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Background. Currently, a great body of data regarding the link between epilepsy and novel coronavirus infection (NCI) has been accumulated. Numerous studies have paid a great attention to rise in frequency and severity of epileptic seizures as well as failure of remission in individuals suffering from epilepsy. Objective(s): to study clinical and mental changes during NCI in patients with epilepsy. Material and methods. Fifty patients with epilepsy were examined, who were divided into two groups depending on the NCI history: Group 1 (main) - 25 patients undergone COVID-19 in the period from 2020 to 2022;Group 2 (control) - 25 patients not undergone COVID-19 during the same period. Slinical-anamnestic and psychometric methods were used as well as the following scales and questionnaires: National Hospital Seizure Severity Scale (NHS-3), Mini-Mental State Examination (MMSE), Hospital Anxiety and Depression Scale (HADS), Beck Depression Inventory (BDI), Medical Outcomes Study Sleep Scale (MOS-SS), Multidimensional Fatigue Inventory (MFI-20). Results. In patients with epilepsy who had undergone COVID-19, there was a tendency for more frequent epileptic seizures and increased severity of seizure course. Among such patients, mild depression and more severe asthenia, cognitive impairment, moderate sleep disturbances were more common than in the control group. Conclusion. The NCI pandemic has had a pronounced negative impact on the severity of epilepsy (the underlying disease).Copyright © 2023 IRBIS LLC. All Rights Reserved.
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Background: Functional Somatic Disorders (FSDs) are characterized by persistent physical symptoms that cannot be explained by other somatic or psychiatric conditions. Multiple Chemical Sensitivity (MCS) is a non-allergic FSD characterized by odour intolerance and various somatic symptoms being attributed to the influence of toxic environmental chemicals in low, usually harmless doses. The pathophysiology of FSDs are still not clear. Smell and taste complaints were also among the notable symptoms characterizing the covid epidemic and the latest evidence suggests overlaps between long COVID and FSDs. Method(s): The study includes advanced analysis of MRI-derived functional and structural connectomes acquired on a 3 T MR scanner. Furthermore, it includes questionnaires and paraclinical tests, e.g. the Sniffin' Stick olfactory test, Mini-Mental State Examination, and Sino-Nasal Outcome test 22. The pilot part of the project included 6 MCS patients who were compared with 6 matched healthy participants. Later follow-up included analysis of 8 multiorgan FSD and 4 post-COVID patients. Result(s): The MCS group showed important brain structural connectivity differences in 34 tracts. Notably, for MCS patients, the olfactory cortex (especially in the right hemisphere) showed decreased connectivity with regions in the emotional system. Conclusion(s): We plan to extend these findings with whole-brain modelling of the functional connectivity in the patient groups. Long-term this could be used as a 'fingerprint' which could help with diagnosis and treatment monitoring in FSDs as well as with new diagnoses such as long-COVID.Copyright © 2023
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Background: The COVID-19 (Coronavirus Disease of 2019) virus has affected millions of people around the world, and it is likely to induce mental health issues in those who have never had one before, as well as worsen the condition of those who already have. Objective(s): To determine the effect of COVID-19 on mental health and quality of life. Methodology: The non-probability convenient sampling strategy was utilized in this cross-sectional research. A sample of 300 Males and Female with age above 30 who have gone through COVID-19 and recovered before one month or more are included in the study. All patients who already had cognitive issues even before COVID-19 were excluded from the study. The study variables were measured using the MMSE (mental health) and WHOQOL-BREF (quality of life). Result(s): The results revealed that 128 participants (43%) of the respondents were male and 172 participants (57%) were female. The findings showed that 32 people were with normal mental health, 100 were with mild and 36 were with moderate mental health between the ages of 30-39. 52 people were with normal mental health, 24 were with mild and no one was with moderate mental health between the ages of 40-49. 4 people were with normal mental health, 4 were with mild and 24 were moderate mental health between the ages of 50-59. 12 people were with normal mental health with, 4 were with mild and no one was with moderate mental health between the ages of 60-69. The results also showed that there was a significant association between mental health and quality of life. chi-square test of independence showed significant association between mental health and quality of life with 2 (N = 300) = 600.0, p = .000. The findings showed that people with normal mental health had very good quality of life, people with mild mental health have poor quality of life and people with moderate mental health have very poor quality of life. Conclusion(s): It was concluded from the study that COVID-19 has badly effected mental health and quality of life of the patients suffered from coronavirus.Copyright © 2023 Lahore Medical And Dental College. All rights reserved.
