Impact of the COVID-19 Lockdown on a Long-Term Care Facility: The Role of Social Contact.

(1) Background: Long-term care facilities (LTCFs) have been harmed by the coronavirus, and older adults have remained isolated for a long time with many restrictions. The aim of this study was to measure the decline in cognitive, functional, and affective status in a care facility after the lockdown in the first wave of the COVID-19 pandemic and to compare it with previous measures in order to determine if this decline was accelerated. (2) Methods: Ninety-eight participants were recruited. Data from three retrospective pre-lockdown assessments and an additional post-lockdown assessment were analyzed. Mixed ANOVA analyses were performed according to the Clinical Dementia Rating levels, considering social-contact frequency during the lockdown as a covariate. (3) Results: The cognitive and functional scores were lower and depression scores were higher after the strict lockdown, accelerating a general pattern of decline that was already present in LTCF residents. The frequency of social contact eliminated the measurement differences in the cognitive and functional scores and the group differences in depression scores. (4) Conclusions: The effects of the SARS-CoV-2 lockdown in an LTCF were mediated by the frequency of contact. Clinical implications: Preventive measures must be taken to ensure social contact with relatives and friends and reduce the negative consequences of social isolation in LTCFs.

Apathy and agitation in institutionalized older adults: an empirically derived classification.

BACKGROUND: Apathy and agitation are often recognized as the most problematic behavioural and psychological symptoms in care settings. In this study, we analyze the relationship between apathy and agitation symptoms other and their relationship with demographic, cognitive, and neuropsychiatric variables and psychotropic medication use. METHODS: A retrospective study was conducted at a gerontological care centre in Láncara, Spain. Participants were 196 residents of the gerontological care centre, including 143 with a diagnosis of dementia. Apathy and agitation were assessed with the Apathy Scale for Institutionalized Patients with Dementia, Nursing Home version, and the Spanish version of the Cohen-Mansfield Agitation Inventory, respectively. Two-stage hierarchical cluster analysis (hierarchical cluster analysis in a first exploratory stage and K-means clustering to obtain the final solution in the second stage) was conducted to assign residents to different groups based on apathy and agitation scores. RESULTS: In cluster 1, a certain level of apathy, the highest levels of agitation, and the most frequent intake of atypical antipsychotics and clomethiazole were observed. The highest levels of apathy and the most frequent intake of memantine were seen in cluster 2. The lowest levels of agitation and apathy and the highest levels of cognitive performance were found in cluster 3. CONCLUSIONS: In this study, subjects with dementia were in a state of high agitation and eventual apathy, had low cognitive status, and were very old. Patients with this profile require well-designed non-pharmacological interventions.

Behavioral Interventions in Long-Term Care Facilities during the COVID-19 Pandemic: A Case Study.

During the COVID-19 pandemic, long-term care (LTC) centers have adopted a series of measures that have affected the physical and cognitive health of patients. The routines of the patients, as well as the interventions of professionals, have been altered. In the case presented here, our aim was to explain the effect that the strong confinement due to the spread of the first COVID-19 wave in Spain had on a 75-year-old resident in an LTC center, with cognitive and behavioral symptomatology compatible with a diagnosis of mixed dementia, as well as the measures that the center adopted to manage the lockdown situation in the best possible way, including personalized attention protocols and a video call program. Different nosological hypotheses are also raised using a semiological analysis, including the analysis of the initial and continuation diagnostic protocols, as well as the therapeutic options.

