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1.
European Geriatric Medicine ; 13(Supplement 1):S393, 2022.
Article in English | EMBASE | ID: covidwho-2175427

ABSTRACT

Introduction: According to the WHO, social isolation in the elderly is a public health problem, more evident after the Covid19 pandemic. Social isolation is the lack of contact and interaction with other people. Especially evident in Residences. It's observed in 20-30% of the elderly in our region, up to 50% in Nursing Homes. OBJECTIVES To measure the prevalence of social isolation in elderly people in Nursing Homes, with the ESTE II multidimensional scale that measures social support, use of communication technologies and social participation in the community. Material(s) and Method(s): Demographic, clinical and functional data of residents of two pulbic Nursing Homes, able to answer the ESTEII Test of Social Loneliness (SL). Result(s): 50 residents. 72% women (mean 86.3 years). MEC-35 scale mean 25.7, Barthel Index mean 62.4. Mild cognitive impairment 38%, Only 29% with studies. Previous depression 38%. 68% have medium loneliness level (values 11-20) and 12% high social loneliness (>21). Results are similiar adjusting scale without technologies (66% and 18%) There are no significant differences between SL and sex (p = 0.2), age (p = 0.6), diagnosis of depression (p = 0.6) or cognitive impairment (p = 0.37). We found a relationship between SL value and Pfeiffer scale (p = 0.05). Conclusion(s): Social loneliness in NH presents a very high prevalence, 80% in our sample, even discarding the technological aspect. Possible associated with cognitive status. The impact of Covid19 pandemic in NH has selected an older and more frailty sample. Interventions are needed to help mitigate social loneliness in residents who are otherwise surrounded by people.

2.
European Geriatric Medicine ; 13(Supplement 1):S297, 2022.
Article in English | EMBASE | ID: covidwho-2175415

ABSTRACT

Introduction: Several difficulties have been identified by the Healthy ageing/Geriatric team regarding the emergency or urgent care and primary healthcare needs for geriatric population during the pandemic in Qatar. This study was designed to compare the ED boarding time and clinically important outcomes in elderly patients >age 65 and above] before and on-going COVID-19 pandemic. Method(s): We conducted a retrospective study from the data retrieved from the Cerner database to include all ED admissions before COVID-19 (01 Sep 2019 to 29 Feb 2020) and during COVID-19 (01 Mar 2020 to 31 August 2020). Result(s): Out of 116 patients, 57 were before COVID-19 and 59 were during COVID-19. Females were presented more to the ED before COVID-19 i.e. 32 (56%) and male were more during COVID-19 i.e. 31 (52.5%). Falls were more frequent during COVID-19 i.e. 12 (20.3%) compared to before 8 (14%). Trauma cases [n = 12 (20.3%)] were more during the COVID-19 as compared to before 7 (12.3%), respiratory infection was also more 28 (47.5%) as compared to 19 (33.3%) and Mild cognitive impairment were more 12 (20.3%) compared to 5 (8.8%). Boarding time was significantly reduced during COVID-19 [52.02;95% CI (44.4-59.6)] as compared to before COVID-19 [79.78;95% CI (64.8-94.8)]. Conclusion(s): The present study highlighted that there was a reduction in ED boarding time during COVID-19 for elderly patients which could be attributed to the new initiative undertaken by the geriatrics department including the geriatric day care unit.