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Background. Currently, a great body of data regarding the link between epilepsy and novel coronavirus infection (NCI) has been accumulated. Numerous studies have paid a great attention to rise in frequency and severity of epileptic seizures as well as failure of remission in individuals suffering from epilepsy. Objective(s): to study clinical and mental changes during NCI in patients with epilepsy. Material and methods. Fifty patients with epilepsy were examined, who were divided into two groups depending on the NCI history: Group 1 (main) - 25 patients undergone COVID-19 in the period from 2020 to 2022;Group 2 (control) - 25 patients not undergone COVID-19 during the same period. Slinical-anamnestic and psychometric methods were used as well as the following scales and questionnaires: National Hospital Seizure Severity Scale (NHS-3), Mini-Mental State Examination (MMSE), Hospital Anxiety and Depression Scale (HADS), Beck Depression Inventory (BDI), Medical Outcomes Study Sleep Scale (MOS-SS), Multidimensional Fatigue Inventory (MFI-20). Results. In patients with epilepsy who had undergone COVID-19, there was a tendency for more frequent epileptic seizures and increased severity of seizure course. Among such patients, mild depression and more severe asthenia, cognitive impairment, moderate sleep disturbances were more common than in the control group. Conclusion. The NCI pandemic has had a pronounced negative impact on the severity of epilepsy (the underlying disease).Copyright © 2023 IRBIS LLC. All Rights Reserved.
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Background. Currently, a great body of data regarding the link between epilepsy and novel coronavirus infection (NCI) has been accumulated. Numerous studies have paid a great attention to rise in frequency and severity of epileptic seizures as well as failure of remission in individuals suffering from epilepsy. Objective(s): to study clinical and mental changes during NCI in patients with epilepsy. Material and methods. Fifty patients with epilepsy were examined, who were divided into two groups depending on the NCI history: Group 1 (main) - 25 patients undergone COVID-19 in the period from 2020 to 2022;Group 2 (control) - 25 patients not undergone COVID-19 during the same period. Slinical-anamnestic and psychometric methods were used as well as the following scales and questionnaires: National Hospital Seizure Severity Scale (NHS-3), Mini-Mental State Examination (MMSE), Hospital Anxiety and Depression Scale (HADS), Beck Depression Inventory (BDI), Medical Outcomes Study Sleep Scale (MOS-SS), Multidimensional Fatigue Inventory (MFI-20). Results. In patients with epilepsy who had undergone COVID-19, there was a tendency for more frequent epileptic seizures and increased severity of seizure course. Among such patients, mild depression and more severe asthenia, cognitive impairment, moderate sleep disturbances were more common than in the control group. Conclusion. The NCI pandemic has had a pronounced negative impact on the severity of epilepsy (the underlying disease).Copyright © 2023 IRBIS LLC. All Rights Reserved.
