring may increase the risk of dehydration, infections, and the decompensation of chronic diseases, such as diabetes or hypertension ( 36 ).…”

Section: Discussionmentioning

confidence: 99%

Neuropsychiatric Symptoms in Elderly With Dementia During COVID-19 Pandemic: Definition, Treatment, and Future Directions

et al. 2020

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Background Neuropsychiatric symptoms (NPS) of dementia, such as anxiety, depression, agitation, and apathy, are complex, stressful, and costly aspects of care, and are associated to poor health outcomes and caregiver burden. A steep worsening of such symptoms has been reported during Coronavirus Disease 2019 (COVID-19) pandemic. However, their causes, their impact on everyday life, and treatment strategies have not been systematically assessed. Therefore, the aim of this review is to provide a detailed description of behavioral and psychopathological alterations in subjects with dementia during COVID-19 pandemic and the associated management challenges. Methods A PubMed search was performed focusing on studies reporting alterations in behavior and mood and treatment strategies for elderly patients with dementia, in accordance with PRISMA guidelines. The following search strategy was utilized: (COVID* OR coronavirus OR “corona vir*” OR SARS-CoV-2) AND (dementia OR demented OR dement* OR alzheimer* OR “pick’s disease” OR “lewy body” OR “mild cognitive” OR mild cognitive impairment OR MCI). Results Apathy, anxiety and agitation are the most frequently NPS during the COVID-19 pandemic and are mainly triggered by protracted isolation. Most treatment strategies rely on pharmacotherapy; technology is increasingly utilized with mixed results. Conclusions NPS of dementia during COVID-19 appear to arise from social restrictions occurring as a consequence of the pandemic. Implementation of caregiver support and the presence of skilled nursing home staff are required to restore social interaction and adjust technological support to the patients’ needs.

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“…This is likely to be due to the lack of mental stimulation, which is linked with levels of cognition in dementia (Woods, Aguirre, Spector, & Orrell, 2012). Recent early evidence into cognitive and behavioural symptomatology in dementia since the pandemic supports this notion (Boutoleau-Bretonni ere et al, 2020;Canevelli et al, 2020), posing a large concern for the increased care needs of PLWD. Increased levels of dependency became particularly difficult for those unpaid carers who suddenly had to take over care that was usually provided by paid carers.…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 related social support service closures on people with dementia and unpaid carers: a qualitative study

Giebel

Cannon

Hanna

et al. 2020

Aging & Mental Health

228

260

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Objectives: Accessing social care and social support services is key to support the well-being of people living with dementia (PLWD) and unpaid carers. COVID-19 has caused sudden closures or radical modifications of these services, and is resulting in prolonged self-isolation. The aim of this study was to explore the effects of COVID-19 related social care and support service changes and closures on the lives of PLWD and unpaid carers. Method: PLWD and unpaid carers were interviewed via telephone in April 2020. Transcripts were analysed using thematic analysis. Demographic characteristics including household Index of Multiple Deprivation score and weekly hours of social support service usage before and since the COVID-19 outbreak were also collected. Paired samples t-tests was used to compare the mean of weekly hours of social support service usage before and since the outbreak. Results: 50 semi-structured interviews were conducted with unpaid carers (n ¼ 42) and PLWD (n ¼ 8). There was a significant reduction in social support service usage since the outbreak. Thematic analysis identified three overarching themes: (1) Loss of control; (2) Uncertainty; (3) Adapting and having to adapt to the new normal. Carers and PLWD were greatly affected by the sudden removal of social support services, and concerned about when services would reopen. Carers were worried about whether the person they cared for would still be able to re-join social support services. Conclusions: PLWD and carers need to receive specific practical and psychological support during the pandemic to support their well-being, which is severely affected by public health restrictions.

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Facing Dementia During the COVID‐19 Outbreak

Abstract: We would like to thank team members Jaimie Roebuck and Andrea Lawson for their contribution to the preparation of the manuscript.

Cited by 160 publications

References 3 publications

Awareness of the COVID-19 Outbreak and Resultant Depressive Tendencies in Patients with Severe Alzheimer’s Disease

Awareness of the COVID-19 Outbreak and Resultant Depressive Tendencies in Patients with Severe Alzheimer’s Disease

Neuropsychiatric Symptoms in Elderly With Dementia During COVID-19 Pandemic: Definition, Treatment, and Future Directions

Impact of COVID-19 related social support service closures on people with dementia and unpaid carers: a qualitative study

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