Frailty, psychological well‐being, and social isolation in older adults with cognitive impairment during the SARS‐CoV‐2 pandemic: data from the GeroCovid initiative

Abstract

BackgroundThe containment measures linked to the COVID‐19 pandemic negatively affected the phyco‐physical well‐being of the population, especially older adults with neurocognitive disorders (NCDs). This study aims to evaluate whether the frailty of NCD patients was associated with different changes in multiple health domains, in particular in relation to loneliness and social isolation, pre‐ and post‐lockdown.Materials and MethodsPatients were recruited from 10 Italian Centers for Cognitive Disorders and Dementia. Data were collected in the pre‐pandemic period (T0), during the pandemic lockdown (T1), and 6–9 months post‐lockdown (T2). The UCLA Loneliness Scale‐3, Activities of Daily Living (ADL), Instrumental ADL (IADL), Mini‐Mental State Examination, and Neuropsychiatric Inventory (NPI) were administered. Caregivers' burden was also tested. Patients were categorized as non‐frail, pre‐frail, and frail according to the Fatigue, Resistance, Ambulation, Illness, and Loss of Weight scale.ResultsThe sample included 165 subjects (61.9% women, mean age 79.5 ± 4.9 years). In the whole sample, the ADL, IADL, and NPI scores significantly declined between T0 and T2. There were no significative variations in functional and cognitive domains between the frail groups. During lockdown we recorded higher Depression Anxiety Stress Scales and Perceived Stress Scale scores in frail people. In multivariable logistic regression, frailty was associated with an increase in social isolation, and a loss of IADL.ConclusionsWe observed a global deterioration in functional and neuro‐psychiatric domains irrespective of the degree of frailty. Frailty was associated with the worsening of social isolation during lockdown. Frail patients and their caregivers seemed to experience more anxiety and stress disorders during SARS‐CoV‐2 pandemic.

Analysis of dementia research trends in nursing using text mining approach

“…41 It was also aimed to determine mortality risks according to the drugs administered to treat behavioural and psychological symptoms of dementia. 42 In addition, considering the increase in neuropsychiatric symptoms of patients with dementia after the global COVID-19 pandemic, worsening in the general course of the disease, caregivers being unprepared for the pandemic like all other people and having difficulties in accessing the health system, [43][44][45] it can be said that these concepts are effective in bringing them to the forefront in research concepts. Therefore, studies involving this concept will ensure that patients have a better quality of life, care practices are improved and the least risky treatment is used in medical treatment.…”

Impactos do distanciamento social da pandemia de COVID-19 em pessoas idosas com Alzheimer: Revisão de escopo

“…Contudo, um número substancial dos estudos incluídos (n = 15), apontou o surgimento ou piora dos SCPD, com destaque para ansiedade, depressão/disforia, apatia, insônia, agitação, atividade motora aberrante, comportamentos noturnos e alucinações Chen et al, 2021;Cohen et al, 2020;Terziotti et al, 2023;El Haj et al,2020a;Gedde et al, 2022;Cinar et al,.2022;Lara et al, 2020;Custódio et al, 2021;El Haj et al, 2022).…”

“…Os SCPD foram mais frequentes em indivíduos com demência leve do que em casos de demência avançada e houve correlação positiva entre piora ou aparecimento de ansiedade, depressão e insônia durante o DS, com idade avançada e presença de ansiedade antes da pandemia (Cohen et al, 2020). Além disso, foram encontrados mais sintomas de ansiedade e stress em pacientes frágeis do que naqueles não frágeis ou pré-frágeis (Terziotti et al, 2023).…”

“…Nesta revisão, dois estudos (n = 2) relataram perdas funcionais resultantes das restrições (Terziotti et al, 2023;Witkowska-Płusa, 2021) e outros dois (n = 2) não encontram piora ou elas foram insignificantes (Tsatali et al, 2021;Tsatali et al, 2023). Os autores que apontaram que o agravamento da condição funcional não sofreu influência das restrições pandêmicas, fizeram essa sugestão após realizar uma análise de trajetória e constatarem que a taxa de deterioração deve ser atribuída à progressão natural dos quadros dos participantes.…”