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The MMSE is one of the most widely used in-person cognitive screeners to assess global cognitive impairment (Folstein, 1975;Fong et al., 2009). The TICS, which is a cognitive screener that can be administered over the telephone, has been found to be highly correlated with the MMSE (Brandt et al., 1988). There is a lack of research comparing the MMSE and TICS ability to predict daily life functioning in older adults with varying degrees of cognitive abilities. Thus, this study examined the utility of the TICS-40 and MMSE to predict daily life functioning at different levels of cognitive impairment (mild cognitive impairment and dementia). Taken from the Aging, Demographics, and Memory Study (Plassman et al., 2007), a sample of 157 participants over the age of 70 with mild cognitive impairment or dementia were administered a battery of surveys and tests that included the MMSE, the TICS-40, the index of activities of daily living (ADLs), and the measure of instrumental activities of daily living (IADLs, Lawton & Brody, 1969). The TICS and MMSE similarly predicted daily life functioning in the total sample and MCI group (n = 133). The MMSE was a better predictor in the dementia group (n = 24) than in the MCI group. Higher scores on both screeners predicted problems with telephone use and medication management in the MCI group. In the dementia group, higher MMSE scores showed marginal support for fewer problems with telephone use and medication management, while higher TICS scores predicted fewer problems with medication management. Investing resources in the development and knowledge of cognitive screeners and procedures for remote administration would benefit older adults. Regularly screening older adults in their homes may lead to earlier detection of decline, better treatment, allocation of more appropriate resources, and improvement in quality of life for older adults who are unable to meet with clinicians in an in-person setting due to illness such as COVID-19, physical disability, or those living in rural areas. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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The aim of this study is to examine the results of physiotherapy in a patient with critical illness polyneuropathy (CIP) due to coronavirus disease 2019 (CO-VID-19). The 48-year-old male patient with CIP due to COVID-19 was enrolled in a physiotherapy program for 3 months with 5 sessions/week. Pain intensity, motor skills, daily living activities, fatigue level, cognitive status, and decubitus ulcer were evaluated with a visual analogue scale, the Medical Research Coun-cil-Sum Score, the Functional Independence Scale, the Fatigue Severity Scale, the Standardized Mini-Mental Test, and pressure wound staging, respectively. Positive improvements were achieved in functional level, fatigue, pain, and pressure sores with the physiotherapy program for this patient with CIP due to COVID-19. This report provides an idea about the effects of physiotherapy programs for COVID-19-related CIP to academics and clinicians working in this field.Copyright © 2022, Derman Medical Publishing. All rights reserved.
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INTRODUCTION. Two-thirds of patients with COVID-19 developed smell and taste dysfunction, of whom half experienced improvement within the first month. After six months, 5-15% still suffered from significant olfactory dysfunction (OD). Before COVID-19, olfactory training (OT) was proved to be effective in patients with post-infectious OD. Therefore, the present study aimed to investigate the progress of olfactory recovery with and without OT in patients with long COVID-19. METHODS. Consecutive patients with long COVID-19 referred to the Flavour Clinic at Godstrup Regional Hospital, Denmark, were enrolled. The diagnostic set-up at the first visit and follow-up included smell and taste tests, questionnaires, ENT examination and instructions in OT. RESULTS. From January 2021 to April 2022, 52 patients were included due to long COVID-19-related OD. The majority of patients complained of distorted sensory quality, in particular, parosmia. Two-thirds of the patients reported a subjective improvement of their sense of smell and taste along with a significant decline in the negative impact on quality of life (p = 0.0001). Retesting at follow-up demonstrated a significant increase in smell scores (p = 0.023) where a minimal clinically important difference (MCID) in smell scores was found in 23% of patients. Full training compliance was significantly associated with the probability of MCID improvement (OR = 8.13;p = 0.04). CONCLUSIONS. The average effect of OT is modest;however, full training compliance was significantly associated with an increased probability of a clinically relevant olfactory improvement. FUNDING. none. TRIAL REGISTRATION. not relevant.Copyright © 2023, Almindelige Danske Laegeforening. All rights reserved.
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COVID-19, which has plagued the world since 2020, has brought changes in the order of human life globally, and ultimately has an impact on the psychological state of individuals, including teenagers. The aim of this study is to find the differences between students' gratitude score before and after the implementation of writing gratitude journal regularly. Participants on this study was 20 adolescents in Ambon City Maluku Indonesia, consists of 6 boys and 14 girls. The participants age was between 15-16 years old. Quantitative Method with experimental design used in this study. From the results, it was found that the significant value in the table paired samples correlations was 0.418, meaning that there are relationship between the results of the pre-test and post-test because the value was > sig. 0.05. Although the increase in the value of gratitude among adolescents in Ambon is not too large and increases their classification to be included in the criteria for groups that have sufficient gratitude scores, the important thing explained in implementing gratitude education actually lies in its aim to inspire students that it is important to be grateful in all circumstances. and it's not just about saying thank you or showing grateful behavior. This is an open access article under the CC BY-SA license.Copyright © 2022, Anka Publishers. All rights reserved.
