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2.
Clin Infect Dis ; 73(11): e4005-e4011, 2021 12 06.
Article in English | MEDLINE | ID: covidwho-1562130

ABSTRACT

BACKGROUND: Racial disparities are central in the national conversation about coronavirus disease 2019 (COVID-19) , with Black/African Americans being disproportionately affected. We assessed risk factors for death from COVID-19 among Black inpatients at an urban hospital in Detroit, Michigan. METHODS: This was a retrospective, single-center cohort study. We reviewed the electronic medical records of patients positive for severe acute respiratory syndrome coronavirus 2 (the COVID-19 virus) on qualitative polymerase chain reaction assay who were admitted between 8 March 2020 and 6 May 2020. The primary outcome was in-hospital mortality. RESULTS: The case fatality rate was 29.1% (122/419). The mean duration of symptoms prior to hospitalization was 5.3 (3.9) days. The incidence of altered mental status on presentation was higher among patients who died than those who survived, 43% vs 20.0%, respectively (P < .0001). From multivariable analysis, the odds of death increased with age (≥60 years), admission from a nursing facility, Charlson score, altered mental status, higher C-reactive protein on admission, need for mechanical ventilation, presence of shock, and acute respiratory distress syndrome. CONCLUSIONS: These demographic, clinical, and laboratory factors may help healthcare providers identify Black patients at highest risk for severe COVID-19-associated outcomes. Early and aggressive interventions among this at-risk population may help mitigate adverse outcomes.


Subject(s)
COVID-19 , African Americans , Cohort Studies , Hospital Mortality , Hospitalization , Humans , Middle Aged , Retrospective Studies , Risk Factors , SARS-CoV-2
3.
BMJ Case Rep ; 14(6)2021 Jun 17.
Article in English | MEDLINE | ID: covidwho-1276911

ABSTRACT

The COVID-19 pandemic significantly impeded face-to-face health and social care delivery for people living with dementia and their carers. Interruption of meaningful activity engagement along with increased social isolation is known to be associated with loss of skills, increased loneliness, physical deterioration and decline in cognition and mood in people with dementia. To ensure continuity of care for people living with dementia, for whom multimodal, non-pharmacological intervention programmes were being provided, there was an urgent need to adopt a remote delivery model. Guidance on digitally delivered assessment and care specific to non-pharmacological interventions for dementia is lacking. Adoption of technology-enabled care for people with dementia requires overcoming barriers to technology use, adaptation of therapeutic guidelines, adaptation of communication methods and carer support. Despite these challenges, therapists successfully transitioned from in-person to digital delivery of therapeutic interventions with associated benefits of continued meaningful activity engagement discussed.


Subject(s)
COVID-19 , Dementia , Caregivers , Humans , Pandemics , SARS-CoV-2
4.
Can Geriatr J ; 24(2): 151-153, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1273651

ABSTRACT

COVID-19 has had a profound impact on long-term care (LTC) homes in Canada. But the measures put in place to control infection within LTC homes have also had devastating impacts on the health and well-being of residents through the effects on social connection. Here, we offer guiding principles to enable social connection and promote health and quality of life for LTC residents during COVID-19 and beyond. These principles were generated by a working group of the COVID-19 and Dementia Task Force, convened by the Alzheimer Society of Canada to identify the urgent and emerging issues raised by COVID-19 for Canadians with dementia.

5.
Gerontol Geriatr Med ; 7: 23337214211020164, 2021.
Article in English | MEDLINE | ID: covidwho-1262489

ABSTRACT

Background: In December 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), or COVID-19, raised worldwide concern. Since then, the COVID-19 pandemic has negatively influenced health and wellness across the globe and caused nearly three million deaths. This study focuses on informal caregivers of people with dementia, a disease that affects about 50 million older adults worldwide and requires much caregiving support. Objective: Examine the current literature on the impact of COVID-19 on the health and well-being of informal caregivers for people with dementia. Method: This rapid review was conducted across five electronic databases for quantitative and qualitative articles published through March 15, 2021. Results: The 10 studies included in this review reported quantitative descriptive data from across the globe; however, no studies existed from the U.S. or East Asia countries. All of the studies examined the psychological rather than physical impact of COVID-19 and highlighted risk and protective factors in the areas of psychosocial (resilience, neuropsychiatric, and social isolation), sociodemographic (gender and education), and environmental (home confinement, living arrangement, and dementia stage). Conclusion: COVID-19 has had a considerable negative impact on the psychological well-being of informal caregivers of people with dementia, namely causing more depression and anxiety than pre-pandemic.