3.
Alzheimer's and Dementia ; 18(S8) (no pagination), 2022.
Article in English | EMBASE | ID: covidwho-2172395

ABSTRACT

Background: Caring for a family member with cognitive impairment can be emotionally and physically exhausting. Caregiver challenges have been exacerbated by the COVID-19 pandemic. This qualitative study examined caregiving experiences during the pandemic, exploring what caregivers perceived as most important in their caregiving experience while navigating through the pandemic. Method(s): We enrolled 158 adults (non-Hispanic White (NHW): 66%;Latino: 16%;Black: 9%;Asian: 8%) caring for a family member with MCI, mild cognitive impairment, (35%) or dementia (65%). Approximately 37% were recruited from an Alzheimer's Disease Research Center (ADRC) and 63% from the community. Caregivers completed demographic questionnaires and open-ended questions about their experience during the pandemic. They were asked (1) what was the most important thing to them in terms of providing care;(2) if they felt that they had enough support to help them provide care;(3) how the COVID-19 pandemic has impacted them and the care they provide;and (4) what strategies have they used to help them provide care. Responses were open-coded by 2 teams of 2, who met several times with the principal investigator to discuss and refine the themes. Result(s): Several themes emerged from the analyses, including (1) caregivers managing their own physical health and safety, or that of their care recipient;(2) changes in relationship dynamics and familial support;(3) fluctuations in availability of formal support;(4) focus on wellness;and (5) employment/financial concerns brought upon by the pandemic. Conclusion(s): The pandemic has filled the lives of caregivers with more adversities and struggles, which can exacerbate the stress of caregiving and call attention to the need for more formal support. These findings highlight the urgent need for more online and at-home caregiving resources that can continue beyond the pandemic. Copyright © 2022 the Alzheimer's Association.

4.
Front Psychiatry ; 11: 570580, 2020.
Article in English | MEDLINE | ID: covidwho-2199297

ABSTRACT

Background: Under the COVID-19 outbreak, the Japanese government has strongly encouraged individuals to stay at home. The aim of the current study was to clarify the effects of the COVID-19 outbreak on the lifestyle of older adults with dementia or mild cognitive impairment (MCI) who live alone. Methods: Seventy-four patients with dementia or MCI aged ≥65 years, who regularly visited the dementia clinic of the Department of Psychiatry, Osaka University Hospital, were recruited in this study. The patients were divided into two groups according to their living situation: living alone group (n = 12) and living together group (n = 62). Additionally, the spouses of patients aged ≥65 years were assigned to the healthy control group (n = 37). Subjects' lifestyle changes were evaluated between April 8 and 28, 2020. Results: No subjects with acquaintances or relatives were infected with COVID-19 within the study period. The proportion of subjects who reduced going out in the living alone group, living together group and healthy control group was 18.2, 52.5, and 78.4%, respectively. The proportion of subjects who went out less frequently was significantly lower in both the living alone (p < 0.01) and living together (p < 0.05) groups than in the healthy control group. Conclusion: Most patients with dementia or MCI who live alone did not limit their outings or activities during the COVID-19 outbreak. Regular monitoring for potential COVID-19 infection in people living alone with dementia is vital for their safety and well-being.

5.
J Alzheimers Dis ; 2022.
Article in English | PubMed | ID: covidwho-2162926

ABSTRACT

BACKGROUND: Older age is a major risk factor for severe COVID-19 disease which has been associated with a variety of neurologic complications, both acutely and chronically. OBJECTIVE: We sought to determine whether milder COVID-19 disease in older vulnerable individuals is also associated with cognitive and behavioral sequelae. METHODS: Neuropsychological, behavioral, and clinical outcomes before and after contracting COVID-19 disease, were compared in members of two ongoing longitudinal studies, the Arizona APOE Cohort and the national Alzheimer's Disease Research Center (ADRC). RESULTS: 152 APOE and 852 ADRC cohort members, mean age overall roughly 70 years, responded to a survey that indicated 21 APOE and 57 ADRC members had contracted COVID-19 before their ensuing (post-COVID) study visit. The mean interval between test sessions that preceded and followed COVID was 2.2 years and 1.2 years respectively for the APOE and ADRC cohorts. The magnitude of change between the pre and post COVID test sessions did not differ on any neuropsychological measure in either cohort. There was, however, a greater increase in informant (but not self) reported cognitive change in the APOE cohort (p = 0.018), but this became nonsignificant after correcting for multiple comparisons. CONCLUSION: Overall members of both cohorts recovered well despite their greater age-related vulnerability to more severe disease.