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Background: Due to the increase in life expectancy and population growth over 65 years, cognitive impairment (CI) is gradually increasing. Because of many changes in the human brain that occur with aging, cognitive decline usually worsens with age. The number of neurons, dendrites, synapses, receptors, glial components, and critical neurotransmitters (norepinephrine, dopamine, acetylcholine) diminishes every year after age 50 (by 0.1–0.2 percent). As a result, the brain's volume, metabolism, and perfusion decrease, and an average age-related cognitive decline emerge. Objective: This review will elucidate the underlying factors mediating the interaction of COVID-19, diabetes, and mental health, which may provide essential clues for tailored intervention for this vulnerable population. Result: As per the World Alzheimer Report, 46.8 million individuals worldwide suffered from dementia in 2015, a figure that's still expected to quadruple every 20 years. During the COVID-19 epidemic, researchers and practitioners are becoming increasingly concerned about the emergence of neurological symptoms, particularly the development of cognitive impairment. Learning, memory, flexible thinking, concentration, and executive function are all cognitive functions. Examples of executive functions include understanding a specific problem, solving problems, judging, halting, or modifying old behaviors, and initiating new ones. When patients are required to complete complex tasks, such as changing their insulin dose, predicting the effects of physical exercise on blood glucose, or even diagnosing and treating appropriate hypoglycemia, all these behavioral reactions are critical. Conclusion: Cognitive problems impair a patient's capacity to carry out several treatment measures, such as adhering to a medical regimen and recognizing signs of deterioration, all of which compromise the patient's treatment compliance. The current review focuses on the state of cognitive functioning in patients with metabolic syndrome and diabetes mellitus at the time of diagnosis and following COVID-19.
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Background: Fatigue is one of the most frequent complaints in patients with motor neuron diseases (MNDs), with a significant impact on the quality of life (QOL). There is lack of enough evidence for current pharmacological or non-pharmacological treatments of fatigue in this population to be applied in clinical setting. Energy conservation strategies are one of the key interventions for fatigue management in chronic diseases. We aimed to investigate the effect of applying these techniques in the fatigue management of patients with MND. Methods: This randomized controlled trial (RCT) study was carried out on 28 patients with MND. Participants were randomly assigned to either the intervention or control group. In addition to routine treatment, patients in the intervention group participated in 3 weekly 1-hour energy conservation programs provided by an experienced occupational therapist. The Fatigue Severity Scale (FSS) score, 36-Item Short Form Survey (SF-36), and Canadian Occupational Performance Measure (COPM) were measured at baseline, immediately after the last intervention session, and one month later. Results: FSS and COPM significantly changed after the course in the intervention group (P < 0.001 and P = 0.001, respectively). Both FSS and COPM improved significantly toward the final assessment only in the intervention group. The SF-36 changes were not significant in each of the groups. Conclusion: According to the findings of the present study, using energy conservation strategies could lead to better mid-term fatigue management and occupational performance improvement, but it did not improve QOL in patients with MND.
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Background and aims: A 36-years-old man was admitted to the neurological department with complaints on severe drowsiness, sudden falling asleep, fatigue, unsteadiness when standing and walking, inability to speak and write intelligibly, increased body temperature and appetite. The first symptoms occurred 2 month before admission. To note, before the onset of the disease, patient felt a pain and dissension in the testes. Methods: There weren't any significant findings in neurological status, unless mild cognitive (MMSE - 20 points) and behavioral impairments. He had been administered a list of analysis: hematology (WBC 10.9 10