6.
Clin Gerontol ; 45(1): 86-96, 2022.
Article in English | MEDLINE | ID: covidwho-1254193

ABSTRACT

OBJECTIVES: This project investigated experiences of caregivers of people living with dementia during COVID-19. We recorded caregivers' perceptions of care before, during, and moving forward from COVID-19, emphasizing positive experiences, coping strategies, creative care adaptation, strengths demonstrated, and benefits of providing care. METHODS: Allied health professionals conducted semi-structured interviews with 26 informal caregivers of people living with dementia. We categorized and thematically analyzed responses as before, during or moving forward from COVID-19. RESULTS: A range of themes were derived from the data. Pre-pandemic care: (1) focusing on the person living with dementia and (2) working together. During-pandemic care: (1) respecting personhood; (2) connecting with virtues and values; (3) improving relationships; (4) seeking and receiving support; (5) prioritizing self-care; (6) being protective and proactive; (7) making practical changes. Moving forward from COVID-19: (1) strengthening commitment to the person living with dementia, (2) looking after my own needs, and (3) considering practical requirements. CONCLUSIONS: Participants reported positive caregiving experiences in all timeframes, focusing more on their own needs and experiences during and moving forward from COVID-19. This research may highlight informal caregivers' challenges and needs. CLINICAL IMPLICATIONS: Enforced isolation produced deeper connections for some caregivers. Caregivers benefit from resources facilitating adaptive care.


Subject(s)
COVID-19 , Dementia , Caregivers , Humans , Pandemics , SARS-CoV-2
7.
Front Public Health ; 9: 660144, 2021.
Article in English | MEDLINE | ID: covidwho-1247947

ABSTRACT

Introduction: Loneliness and low social support can be detrimental to the health of individuals living with Alzheimer's and related dementias (ADRD) and family care partners. Restrictions on gatherings to prevent the spread of COVID-19 create an even greater risk for social isolation. Memory Cafés are a highly replicated program that provide individuals living with ADRD and care partners an opportunity to socialize in an inclusive and supportive environment without fear of judgment, pressure, or stigma. Following restrictions on in-person gatherings, virtual Memory Cafés offer regular social engagement opportunities in an online format. While the Memory Café model has been replicated globally, their effects on loneliness and perceived social support are generally unknown. Even less is known about their impact when operating in a virtual environment. Methods: Semi-structured interviews in Spanish and English were conducted with individuals living with dementia and family care partners who regularly attend Memory Cafés hosted by partners in a Texas Memory Café Network. Interviews took place online using video conferencing software, were transcribed, then analyzed for common themes using a combined inductive and deductive approach. Results: A total of 17 interviews were conducted with persons living with dementia (n = 5) and family care partners (n = 12) who attend Memory Cafés to learn about their perceived experiences of social connectedness since COVID-19. Care partners included spouses (n = 8) and adult children (n = 4). Interviews included attendees of different Memory Café models, including in-person only (n = 2), virtual only (n = 9), and those who attend both models (n = 6). Five key themes were identified: (1) Reprieve; (2) What is still possible; (3) Connectedness; (4) Inclusivity; and (5) Value added, with ten sub-themes supporting these main themes. Discussion: Findings substantiate evidence that Memory Cafés offer important benefits for families living with dementia, providing vital new insight into the potential for virtual Memory Cafés to offer similar benefits. Findings have implications beyond the context of COVID-19, where virtual models may support the social connectedness of those living in geographically marginalized and underserved areas. Virtual models may not address the needs of all families experiencing dementia due to lack of access to technology and limitations for virtual engagement with those experiencing later stage dementia.