6.
European Psychiatry ; 65(Supplement 1):S498-S499, 2022.
Article in English | EMBASE | ID: covidwho-2153994

ABSTRACT

Introduction: SARS-Co-V2 neuroinvasive ability might be the basis for the onset of delirium and neuropsychiatric outcomes. Objective(s): We hypothesized that some infected patients with preexisting cognitive dysfunction may present delirium as unique manifestation of COVID-19 infection or as a prodrome of a new episode consistent with the psychiatric history. Method(s): We conducted a PubMed literature search to verify whether cognitive impairment might predispose to COVID-19. We included three patients with mild cognitive impairment and delirium at admission for SARS-Co-V2 suspected infection. Delirium was diagnosed according to DSM-5 criteria, Cognitive Assessment Method and Coma Glasgow Scale. Result(s): Literature analysis evidenced patients presenting delirium or delirium-like symptoms as clinical manifestation of COVID-19, plus a cognitive impairment, from mild to severe, which preexisted or was evidenced during the acute phase or after the infection. Most studies described delirium in patients with a past neurological/ psychiatric history. Contrasting data emerged on the potential link between COVID-19 and delirium in patients with cognitive impairment and without a past neuropsychiatric history. Our patients had no history of other medical complications. Our first patient had no psychiatric history, the second reported only a depressive episode, and the third had story of bipolar disorder. Delirium resolved completely after 2 days in the first patient. The other patients required 4 and 14 days to resolve: delirium appeared as the prodrome of a new psychiatric episode in line with their past history. Conclusion(s): Clinicians should acknowledge the possibility that COVID-19 infection may appear as delirium and acute psychiatric sequelae as unique manifestation.

7.
Advances and Applications in Statistics ; 74:29-45, 2022.
Article in English | Web of Science | ID: covidwho-2124135

ABSTRACT

With the U.S. Food and Drug Administration's (FDA) approval and widespread use of COVID mRNA vaccines (principally the Pfizer-BioNTech and Moderna COVID vaccines), mRNA techniques have become widely recognized by both the media and the general public. Correspondingly, many topics related to these techniques have attracted significant interest in many research areas, including microRNA (miRNA), which regulates many mRNA types. Although miRNA has been researched since early 2000, the studies focused on miRNA in the context of individual diseases are all very recent. What constitutes an appropriate miRNA pair for a biomarker to support disease diagnosis is still an open question in many biochemical and medical investigations, for example, Alzheimer's disease. Sometimes, synthetic (artificial) miRNA is used as a normalizer (denominator of biomarker). Sometimes, a ubiquitous normalizer with a robust concentration value across many pathologies is chosen. In the biomedical field, researchers have selected markers in different ways, often without rigorous mathematical or statistical study. In this paper, instead of using these pathology-insensitive miRNAs as normalizers, we propose a new miRNA-pairs-selection algorithm with a multivariate statistics approach to search for a pair or of pathology-sensitive miRNAs for a given pathology. We demonstrate the performance of this algorithm through a published experiment using published Mild Cognitive Impairment (MCI) data.

8.
Int J Environ Res Public Health ; 19(22)2022 Nov 11.
Article in English | MEDLINE | ID: covidwho-2110092

ABSTRACT

Mild cognitive impairment is frequent among people with Parkinson's disease. Cognitive training seems effective for cognitive status and for mitigating anxiety and depression. With the COVID-19 outbreak, such therapeutic interventions were delivered online. This longitudinal mixed-method study was aimed at evaluating the effectiveness of an online cognitive treatment, carried out during COVID times and based on Parkinson's-Adapted Cognitive Stimulation Therapy, on cognitive domains and mood of 18 older people with Parkinson's disease. After screening, the cognitive status and mood were assessed three times by Addenbrooke's Cognitive Examination-Revised scale and the Geriatric Depression Scale-Short Form. At the follow-up, patients were also interviewed for understanding their experience with the technology. Such treatment was effective on the participants' cognitive functions, but not on their mood. Despite some initial problems with the technology, the online intervention was experienced as a way of not being 'left behind', staying in contact with others, and being safe during the lockdown. This suggests that online cognitive treatment can be adopted to integrate face-to-face interventions by increasing their efficacy, accessibility, and long-term outcomes. Suggestions for future research are given.


