Aida Suárez-González (Dementia Research Centre, UCL Institute of Neurology at Queen Square, University College London)
New report on emerging evidence on the detrimental effects of confinement and isolation on the cognitive and psychological health of people living with dementia during COVID-19, and mitigating measures. The full report is available here:
Key findings
- 3 papers describing the effects of lockdown on people with dementia living in the community have been published to date[1]–[2]–[3]. They show a worsening of functional independence and cognitive symptoms during the first month of lockdown (31% of people surveyed) and also exacerbated agitation, apathy and depression (54%), along with the deterioration of health status (40%) and increased used of antipsychotics or related drugs (7%). People with frontotemporal dementia (FTD) and their family caregivers seem to be particularly struggling to comply with protective measures.
- Only 2 case studies reporting strategies to support people with dementia in care homes have been produced so far[4]–[5]. One describes a quarantine care plan for a person with FTD and the other, a mitigating strategy to ease the distress experienced by a man when his family stopped visiting during the pandemic.
- People living with dementia in care homes have experienced a particularly harsh version of lockdown. Although no observational studies on the effects of confinement in care home residents have been published yet, the ban on visits from spouses and partners in care is believed to be causing a significant deterioration in the health and wellbeing of residents with dementia[6]. It is worth noting that a study involving 26 care homes proved that it is possible to implement successful infection control measures at the same time that visits are permitted[7].
- COVID-19 infections will continue happening until a vaccine is developed. Learnings from this first COVID-19 wave can help the home care and day care sector prepare to minimise the disruption of their services in future waves so support can continue for people with dementia in the community. In care homes, evidence-based compassionate protocols should contribute to mitigating the detrimental effects of isolation and quarantine in residents with dementia (and their families).
[1] https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.16644
[2] https://onlinelibrary.wiley.com/doi/epdf/10.1111/ene.14339
[3] https://pubmed.ncbi.nlm.nih.gov/32517839/
[4] https://www.sciencedirect.com/science/article/pii/S1064748120303262?via%3Dihub
[5] https://www.sciencedirect.com/science/article/pii/S0165178120307587?via%3Dihub
[6] https://www.alzheimers.org.uk/news/2020-06-05/thousands-people-dementia-dying-or-deteriorating-not-just-coronavirus-isolation
[7] https://www.jamda.com/article/S1525-8610(20)30526-0/fulltext