Subject(s)
COVID-19 , Dementia , Adult , Caregivers , Child , Humans , SARS-CoV-2 , Texas
8.
Int J Geriatr Psychiatry ; 36(11): 1597-1639, 2021 11.
Article in English | MEDLINE | ID: covidwho-1233187

ABSTRACT

OBJECTIVES: In response to a commissioned research update on dementia during the COVID-19 pandemic, a UK-based working group, comprising dementia researchers from a range of fields and disciplines, aimed to describe the impact of the pandemic on dementia wellbeing and identify priorities for future research. METHODS: We supplemented a rapid literature search (including unpublished, non-peer reviewed and ongoing studies/reports) on dementia wellbeing in the context of COVID-19 with expert group members' consensus about future research needs. From this we generated potential research questions the group judged to be relevant that were not covered by the existing literature. RESULTS: Themes emerged from 141 studies within the six domains of the NHS England COVID-19 Dementia Wellbeing Pathway: Preventing Well, Diagnosing Well, Treating Well, Supporting Well, Living Well and Dying Well. We describe current research findings and knowledge gaps relating to the impact on people affected by dementia (individuals with a diagnosis, their carers and social contacts, health and social care practitioners and volunteers), services, research activities and organisations. Broad themes included the potential benefits and risks of new models of working including remote healthcare, the need for population-representative longitudinal studies to monitor longer-term impacts, and the importance of reporting dementia-related findings within broader health and care studies. CONCLUSIONS: The COVID-19 pandemic has had a disproportionately negative impact on people affected by dementia. Researchers and funding organisations have responded rapidly to try to understand the impacts. Future research should highlight and resolve outstanding questions to develop evidence-based measures to improve the quality of life of people affected by dementia.


Subject(s)
COVID-19 , Dementia , Consensus , Dementia/epidemiology , Humans , Pandemics , Quality of Life , SARS-CoV-2
9.
Geriatr Nurs ; 42(3): 780-781, 2021.
Article in English | MEDLINE | ID: covidwho-1231996

ABSTRACT

The older population and medically frail persons are at higher risk of severe infections and death from coronavirus disease 2019 (COVID-19). Long-term care (LTC) facilities are encouraged to take various actions to safeguard residents and reduce the spread of COVID-19 including by restricting visitors, which leads to isolation. The imposed isolation undermines the autonomy of older adults living in LTC facilities, especially those with dementia, and the isolation from loved ones can worsen cognition and depression. The purpose of this case report is to highlight isolation practices implemented to reduce the spread of COVID-19 in an LTC facility, which increased the social isolation and worsened cognition and depression in a resident with dementia and depression. Because many residents of LTC facilities have dementia, this case is an example of the need for interventions to support the mental health of persons living in LTC facilities during the COVID-19 pandemic.


Subject(s)
COVID-19/prevention & control , Dementia/psychology , Depressive Disorder/psychology , Long-Term Care/psychology , Physical Distancing , Social Isolation/psychology , Aged, 80 and over , COVID-19/epidemiology , COVID-19/transmission , Female , Humans
10.
Can J Public Health ; 112(3): 400-411, 2021 06.
Article in English | MEDLINE | ID: covidwho-1229507

ABSTRACT

OBJECTIVES: Compared with the general population, people living with dementia have been unequivocally affected by the COVID-19 pandemic. However, there is a paucity of knowledge on the COVID-19 impact on people with dementia and their care partners. The objective of this scoping review was to synthesize the existing literature on the COVID-19 experiences of people with dementia and their care partners. METHODS: Following Arksey and O'Malley's scoping review framework, we searched five electronic databases (Scopus, PubMed, CINAHL, EMBASE, and Web of Science) and an online search engine (Google Scholar). Inclusion criteria consisted of English-language articles focusing on the COVID-19 experiences of people with dementia and their care partners. SYNTHESIS: Twenty-one articles met our inclusion criteria: six letters to the editor, seven commentaries, and eight original research studies. In the literature, five main themes were identified: (i) care partner fatigue and burnout; (ii) lack of access to services and supports; (iii) worsening neuropsychiatric symptoms and cognitive function; (iv) coping with COVID-19; and (v) the need for more evidence-informed research. Factors such as living alone, having advanced dementia, and the length of confinement were found to exacerbate the impact of COVID-19. CONCLUSION: Urgent action is needed to support people living with dementia and their care partners in the pandemic. With little access to supports and services, people with dementia and their care partners are currently at a point of crisis. Collaboration and more evidence-informed research are critical to reducing mortality and supporting people with dementia during the pandemic.