Subject(s)
COVID-19 , Parkinson Disease , Humans , Aged , Pilot Projects , Parkinson Disease/complications , Parkinson Disease/therapy , COVID-19/therapy , Communicable Disease Control , Cognition
9.
Otolaryngology - Head and Neck Surgery ; 167(1 Supplement):P144-P145, 2022.
Article in English | EMBASE | ID: covidwho-2064489

ABSTRACT

Introduction: Olfactory dysfunction is a common symptom associated with COVID-19 infection. While often transient, nearly 1 in 8 patients experience persistent dysfunction after initial infection resolution. Given the known association between impaired olfaction and mild cognitive impairment (MCI), this persistent COVID-19 olfactory dysfunction may impede early detection of cognitive decline. Method(s): Patients with confirmed COVID-19-associated hyposmia (n=73), MCI (n=58), and normal controls (n=86) were prospectively enrolled. Demographic data were collected alongside formal olfactory testing via AROMA (Affordable Rapid Olfaction Measurement Assay) at time of initial enrollment. MCI was assessed via MoCA (Montreal Cognitive Assessment). Multivariate logistic regressions were utilized to evaluate for associations between variables and etiology of olfactory dysfunction. Result(s): After controlling for age and gender, when compared against normal controls, the inability to smell licorice, cinnamon, and lemon at the lowest 3 concentrations increased odds of COVID-19 hyposmia by 10.8 (95% CI, 4.6-25.6), 5.7 (95% CI, 2.7-11.7), and 5.3 (95% CI, 2.6-10.8), respectively. While the inability to smell coffee (9.9 odds ratio [OR];95% CI, 2.02-48.1), eucalyptus (6.7 OR;95% CI, 2.2-20.0), and rose (4.0 OR;95% CI, 1.7-9.7) were associated with MCI, decreased ability to smell licorice, cinnamon, and lemon were not. When combined into a composite score and compared against controls, decreased detection of licorice, cinnamon, and lemon was associated with a 16.5 OR (95% CI, 6.6-41.3) for COVID-19 hyposmia. This composite score was not significantly associated with MCI (1.2 OR;95% CI, 0.6-2.2) and, as such, performed well at discriminating between COVID-19 and MCI patients (receiver operating characteristic area under the curve=0.76). Conclusion(s): Distinct patterns of impaired olfaction were noted for COVID-19. We show that this etiology-specific phenotype has good discriminative performance when differentiating from MCI-associated hyposmia, which may allow for continued utilization of olfactory screening for MCI even among those with previous COVID-19 infection.

10.
Dissertation Abstracts International: Section B: The Sciences and Engineering ; 83(11-B):No Pagination Specified, 2022.
Article in English | APA PsycInfo | ID: covidwho-2046812

ABSTRACT

Rates of cognitive impairment among older adults are expected to increase substantially in the coming decades. Older adults may experience mild cognitive difficulties, characterized as a decline in cognition that does not significantly interfere with an individual's ability to complete activities of daily living. However, these individuals may need additional time, strategies, or help from a care partner (CP) to complete more complex functional activities. Cognitive training (CT) interventions have been shown to be beneficial for improving or stabilizing objective cognitive functioning, with less known about how CT may impact daily functioning or the lives of CPs. Additionally, CT is typically delivered in-person, which was not feasible during the COVID-19 pandemic. Thus, this study used a pre-post design to investigate the feasibility of a telehealth compensatory CT program for older adults with mild cognitive difficulties. It also examined the effects of program participation on participants' daily, emotional, and subjective cognitive functioning, as well as the effects CPs experienced through participation in the program. Feasibility was measured through tracking enrollment and completion rates, participant and clinician ratings of sessions' technological interference, and qualitative feedback from patients about the telehealth delivery. Paired t-tests were used to evaluate sets of pre- and post-measures completed by both participants and CPs. Results showed that older adults found the telehealth delivery to be feasible. After statistical correction, no significant differences were found between participant pre- and post-measures, though small to medium effect sizes were observed and participants qualitatively reported benefits from the CT. CPs experienced a significant increase on measures assessing the rewarding aspects of providing care, and they provided qualitative feedback on the benefits of the program without significant added burden. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