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Purpose or Objective A growing number of elderly patients every year is treated with radiation therapy (RT), but little is known about side effects and outcome of irradiation in this potentially frail population. The identification of predictive factors of toxicity and frailty could offer a personalized treatment approach, thanks also to a multidisciplinary management of patients with increased risk of adverse outcomes. In this study we investigated the correlation of patient parameters with acute toxicities in elderly aged > 75 years treated with curative RT. Materials and Methods A prospective observational study was designed in our Center for patients with > 75years, candidate for curative RT. To these patients the radiation oncologist submitted the Geriatric 8 questionnaire (G8q) before and at the end of RT. Patients with G8 score < 14 were then evaluated by a multidimensional geriatric assessment, investigating cognitive (MMSE, GDS), functional (ADL, IADL, Tinetti) and nutritional (MNA short) domains, to define the frailty phenotype. In this setting, we retrospectively analyzed parameters like body mass index (BMI), number of comorbidities, total blood count, neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR) and basal G8 score, and correlated these parameters to acute toxicity. Results G8q was administered to 150 patients from December 2019 to April 2021. In this study we included 98 patients who started and completed RT in our Unit in this period. Of them, 38 (38.8%) had a baseline G8 score < 14 (range 4-14) and 23 agreed to underwent a multidimensional assessment, while 15 could not be evaluated due to COVID-19 dispositions or their refusal. Eleven patients resulted fit, while 12 patients were classified as vulnerable. Acute toxicity grade was < grade 2 in 67 patients (68.4%) (Table 1). We evaluated associations between BMI, number of comorbidities, total blood count, NLR, PLR, G8 score and acute toxicity (Table 2). Total blood count, NLR, PLR and G8 score resulted not significantly correlated to toxicity. Instead, a higher BMI was associated with worse acute toxicity (p=0.031): considering the 31 patients reporting toxicity > grade 2, 17 patients were over-weighted (54.8%), 1 patient was under-weighted (3.2%). Overall, the 63.3% of population (62 patients) was over-weighted, with a median BMI of 26.3. (Table Presented) (Table Presented) Conclusion Although G8q considers under-weight as a possible responsible of frailty, our study suggested that attention should be paid to over-weight too, due to its prevalence in elderly patients. Furthermore our results suggested that in elderly patients > 75years the BMI correlates with worse acute toxicity, according to literature data. The 38.8% of patients needed a multidimensional evaluation;this approach resulted useful in order to obtain compliance to the treatment without increased toxicity. The study is still ongoing and further analysis will be done.
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Background. The COVID-19 pandemic is a major stressor with predictable negative impacts on mental health, especially for vulnerable populations, which include older people. Emotional disorders, a decrease in intellectual, physical, social activity are the risk factors for the development of cognitive decline in older people;in the situation of the COVID-19 pandemic, the influence of all these factors is exacerbated. In this regard, it seems relevant to study the level of emotional disorders and factors affecting the emotional state of patients with mild cognitive impairment (MCI) in the context of the COVID-19 pandemic in comparison with the period before the pandemic. Aims: emotional state assessment in patients over 55 years old with MCI during the COVID-19 pandemic and identification of factors influencing the emotional state of these patients. Materials and methods: A cross-sectional single-center observational study of patients with MCI who applied to the Memory Clinic in the autumn of 2018 (n = 121), 2019 (n = 114), in the autumn of 2020 (n = 70), and in the spring of 2020 (n = 110). Patients were examined using the Hospital Anxiety and Depression Scale (HADS), the Montreal Cognitive Assessment (MoCA), the Mini-Mental State Examination (MMSE), and the Khachinsky Modified Ischemia Assessment Scale. In 2020, in addition to these scales, a questionnaire "Personal experience of COVID-19 pandemic" was applied to assess the experience associated with the new coronavirus infection. Results: The severity of emotional disorders, assessed by HADS scale, did not differ between groups (F = 0.751;p = 0.522 and F = 0.310;p = 0.818 for the HADS anxiety and depression subscales, respectively). Adjustment for covariates (scores on the Khachinsky and/or MoCA and/or MMSE scales) did not affect the significance of differences between groups on the HADS subscales, regardless of the correction for multiple comparisons. Pathway modeling analysis demonstrated the low ability of the models to predict emotional state based on risk factors (age, gender, Khachinsky score) and cognitive symptoms (MoCA and MMSE scores) - all coefficients r < 0.7. A change in intellectual activity (decrease) and subjective impression of the difficulties obtaining medical care were associated with a higher score on the HADS anxiety scale. Decreased physical health and decreased personal communication were associated with higher scores on the HADS depression scale. Clinically pronounced changes in the emotional state were noted only in relation to anxiety, which depended on the changes in intellectual activity. Conclusions: severity of anxiety and depression was not increased in patients with MCI, regardless of the control of additional factors. No differences were found in the contribution of risk factors (age, gender, vascular and atrophic factors of cognitive decline) and cognitive dysfunction to the formation of emotional disorders in comparing with previous years.