RéSUMé: OBJECTIFS: Comparativement à la population générale, les personnes vivant avec la démence ont incontestablement été touchées par la pandémie de COVID-19. On en sait toutefois peu sur l'effet de la COVID-19 sur les personnes atteintes de démence et leurs partenaires soignants. Notre étude de champ visait à résumer la littérature existante sur l'expérience de la COVID-19 chez les personnes atteintes de démence et leurs partenaires soignants. MéTHODE: En suivant le cadre méthodologique d'Arksey et O'Malley pour les études de champ, nous avons interrogé cinq bases de données électroniques (Scopus, PubMed, CINAHL, EMBASE et Web of Science) et un moteur de recherche en ligne (Google Scholar). Nous avons inclus tous les articles en anglais portant sur l'expérience de la COVID-19 chez les personnes atteintes de démence et leurs partenaires soignants. SYNTHèSE: Vingt et un articles ont correspondu à nos critères d'inclusion : six lettres publiées dans le courrier des lecteurs, sept commentaires et huit études de recherche originales. Cinq grands thèmes sont ressortis de ces articles : i) la fatigue et l'épuisement professionnel des partenaires soignants; ii) le manque d'accès aux services et aux mesures d'aide; iii) l'aggravation des symptômes neuropsychiatriques et des fonctions cognitives; iv) les façons de faire face à la COVID-19; et v) le besoin de plus de recherche fondée sur les preuves. Nous avons constaté que trois facteurs, soit le fait de vivre seul(e), la démence avancée et la durée du confinement, exacerbaient l'effet de la COVID-19. CONCLUSION: Une action urgente est nécessaire pour aider les personnes vivant avec la démence et leurs partenaires soignants durant la pandémie. N'ayant guère accès aux mesures d'aide et aux services, les personnes atteintes de démence et leurs partenaires soignants se trouvent actuellement dans une situation de crise. La collaboration et la recherche fondée sur les preuves sont essentielles pour réduire la mortalité et aider les personnes atteintes de démence durant la pandémie.


Subject(s)
COVID-19/psychology , Caregivers/psychology , Dementia/therapy , COVID-19/epidemiology , Dementia/epidemiology , Humans
11.
BMC Geriatr ; 21(1): 301, 2021 05 10.
Article in English | MEDLINE | ID: covidwho-1223763

ABSTRACT

BACKGROUND: The impact of COVID-19 restrictions on people living with dementia and their carers is an emerging focus of recent research determining how we can best support this population. People living with dementia have faced service curtailment, increased risk for COVID-19, as well as potential heightened deterioration. This study reports the experiences of people living with dementia and their family carers during the early months of the COVID-19 pandemic in England and the impact on them. METHODS: We recruited and remotely interviewed 30 people living with dementia in their own homes and 31 family carers, via video or telephone call in mid-2020. Data were transcribed and analysed using thematic analysis. RESULTS: People living with dementia often had a basic understanding of COVID-19 restrictions but could have difficulty translating this into personalised risk-appraisal of their own actions. Managing COVID-19 risks facing people living with dementia at home was largely done by family carers, exemplified by changes to living arrangements, which could strain or sustain caring relationships. Well-established familial caring relationships contributed to the wellbeing of the person living with dementia and their carer, as well as keeping to simple routines that included leaving the home for exercise and stimulation. People living with dementia reported some negative psychological and cognitive effects due to the imposed restrictions, such as increased apathy, irritability, or anxiety, which were fuelled by lack of social engagement. CONCLUSIONS: Structuring routine (remote) social interactions where possible could increase social engagement and improve wellbeing for people living with dementia, especially those with limited familial support in a post-COVID-19 context. As some care relationships had been restructured to manage COVID-19 risks, additional carer strain may emerge as a result of the impact on the independence of the person living with dementia and come to the attention of professionals in health and care services. People living with dementia and their carers highlighted the importance of maintaining or adapting routines which may be useful learning for professionals, although additional support may be necessary for those who are impacted by more severe or worsening symptoms of dementia.