11.
Gerontol Geriatr Med ; 8: 23337214221123708, 2022.
Article in English | MEDLINE | ID: covidwho-2029678

ABSTRACT

Objective: Advanced age poses an increased risk for cognitive impairment, and therefore, poor knowledge regarding the risks associated with COVID-19 may confer vulnerability. We administered a COVID-19 Knowledge Questionnaire to older persons to evaluate the association between knowledge regarding public health recommendations, and cognitive status as measured by the Montreal Cognitive Assessment (MoCA). Method: Ninety-nine participants completed a 22-item questionnaire about COVID-19 symptoms, risks, and protective strategies, and they also completed the MoCA. Associations between knowledge and cognitive status were examined via Spearman correlations. Results: The mean (SD) age of participants was 72.6 (7.6) years, and MoCA scores averaged 23.4 (4.5) points. Higher MoCA total scores were significantly (p < .001) correlated with a greater number of correct questionnaire responses. Higher Orientation and Memory Index scores were moderately associated with an increased number of correct responses (p < .001), with the Executive Index exhibiting a significant albeit weaker association. MoCA Index scores assessing attention, language, and visuospatial functioning were not significantly associated with COVID-19 knowledge. Conclusions: Given the rapid transmission rate of the SARS CoV-2 infections, COVID knowledge lapses will likely have deleterious repercussions. Public health messages should ensure effective acquisition and retention of COVID specific information, especially in cognitively compromised older adults.

12.
Journal of the Formosan Medical Association ; 121(9):1617-1621, 2022.
Article in English | Scopus | ID: covidwho-2015654
13.
Int J Environ Res Public Health ; 19(16)2022 08 15.
Article in English | MEDLINE | ID: covidwho-1987792

ABSTRACT

(1) Background: Preventive measures to control the spread of COVID-19 are essential, but they often cause social isolation and diminish the physical and mental health of older adults. In cognitively impaired individuals, the pandemic has worsened behavioral and psychological symptoms of dementia (BPSD). Here, we explored the factors contributing to the worsening of BPSD during the COVID-19 pandemic. (2) Methods: Potential patients were identified at a memory clinic in Japan between June 2017 and June 2021. Eligible patients had a diagnosis of mild cognitive impairment (MCI) or dementia during the study period. The outcome was BPSD, as assessed by using the Dementia Behavioral Disorders Scale. Information on patients' lifestyle habits and use of care services was obtained for use as primary explanatory variables; multiple regression analysis was performed to examine the relationship between BPSD and care services use or lifestyle habits. The model was adjusted for sociodemographic factors, and the interaction terms of the pandemic period with lifestyle and service use were included to evaluate the effects of COVID-19. (3) Results: We identified 977 participants with MCI and 1380 with dementia (MCI group: 69.8% age 75 years or older, 54.2% female; dementia group: 79.8% age 75 years or older, 64.8% female). After adjustment for possible confounders, significantly worse BPSD was demonstrated in those who used daycare services during COVID-19 (both MCI and dementia patients; p = 0.007 and p = 0.025 respectively) and in those with poor nutritional function (dementia patients; p = 0.040). (4) Conclusions and Implications: During COVID-19, poor nutritional status and use of daycare services were associated with BPSD in those with cognitive decline. These findings indicate the need to fully examine the quantity and quality of care services for people with cognitive decline during emergencies and to continue to provide effective services.