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Introduction and Purpose of the study: COVID-19 has been associated with long-term symptoms. The aim of this study was to describe the incidence of long-term health consequences and investigate the associated risk factors. Materials and Methods: We organized a multidisciplinary assessment for Covid-19 pts discharged from Covid Department of Jesi H. All pts underwent clinical examination, laboratory and instrumental examinations (HRTC and spirometry+DLCO, walking test). All pts were interviewed with questionnaires (MMSE, IES-R and SF-36) for evaluation of cognitive order, psychiatric symptoms and health-related quality of life.Statistical tests (Fisher's exact test for qualitative variables;Wilcoxon test for quantitative) were used to evaluate the association between the long syndrome and all variables. Results: During the study (June 20-September 21) the first 358 pts had completed the post-discharge multidisciplinary assessment. Among them, 56% have experienced long Covid symptoms: 35,8% still complained fatigue, 15.4% dyspnea, 9% alopecia, and 45.2% experienced post-traumatic psychological consequences (insomnia, anhedonia and irritability the most frequent). The statistical analysis showed that “Long Covid” is significantly associated with gender (female), age (youth), employment status (employed more than unemployed), HRTC findings and the results of SF-36 and IES-R neuropsychiatric tests. Conclusions: These findings highlight the importance of following up survivors of COVID-19. A multidisciplinary approach is fundamental to respond to a complex array of “long Covid”.
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Background COVID-19 has had a disproportionate impact on nursing home residents with significantly higher mortality rates compared to the general population. Less attention however has been paid to COVID- 19 induced morbidity in this cohort. Our study aims to examine how nursing home (NH) residents who survived a COVID-19 infection, have been affected in terms of their cognitive, mood and functional outcomes as compared to residents that did not contract the virus. Method We performed an observational retrospective cohort study of the records of 452 residents in NHs affected by COVID-19 in Ireland from February 2020 to February 2021. We extracted data from the scheduled monthly assessments of the Barthel Index (BI), the Mini Mental State Examination (MMSE) and the Geriatric Depression Scale (GDS) performed on residents of these NHs. We compared data from residents who had contracted COVID-19 (cases) to those that had not (controls);at 6, 3 and 1 month prior to a positive COVID-19 PCR test, to ensure comparability of control group, and again at 1, 3 and 6 months after the infection using a Students-T test for normally distributed data. Results We noted a significant deterioration in MMSE, BI and GDS scores in residents who had contracted COVID-19 as outlined in the table. While there was recovery in BI and GDS in the months following the index infection, the MMSE score in COVID-19 affected residents remained significantly adversely affected at 6 months. Conclusion Our study demonstrates the significant impact of COVID-19 infection on the physical, functional, cognitive and mental health of nursing home residents. The patient cohort displayed significant resilience in recovering from the physical and psychological consequences of the disease. The failure of cognitive function to improve over the period of observation may represent the development of 'Long COVID' in these patients. The development of this condition in nursing home residents has been poorly studied, is likely under reported and requires further exploration.
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Since March 2020, COVID-19 has affected the physical and mental health of older adults. However, when faced with adversity, studies have shown older adults to be at least, if not more, resilient than younger cohorts. This study aimed to understand the extent of psychosocial impact the pandemic had on older adults with and without depression currently enrolled in the Neurobiology of Late-Life Depression (NBOLD) Study. We hypothesized that over the course of the pandemic depression and resilience scores would increase. There is still little research available regarding outcomes and factors from COVID-19 impacting older adults' depression and resilience, which this study aims to address while strengthening the validity of the EPII-G. The study population included older adults previously diagnosed with Major Depressive Disorder (MDD) and non-depressed controls, enrolled in the N-BOLD study at the University of Connecticut Health Center. Inclusion criteria were: age of 60 or greater, ability to read and write English, and Mini-Mental State Examination score of 25 or greater. Depressed subjects met the criteria for MDD. The study utilized the EPII-G, Brief Carroll Depression Scale (BC), and Brief Resilience Scale (BRS). The surveys were verbally administered by the research staff in both in-person and via phone interviews. From mid-2020 to summer 2021, both older adults with a history of depression and emotional controls saw BC scores and BRS scores increase, as seen in the included table. We found a negative correlation between positive home life on EPII-G and BC scores, with a correlation coefficient of -0.3645 and a p-value of 0.0616. There was also a positive correlation with positive home life and social activities and BRS scores, with correlation coefficients of 0.26304 and 0.29869 and p-values of 0.0845 and 0.0489 respectively. Individuals who didn't see disruption to their normal routine and had the means to communicate with loved ones had strong psychosocial supports in place but were still vulnerable to the detrimental effects of isolation. Through their years of experience, older adults have had the time needed to develop protective factors such as selfreliance. They have also lived through poignant events such as war and economic depression, putting suffering into perspective. This strong foundation has contributed to the resilience needed to overcome the stressors that surfaced during the pandemic.