Subject(s)
COVID-19 , Dementia , Caregivers , Communicable Disease Control , Dementia/diagnosis , Dementia/epidemiology , England/epidemiology , Humans , Pandemics , SARS-CoV-2
13.
Dementia (London) ; 20(8): 2779-2801, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1207590

ABSTRACT

BACKGROUND AND OBJECTIVES: The Covid-19 pandemic reduced access to social activities and routine health care that are central to dementia prevention. We developed a group-based, video-call, cognitive well-being intervention; and investigated its acceptability and feasibility; exploring through participants' accounts how the intervention was experienced and used in the pandemic context. RESEARCH DESIGN AND METHOD: We recruited adults aged 60+ years with memory concerns (without dementia). Participants completed baseline assessments and qualitative interviews/focus groups before and after the 10-week intervention. Qualitative interview data and facilitator notes were integrated in a thematic analysis. RESULTS: 12/17 participants approached completed baseline assessments, attended 100/120 (83.3%) intervention sessions and met 140/170 (82.4%) of goals set. Most had not used video calling before. In the thematic analysis, our overarching theme was social connectedness. Three sub-themes were as follows: Retaining independence and social connectedness: social connectedness could not be at the expense of independence; Adapting social connectedness in the pandemic: participants strived to compensate for previous social connectedness as the pandemic reduced support networks; Managing social connections within and through the intervention: although there were tensions, for example, between sharing of achievements feeling supportive and competitive, participants engaged with various lifestyle changes; social connections supported group attendance and implementation of lifestyle changes. DISCUSSION AND IMPLICATIONS: Our intervention was acceptable and feasible to deliver by group video-call. We argue that dementia prevention is both an individual and societal concern. For more vulnerable populations, messages that lifestyle change can help memory should be communicated alongside supportive, relational approaches to enabling lifestyle changes.


Subject(s)
COVID-19 , Dementia , Adult , Humans , Pandemics , SARS-CoV-2
14.
Aging Ment Health ; 26(5): 905-910, 2022 May.
Article in English | MEDLINE | ID: covidwho-1205493

ABSTRACT

OBJECTIVES: Little is known about how community services and institutional care settings have adapted to providing support since the COVID-19 pandemic. The aim was to explore how these care services have adapted during the pandemic in the UK and are providing care to people living with dementia (PLWD) and carers. METHOD: Semi-structured telephone interviews were conducted in June and July 2020 with 16 purposefully sampled unpaid dementia carers. Participants were asked about their experiences of accessing care services since the lockdown, and whether they were beneficial, if accessed at all. RESULTS: Three themes were identified: (1) Impacts of no activities; (2) Difficulties accessing care during the pandemic; (3) Remote vs. face-to-face support. Loss of access to previously enjoyed activities and having had to shield for many PLWD is suggested to have led to severe physical and cognitive deteriorations, advancing the dementia. Where remote support was available, this was helpful to some, but did not replace the benefits of face-to-face support. Where PLWD were residing in a care home, carers had very limited remote access. CONCLUSIONS: This is the first study to explore the impact on carers both from a community and institutionalised care angle. Few care services have adapted to providing remote support. With the vaccine taking time to be accessible to everyone, it is vital for organisations to work closely with carers and PLWD to adapt services to provide much needed support.


Subject(s)
COVID-19 , Dementia , Caregivers/psychology , Communicable Disease Control , Dementia/psychology , Humans , Pandemics
15.
Int J Environ Res Public Health ; 18(9)2021 04 23.
Article in English | MEDLINE | ID: covidwho-1201904

ABSTRACT

In Poland, 92% of elderly people with dementia are cared for at home from diagnosis until death, and 44% of caregivers provide care on their own, without any support from other people. The aim of this study was to identify the needs, created because of the Covid-19 pandemic, of caregivers of people with Alzheimer's disease (AD). The study group consisted of 85 caregivers in the age range from 23 to 78 years and 80 (91.1%) were women. The questionnaire on the life situation of the caregiver and 10-item Perceived Stress Scale (PSS-10) were used. High levels of stress were found in 75 of the 85 subjects, representing 88% of the total. The greatest difficulties were identified in health care and in finding additional care for the charge. PSS-10 correlated with the deterioration of illness during Covid-19, changes in daily functioning, and concerns about both the health of the charge and caregiver. The level of stress severity in the caregiver group of charges with mild AD was higher than in the caregiver group of charges with moderate AD. The provision of extra care and professional psychological support for caregivers were identified as the greatest needs.