Subject(s)
COVID-19 , Cognitive Dysfunction , Dementia , Aged , Behavioral Symptoms , COVID-19/epidemiology , Cognitive Dysfunction/psychology , Dementia/psychology , Female , Humans , Male , Pandemics
14.
Int J Environ Res Public Health ; 19(13)2022 06 22.
Article in English | MEDLINE | ID: covidwho-1934029

ABSTRACT

Background: Person-centered care (PCC) requires knowledge about patient preferences. This formative qualitative study aimed to identify (sub)criteria of PCC for the design of a quantitative, choice-based instrument to elicit patient preferences for person-centered dementia care. Method: Interviews were conducted with n = 2 dementia care managers, n = 10 People living with Dementia (PlwD), and n = 3 caregivers (CGs), which followed a semi-structured interview guide including a card game with PCC criteria identified from the literature. Criteria cards were shown to explore the PlwD's conception. PlwD were asked to rank the cards to identify patient-relevant criteria of PCC. Audios were verbatim-transcribed and analyzed with qualitative content analysis. Card game results were coded on a 10-point-scale, and sums and means for criteria were calculated. Results: Six criteria with two sub-criteria emerged from the analysis; social relationships (indirect contact, direct contact), cognitive training (passive, active), organization of care (decentralized structures and no shared decision making, centralized structures and shared decision making), assistance with daily activities (professional, family member), characteristics of care professionals (empathy, education and work experience) and physical activities (alone, group). Dementia-sensitive wording and balance between comprehensibility vs. completeness of the (sub)criteria emerged as additional themes. Conclusions: Our formative study provides initial data about patient-relevant criteria of PCC to design a quantitative patient preference instrument. Future research may want to consider the balance between (sub)criteria comprehensibility vs. completeness.


Subject(s)
Dementia , Patient Preference , Analytic Hierarchy Process , Caregivers/psychology , Dementia/psychology , Dementia/therapy , Humans , Patient-Centered Care/methods , Qualitative Research , Research Design
15.
Neurology ; 98(18 SUPPL), 2022.
Article in English | EMBASE | ID: covidwho-1925283

ABSTRACT

Objective: To present initial validity evidence for MyCog. Background: Cognitive Impairment (CI) affects more than 16 million people, with dementia or severe cognitive decline projected to increase significantly by 2050. MyCog is a brief, standardized iPad-based, self-administered cognitive screening assessment designed for use in diverse clinical settings, among older adults or any patient with a recognized cognitive concern. It will address the need for sensitive measures of CI feasible for use in primary care settings. Design/Methods: Participants were recruited from an ongoing cognitive aging study conducted in academic internal medicine clinic and community health centers. CI was determined based on either a chart diagnosis of dementia or mild cognitive impairment (MCI), or by normative performance on a comprehensive cognitive battery within the prior 18 months. The MyCog assessments, Dimensional Change Card Sort (DCCS) and Picture Sequence Memory (PSM), measure executive function, cognitive flexibility, and episodic memory. We evaluated the efficacy of MyCog as a detection tool using sensitivity, specificity, and receiver operator characteristic (ROC) curves. Results: Of the 80 participants administered the MyCog assessment, 31 were classified as CI. In the sub-sample of participants who expressed concern about their cognition (n = 52), PSM and DCCS demonstrated exceptional ability in detecting CI (the area under the ROC curve, or AUC, = 0.92), with an average administration time of 12 minutes. When only including the first of two PSM trials along with DCCS, time was reduced on an average to <7 minutes, with little change in AUC (0.90). Conclusions: Preliminary validity evidence supports the use of MyCog as a self-administered cognitive screening battery. Given the COVID-19 pandemic, it is important to provide physicians and clinical staff access to well-designed cognitive assessments that can be selfadministered. We are currently validating MyCog in MCI clinical populations, and our next steps include a clinical trial with modified clinic workflows.

