The Impact of COVID-19 Confinement on Cognition and Mental Health and Technology Use Among Socially Vulnerable Older People: Retrospective Cohort Study

Abstract

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

Evolution of physical function, cognition, depressive mood, and quality of life during the Covid-19 pandemic in prefrail elderly people: A longitudinal cohort study (Covid-Mefap)

“…The drastic changes in lifestyle habits that occurred in the first months of the COVID-19 pandemic, especially during the months of strict population confinement, did not entail a worsening in the physical function, cognitive function, mood, or quality of life of the pre-frail studied population. The results of the present study even pointed to an improvement in the physical function, cognitive function, and depressive mood of this population, in line with other studies conducted in our setting ( Dura-Perez et al, 2022 ).…”

“…The study population was comprised of pre-frail adults over 70 years of age who preferably live accompanied and rely on a stable social and family network. Similar to reports by other research ( Dura-Perez et al, 2022 ), the use of ICTs increased during the pandemic, especially Whatsapp messages or video calls on the smartphone, as well as the time spent reading, exercising memory, doing arts and crafts, or performing daily and structured physical activity. The practice of the above-mentioned activities supports the idea that establishing a daily routine with sleep habits and leisure activities, staying physically and mentally active with cognitive stimulation exercises, and maintaining social connections help to overcome a negative experience such as long-term confinement ( Goodman-Casanova et al, 2020 ).…”

“…Television was the most frequently used source of information during confinement. The majority of the participants in the present study reported spending the same or more time watching television than before the pandemic with an average daily consumption of 4 h, which may have contributed to a better understanding of the situation and thus facilitated better adaptation and adequate response to the pandemic ( Dura-Perez et al, 2022 ; Goodman-Casanova et al, 2020 ; Ministerio de Sanidad, 2022 ).…”

Examining the Impact of COVID-19 on People With Dementia From the Perspective of Family and Friends: Thematic Analysis of Tweets

“…Beyond having 1 of the highest COVID-19 mortality rates [ 1 ], people with dementia have experienced challenges to their mental, physical, and cognitive health [ 2 ]. In attempts to mitigate the spread of the COVID-19 virus, governments have implemented various infection control measures, such as public curfews, social distancing protocols, regional lockdowns, required masking, quarantines, visitation bans, and travel restrictions [ 3 ].…”

Association between Frequency of Going Out and Psychological Condition among Community-Dwelling Older Adults after the COVID-19 Pandemic in Japan

“…Previous studies have linked social isolation to an increased risk of depression and anxiety disorders in older adults [ 12 ], and the psychological impact of the COVID-19 pandemic on older adults is certainly an area of research that is rapidly expanding. In particular, older adults perceive moderate stress due to COVID-19 outbreaks [ 13 ]; impact on psychiatric hospitalization of the older adults in the early stages of the epidemic [ 14 ]; and decline in quality of life, self-perceived health, and well-being before and after the lockdown [ 15 ], and insomnia was reported in 24.6% [ 16 ]. Hence, it is clear that mental health support for older adults is necessary for living with COVID-19, which is still expanding.…”