Subject(s)
Alzheimer Disease , COVID-19 , Adult , Aged , Alzheimer Disease/epidemiology , Caregivers , Cost of Illness , Female , Humans , Male , Middle Aged , Pandemics , Poland/epidemiology , SARS-CoV-2 , Young Adult
16.
Front Aging Neurosci ; 13: 653533, 2021.
Article in English | MEDLINE | ID: covidwho-1200094

ABSTRACT

Background: Family caregivers of patients with dementia are at high risk of stress and burden, and quarantine due to the coronavirus disease 2019 (COVID-19) pandemic may have increased the risk of psychological disturbances in this population. The current study was carried out during the national lockdown declared in March 2020 by the Italian government as a containment measure of the first wave of the coronavirus pandemic and is the first nationwide survey on the impact of COVID-19 lockdown on the mental health of dementia informal caregivers. Methods: Eighty-seven dementia centers evenly distributed on the Italian territory enrolled 4,710 caregiver-patient pairs. Caregivers underwent a telephone interview assessing classical symptoms of caregiver stress and concern for the consequences of COVID-19 infection on patient's health. We calculated prevalence of symptoms and regressed them on various potential stress risk factors: caregivers' sociodemographic characteristics and lifestyle, patients' clinical features, and lockdown-related elements, like discontinuity in medical care. Results: Approximately 90% of caregivers reported at least one symptom of stress, and nearly 30% reported four or more symptoms. The most prevalent symptoms were concern for consequences of COVID-19 on patient's health (75%) and anxiety (46%). The main risk factors for stress were identified as a conflicting relationship with the patient and discontinuity in assistance, but caregiver's female sex, younger age, lower education, and cohabitation with the patient also had an impact. Availability of help from institutions or private individuals showed a protective effect against sense of abandonment but a detrimental effect on concern about the risk for the patient to contract COVID-19. The only protective factor was mild dementia severity, which was associated with a lower risk of feeling isolated and abandoned; type of dementia, on the other hand, did not affect stress risk. Conclusion: Our results demonstrate the large prevalence of stress in family caregivers of patients with dementia during the COVID-19 pandemic and have identified both caregivers and situations at a higher risk of stress, which should be taken into account in the planning of interventions in support of quarantined families and patients.

17.
Int J Environ Res Public Health ; 18(8)2021 04 18.
Article in English | MEDLINE | ID: covidwho-1194634

ABSTRACT

(1) Background: To limit the COVID-19 outbreak, the Italian government implemented social restrictions that may have had psychological and cognitive repercussions on people with dementia. We aimed to analyze cognitive decline during the pandemic year in people evaluated in a memory clinic in northern Italy, the epicenter of COVID-19 spread. (2) Methods: A single-center retrospective study was carried out, including individuals with annual follow-up evaluated in three different years (2020-GROUP, 2019-GROUP, 2018-GROUP). We performed an intergroup comparison of cognitive decline over a one-year follow-up, and an intragroup comparison in the 2020-GROUP to analyze the five-year cognitive decline trajectory, as measured by the MMSE. (3) Results: The 2020-GROUP showed a significant loss of MMSE points per year in the considered follow-up period compared with the 2019-GROUP and 2018-GROUP (p = 0.021). Demographics, clinical features, and the other analyzed variables, including rate of diagnosis, therapy, and comorbidities, did not significantly differ between groups. The five-year cognitive decline trajectory confirmed a significant worsening of cognitive decline between 2019 and 2020 (p < 0.001), while the decrease in MMSE scores was not statistically significant between previous time points. (4) Conclusions: COVID-19 pandemic measures have induced a significant worsening of cognitive decline in people with dementia, needing more careful assistance to minimize the adverse effects of social isolation in case of future lockdowns.


Subject(s)
COVID-19 , Dementia , Cognition , Communicable Disease Control , Dementia/epidemiology , Humans , Italy/epidemiology , Pandemics , Retrospective Studies , SARS-CoV-2
18.
J Alzheimers Dis ; 80(4): 1705-1712, 2021.
Article in English | MEDLINE | ID: covidwho-1194580