16.
Neurology ; 98(18 SUPPL), 2022.
Article in English | EMBASE | ID: covidwho-1925233

ABSTRACT

Objective: To examine the natural history of neurological symptoms in mild COVID-19. Background: Various neurological manifestations have been reported with COVID-19, mostly in retrospective studies of hospitalized patients. There are few data on patients with mild COVID19. Design/Methods: Consenting participants in the ALBERTA HOPE COVID-19 trial( NCT04329611, hydroxychloroquine vs placebo for 5-days), managed as outpatients, were prospectively assessed 3-months and 1-year after their positive test. They completed detailed neurological symptom questionnaires, Telephone Montreal Cognitive Assessment(T-MoCA), Kessler Psychological Distress Scale(K10), and the EQ-5D-3L(quality-of-life). Informants completed the Mild Behavioural Impairment Checklist(MBI-C) and Informant Questionnaire on Cognitive Decline(IQCODE). We tracked healthcare utilization and neurological investigations using medical records. Results: Among 198 patients (median age:45, IQR:37-54, 43.9% female);28(14.1%) had preexisting neurological/psychiatric disorders. Among 179 patients with symptom assessments, 139(77.7%) reported ≥1 neurological symptom, the most common being anosmia/dysgeusia(56.3%), myalgia(42.6%), and headache(41.8%). Symptoms generally began within 1-week of illness(median:6-days, IQR:4-8). Most resolved after 3-months;40 patients(22.3%) reported persistent symptoms at 1-year, with 27(15.1%) reporting no improvement. Persistent symptoms included confusion(50%), headache(52.5%), insomnia(40%), and depression(35%). Body mass index, prior neurologic/psychiatric history, asthma, and lack of full-time employment were associated with presence and persistence of neurological symptoms;only female sex was independently associated on multivariable logistic regression(aOR:5.04, 95%CI:1.58-16.1). Patients with persistent symptoms had more hospitalizations and family physician visits, worse MBI-C scores, and were less often independent for instrumental daily activities at 1-year(77.8% vs 98.2%, p=0.005). Patients with any or persistent neurological symptoms had greater psychological distress defined as K10≥20(aOR:21.0, 95%CI:1.96-225) and worse quality-of-life ratings(mean EQ-5D VAS:67.0 vs 82.8, p=0.0002). 50.0% of patients had T-MoCA<18 at 3-months versus 42.9% at 1-year;patients reporting memory complaints were more likely to have informant-reported cognitive-behavioural decline (aOR[1-year IQCODE>3.3]:12.7, 95%CI:1.08-150). Conclusions: Neurological symptoms were commonly reported in survivors of mild COVID-19 and persisted in one in five patients 1-year later. These symptoms were associated with worse patient-reported outcomes.

17.
Neurology ; 98(18 SUPPL), 2022.
Article in English | EMBASE | ID: covidwho-1925202

ABSTRACT

Objective: This analysis describes strategies to overcome challenges posed by the COVID-19 pandemic in a clinical study involving Mild Cognitive Impairment (MCI) patients. Background: COVID-19 presents safety risks and technical difficulties for research involving in-person visits. Design/Methods: A prospective study investigating digital cognitive assessments in MCI patients was conducted in an outpatient memory clinic starting January 2020. In-person assessments were completed via tablet and paper. Recruitment paused during stay-at-home mandates for nonessential employees starting March 2020 and lasted six months. To optimize paused recruitment, study activities shifted to chart screening which also maintained grant supported study personnel. After resuming recruitment, precautions were applied, mitigating infection risk: protective glass, disinfection, temperature checks, six-foot distancing, surgical masks for patients, and respirators for staff. Participants were informed of precautions prior to scheduling a visit. Patient portal direct messaging, SMS appointment reminders, and increased compensation were implemented. Effects of masks on verbal response analysis by a speech recognition algorithm were assessed during a second, three-month pause starting January 2021. Results: 4569 medical charts were screened. 332 patients were eligible of which 190 patients declined participation with three citing COVID-19 as the reason. Four participants were enrolled prior to shutdown, 22 were analyzed for masking effects, and 62 were enrolled after the second pause (n=88, 74.9±6.8 years old, 46 female). Enrollment rates before and after portal messaging alongside increased compensation were 23.6% and 31.5%, respectively. Data suggested that masks had no effect on speech analysis. No COVID-19 cases were reported among research personnel or participants. Conclusions: The applied strategies allowed proper COVID-19 risk management without negatively affecting data quality. Rearranging study tasks mitigated the effect of recruitment pauses and transparent communication with patients regarding precautions helped instill confidence in their decision to participate, allowing for successful execution of the study. This work offers guidance for investigators faced with similar challenges.