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Wang et al. analyze Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment accuracy as screening tests for detecting dementia associated with Alzheimer's disease (AD). Such tests are at the center of controversy regarding recognition and treatment of AD. The continued widespread use of tools such as MMSE (1975) underscores the failure of advancing cognitive screening and assessment, which has hampered the development and evaluation of AD treatments. It is time to employ readily available, efficient computerized measures for population/mass screening, clinical assessment of dementia progression, and accurate determination of approaches for prevention and treatment of AD and related conditions.
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Alzheimer Disease , Cognitive Dysfunction , Alzheimer Disease/psychology , Cognition , Cognitive Dysfunction/psychology , Humans , Mass Screening , Mental Status and Dementia Tests , Neuropsychological TestsABSTRACT
Background: Significant risk factors for severe Covid-19 infection include old age, chronic illnesses such as diabetes, hypertension, cardiovascular, Chronic obstructive pulmonary disease[1], dementia [2]) as well as schizophrenia [3]. In contrast, high Vitamin D levels are known to augment immune activity and to reduce the severity of viral infections such as influenza virus and COVID19. Recently, a possible association between the likelihood of Covid-19 infection, Covid-19 severity, and Vitamin D blood levels was reported. An association has been found between low Vitamin D levels and an increased likelihood of Covid-19 infection [4,5]. Furthermore, low Vitamin D levels seem to be linked to higher likelihood of hospitalization and severity of symptoms in Covid-19 infection[4]. Low Vitamin D levels show a tendency to be a potential risk factor for Covid-19 infection and hospitalization, independent of demographic characteristics and medical conditions. Aim: to assess the possible association between Vitamin D long term supplementation and Covid-19 symptomatic severity and complications of Covid-19 infection in elderly psychiatric inpatients, a highest at-risk group. Methods: a retrospective case series study. Demographic and clinical data of 14 elderly Covid-19 positive inpatients, suffering from dementia or schizophrenia, and other medical conditions were extracted from their medical records. All patients were maintained on 800IU daily dose of Vitamin D months prior to the infection(mean=20 months). The cognitive functioning as measured in Mini-Mental State Examination (MMSE) scores were performed right away at their return from hospitalization due to Covid 19 infection and were compared to the scores six months before infection, using two-tailed paired sample t-test. Summary: During the month of September 2020, when the second wave of the novel Coronavirus Covid-19 culminated in Israel, an outbreak of the epidemic spread in our Holocaust survivor's elderly residence. 31 patients most probably were exposed to a confirmed Covid-19 positive elderly patients. In result, 14 patients, all suffering from dementia or schizophrenia tested positive and immediately placed in quarantine in Corona departments in general hospitals. Those elderly patients (mean age 82) were expected to present an aggravated version of the virus, according to their affiliation to the highest at-risk groups. They suffered from schizophrenia, N =8/14;dementia, N = 6/14 and other at-risk physical illnesses such as diabetes (29%), COPD (7%) and hypertension (57%). Contrary to the expectations, most of the patients were either asymptomatic (28%) or presented very few symptoms. Only two inpatients needed oxygen support, and only one of them stayed dependent on it after release from a Corona department. No one needed intensive care unit (ICU) intervention No significant difference in cognitive function was observed beforehand and after the infection(mean MMSE 13/30, p-NS). Conclusions:according to our unique case series study pre-existing Vitamin D supplementation for a long period before Covid 19 epidemic may reinforce immunity and reduce Covid-19 severity and complications in elderly psychiatric inpatients. No conflict of interest