Estudio exploratorio sobre el uso de instrumentos de evaluación cognitiva y neuropsicológica en centros de personas mayores de Galicia / An exploratory study on the use of cognitive and neuropsychological assessessments in centres for the elderly in Galicia

Introducción: La evaluación cognitiva es una herramienta fundamental en los centros de mayores a la hora de planificar la atención e individualizar la intervención. La Sociedade Galega de Xerontoloxía e Xeriatría ha constituido un Grupo de Trabajo sobre Evaluación Cognitiva y Neuropsicológica con el objetivo de estudiar los instrumentos empleados e identificar los principales retos en esta área. Material y métodos: Se realizó un estudio exploratorio a través de encuesta en línea a los socios de la Sociedade Galega de Xerontoloxía e Xeriatría entre diciembre de 2013 y enero de 2014. Participaron 49 profesionales, de los cuales 26 eran profesionales de la psicología y 10 de la medicina. Resultados: Se encuentra un consenso en el uso del MMSE como instrumento de cribado y del GDS como escala global de la demencia. Existe mayor variabilidad en las baterías generales para la valoración de las demencias (CAMCOG-R, ADAS-Cog, Test Barcelona abreviado) y en el uso de pruebas específicas y de baterías de deterioro severo. Conclusiones: Se sugiere un riesgo de polarización del sector, en el que un porcentaje elevado de profesionales emplearía unos pocos instrumentos generales y un porcentaje pequeño un número elevado de instrumentos específicos. Se subraya la necesidad de un consenso que facilite el desempeño, objetive las necesidades formativas, maximice la relación entre evaluación e intervención cognitiva y proporcione herramientas para valorar el cambio (AU)

Introduction: Cognitive assessment is a fundamental tool in centres for the elderly when planning individualized care and intervention. The Galician Society of Gerontology and Geriatrics (Sociedade Galega of Xerontoloxía and Xeriatría) has formed a Working Group on Cognitive and Neuropsychological Assessment, with the aim of studying the tools used and to identify the main challenges in this area. Material and methods: An exploratory study was conducted via an online questionnaire with Sociedade Galega of Xerontoloxía and Xeriatría members between December 2013 and January 2014. It was completed by 49 professionals, of whom 26 were professionals in psychology and 10 medical doctors. Results: Consensus was found on the use of the MMSE as a screening tool, as well as the Global Deterioration Scale for dementia. There is a wide variation in the choice of general batteries of tests for the assessment of dementia (CAMCOG-R, ADAS-Cog, abbreviated Barcelona Test), and of the use of specific tests and a severe impairment battery. Conclusions: The risk of bias in the sector is suggested, with a high percentage of general practitioners using a few tools, and a small percentage using a large number of specific tools. The need for a consensus is stressed in order to facilitate assessment, objectify training needs, maximize the relationship between assessment and cognitive intervention, and provide tools to assess change (AU)

[An exploratory study on the use of cognitive and neuropsychological assessessments in centres for the elderly in Galicia]. / Estudio exploratorio sobre el uso de instrumentos de evaluación cognitiva y neuropsicológica en centros de personas mayores de Galicia.

INTRODUCTION: Cognitive assessment is a fundamental tool in centres for the elderly when planning individualized care and intervention. The Galician Society of Gerontology and Geriatrics (Sociedade Galega of Xerontoloxía and Xeriatría) has formed a Working Group on Cognitive and Neuropsychological Assessment, with the aim of studying the tools used and to identify the main challenges in this area. MATERIAL AND METHODS: An exploratory study was conducted via an online questionnaire with Sociedade Galega of Xerontoloxía and Xeriatría members between December 2013 and January 2014. It was completed by 49 professionals, of whom 26 were professionals in psychology and 10 medical doctors. RESULTS: Consensus was found on the use of the MMSE as a screening tool, as well as the Global Deterioration Scale for dementia. There is a wide variation in the choice of general batteries of tests for the assessment of dementia (CAMCOG-R, ADAS-Cog, abbreviated Barcelona Test), and of the use of specific tests and a severe impairment battery. CONCLUSIONS: The risk of bias in the sector is suggested, with a high percentage of general practitioners using a few tools, and a small percentage using a large number of specific tools. The need for a consensus is stressed in order to facilitate assessment, objectify training needs, maximize the relationship between assessment and cognitive intervention, and provide tools to assess change.