18.
Vestnik Rossiiskoi Akademii Meditsinskikh Nauk ; 77(2):107-118, 2022.
Article in Russian | EMBASE | ID: covidwho-1918186

ABSTRACT

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.

19.
Healthcare (Basel) ; 10(6)2022 May 24.
Article in English | MEDLINE | ID: covidwho-1911273

ABSTRACT

BACKGROUND: The Taiwanese government implemented a stay-at-home order that restricted all community-based health promotion activities for the elderly by shutting down all community care centers from May 2021 to August 2021 to control the spread of COVID-19. Community-based dementia care centers were barely able to provide dementia care services during that period. METHODS: The data used in this study were collected from a community-based dementia care center that was able to continue their dementia care services through a Tele-Health intervention program. The difference-in-differences methodology was applied to evaluate the effects of the Tele-Health intervention program on home-dwelling persons with dementia or mild cognitive impairment and on their primary caregivers during the COVID-19 pandemic. RESULTS: The Tele-Health intervention program significantly increased the well-being of the participants and their primary caregivers, but the negative correlations between the Tele-Health intervention program and family functioning were also found to be significant. CONCLUSIONS: The significant substitution (negative) effects between the Tele-Health intervention program and family functioning raises the concern that promotion of the Tele-Health intervention program comes at the potential cost of a loss of family functioning. Policymakers should be cautious when considering the Tele-Health intervention program in response to pandemics and demographic transitions.

20.
Front Psychiatry ; 13: 898990, 2022.
Article in English | MEDLINE | ID: covidwho-1911107

ABSTRACT

Psychological resilience refers to the ability to cope with adversities, and deficits in resilience might lead to mental illness. The COVID-19 pandemic has had impact on psychological resilience for older adults, but there are as yet no data on its impacts on the mental health of older adults who were living with mild cognitive impairment (MCI). Therefore, the aim of this study was to investigate the impact of the COVID-19 pandemic on psychological resilience in older adults with MCI and to explore associated physical and psychosocial factors. In this cross-sectional study of 268 older adults aged 65-85, we defined MCI as age- and education-adjusted cognitive decline with a standard deviation of 1.0 or more from the reference threshold. During December 2020 to April 2021, we carried out to all participants the 10-item version of the Connor-Davidson Resilience Scale (CD-RISC-10) to measure psychological resilience. We also conducted a comprehensive geriatric assessment including sleep quality and depressive symptoms (Pittsburgh Sleep Quality Index and 15-item Geriatric Depression Scale, respectively). To identify factors associated with CD-RISC-10 scores (mean: 23.3 ± 0.4), multiple regression analysis revealed that older age [coefficient = 0.23, 95% confidence interval (CI) = 0.06-0.39] was significantly correlated with higher scores, whereas poor sleep quality (coefficient = -2.06, 95% CI = -3.93 to -0.19) and depressive symptoms (coefficient = -2.95, 95% CI = -5.70 to -0.21) were significantly correlated with lower scores. In this study, older adults with MCI showed low psychological resilience during the COVID-19 pandemic, and people with low psychological resilience indicated poor sleep quality and depressive symptoms. Our findings suggest directions for devising interventions to maintain mental health and psychological resilience among the vulnerable population of older adults with MCI living under the socially isolated conditions of COVID-19 pandemic restrictions. Our recommendation includes continuous assessment of this population and appropriate care for poor sleep quality and depressive symptoms.

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