ABSTRACT

BACKGROUND: The social isolation imposed by COVID-19 pandemic can have a major impact on the mental health of dementia patients and their caregivers. OBJECTIVE: We aim to evaluate the neurological decline of patients with dementia and the caregivers' burden during the pandemic. METHODS: We performed a cross-sectional study. Caregivers of dementia patients following in the outpatient clinic were included. A structured telephone interview composed of the Neuropsychiatric Inventory Questionnaire (NPI-Q), Zarit Burden Interview (ZBI), Beck Depression (BDI) and Anxiety (BAI) Inventories to address cognitive, behavioral, and functional changes associated with social distancing during the Sars-Cov-2 outbreak. Patients were divided in two groups according to caregivers' report: with perceived Altered Cognition (AC) and Stable Cognition (SC). RESULTS: A total of 58 patients (median age: 57 years [21-87], 58.6%females) and caregivers (median age: 76.5 years [55-89], 79.3%females) were included. Cognitive decline was shown by most patients (53.4%), as well as behavioral symptoms (48.3%), especially apathy/depression (24.1%), and functional decline (34.5%). The AC group (n = 31) presented increased behavioral (67.7%versus 25.9%, p = 0.002) and functional (61.3%versus 3.7%, p < 0.001) changes when compared to the SC group. In the AC group, ZBI, BDI, NPI-Q caregiver distress, and NPI-Q patient's severity of symptoms scores were worse than the SC group (p < 0.005 for all). CONCLUSION: Patients' neuropsychiatric worsening and caregiver burden were frequent during the pandemic. Worsening of cognition was associated with increased caregivers' psychological distress.


Subject(s)
COVID-19/psychology , Caregivers/psychology , Dementia/psychology , Mental Disorders/psychology , Psychological Distress , Social Isolation/psychology , Adult , Aged , Aged, 80 and over , Brazil/epidemiology , COVID-19/diagnosis , COVID-19/epidemiology , Caregivers/trends , Cross-Sectional Studies , Dementia/diagnosis , Dementia/epidemiology , Female , Humans , Male , Mental Disorders/diagnosis , Mental Disorders/epidemiology , Middle Aged , Outpatient Clinics, Hospital/trends , Pandemics , Young Adult
19.
Acta Clin Belg ; : 1-8, 2021 Apr 17.
Article in English | MEDLINE | ID: covidwho-1191081

ABSTRACT

AIM: Associations of depression, dementia, and poor life quality with mortality of COVID-19have not been studied yet. We aimed to identify the risk factors for mortality and analyze the associations with patients' physiological and mental well-being, as reflected by comorbidities, life quality, depression, and cognitive impairment. METHODS: : Older patients receiving inpatient hospital care for COVID-19 were included.Demographic data, medical history, symptoms at admission, laboratory findings, and treatment outcomes were recorded. RESULTS: : There were 122 patients with a median age of 73.0 years. The mortality rate was 9.0% (n = 11 patients). Patients with mortality were significantly active smokers, obese, and having comorbidities using polypharmacy. Weight loss ≥of 10% during hospitalization was significantly associated with mortality.Poor life quality and a higher risk of depression, cognitive impairment, and falling were more frequently seen in non-survived patients. (p < 0.05). High ferritin was the only independent risk factor for mortality (OR = 15.61, 95% CI:1.08-226.09, p = 0.044). CONCLUSION: : The presence of comorbidities, depression, cognitive impairment, higher falling risk, and poor life quality were significantly associated with higher mortality rates in older adults with COVID-19. High ferritin level was an independent risk factor for mortality.

20.
Am J Alzheimers Dis Other Demen ; 36: 15333175211008768, 2021.
Article in English | MEDLINE | ID: covidwho-1186529

ABSTRACT

Little is known about the family experience of caregiving for persons living with dementia (PLWD) at home during the COVID-19 pandemic. The purpose of this study was to examine the influence of COVID-19 on concerns of current family caregivers of PLWD. Study participants were recruited from the parent study, Healthy Patterns Clinical Trial (NCT03682185). Data was collected from 34 caregivers via semi-structured telephone interviews. Over 70% of the study participants reported worrying about spreading COVID-19 to the PLWD, 41% reported they had taken on additional caregiving duties for others in their family since COVID-19, and 62% reported one or more anxiety symptoms. Dementia caregivers who reported anxiety symptoms reported lower scores on functional independence of their care recipients compared to dementia caregivers who did not report anxiety symptoms (p=0.036). Health care professionals should be alert to the concerns expressed by dementia caregivers for their well-being during this unprecedented pandemic.


Subject(s)
COVID-19 , Dementia , Anxiety , Caregivers , Dementia/epidemiology , Humans , Pandemics , SARS-CoV-2
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