Perception of stress and cognitive efficiency in older adults with mild and moderate dementia during the COVID-19-related lockdown.

AIM: Many studies have been carried out with the aim of understanding the manifold effects of the novel coronavirus (Covid-19) on individuals' clinical and psychological states. This paper deals with perceived stress (PS) and cognitive efficiency (CE) in older adults with dementia during the first wave of the pandemic. The study also investigated the potential effects of PS and CE on participants' cognitive functioning. The modulating effect of cognitive reserve (CR) on these variables was also considered, given its well-known role in the onset and evolution of neurodegenerative diseases. METHOD: Thirty-eight older adults with mild/moderate dementia (mean age: 81.47 ± 5.05; mean MMSE pre-lockdown: 24.03 ± 3.14) were recruited for this study from March to May [4]. Two questionnaires, the Perceived Stress Scale (PSS) and the FLEI Mental Ability Questionnaire (FLEI), were administered to all participants by telephone every two weeks during lockdown (T1: early April, T2: mid-April, T3: early May). After lockdown, their neuropsychological and psychological profiles were assessed. Linear mixed-effects models were used to investigate changes over time. RESULTS: The level of PS increased at both Time 2 and Time 3 (f2 = 0.10). Cognitive functioning worsened during lockdown, resulting in lower scores at the post-lockdown evaluation (f2s = 0.09 and 0.06 for MMSE and ENB-2, respectively). The decrease in these scores was not associated with either PS or CE. Although the size of these effects was rather small, their clinical relevance is not negligible. CONCLUSION: Individuals with dementia seem to have experienced stress (S) during the first-wave of lockdown related to Covid-19. Cognition worsened during the pandemic, in accordance with the neurodegenerative nature of the disease, but it was unrelated to PS and CE.

Increase in Frailty in Nursing Home Survivors of Coronavirus Disease 2019: Comparison With Noninfected Residents.

OBJECTIVES: Institutionalized older adults have a high prevalence of frailty and disability, which may make them more vulnerable to the negative consequences of coronavirus disease 2019 (COVID-19). We investigated the impact of COVID-19 on the level of frailty, physical, and cognitive performance in nursing home residents. DESIGN: Nested case-control study. SETTING AND PARTICIPANTS: The study included nursing home residents who were infected with COVID-19 (case group, n = 76), matched by age to a control group (n = 76). METHODS: Participants' sociodemographic and medical data were collected, and they were also assessed for physical function (handgrip and walking speed), cognitive performance (Mini-Mental State Examination) and frailty (Frail-NH scale) before the first wave of the COVID-19 pandemic (October to December 2019, pre-COVID-19) and after (June to July 2020, post-COVID-19). COVID-19 symptoms and clinical course were recorded for the cases. RESULTS: Between the pre- and post-COVID-19 assessments, we found a 19% greater deterioration in handgrip, a 22% greater decrease in walking speed, and a 21% greater increase in Frail-NH scores in cases compared with controls. In both cases and controls, on the other hand, there was a significant 10% decrease in Mini-Mental State Examination scores over the study period. Multivariable logistic regression showed that COVID-19 survivors had a 4-fold increased chance of developing frailty compared with controls (odds ratio 4.95, 95% confidence interval 1.13-21.6, P = .03), but not cognitive decline. CONCLUSIONS AND IMPLICATIONS: COVID-19 can accelerate the aging process of institutionalized older adults in terms of physical performance and frailty by around 20%. However, we found similar levels of decline in cognitive performance in both cases and controls, likely because of the burden of social isolation and containment measures on neuropsychological health.