Frailty, psychological well-being, and social isolation in older adults with cognitive impairment during the SARS-CoV-2 pandemic: data from the GeroCovid initiative.
NPI
SARS-CoV-2
UCLA
frailty
older adults
social isolation
Journal
Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society
ISSN: 1479-8301
Titre abrégé: Psychogeriatrics
Pays: England
ID NLM: 101230058
Informations de publication
Date de publication:
Nov 2023
Nov 2023
Historique:
revised:
26
06
2023
received:
09
02
2023
accepted:
16
08
2023
medline:
6
11
2023
pubmed:
8
9
2023
entrez:
8
9
2023
Statut:
ppublish
Résumé
The containment measures linked to the COVID-19 pandemic negatively affected the phyco-physical well-being of the population, especially older adults with neurocognitive disorders (NCDs). This study aims to evaluate whether the frailty of NCD patients was associated with different changes in multiple health domains, in particular in relation to loneliness and social isolation, pre- and post-lockdown. Patients were recruited from 10 Italian Centers for Cognitive Disorders and Dementia. Data were collected in the pre-pandemic period (T0), during the pandemic lockdown (T1), and 6-9 months post-lockdown (T2). The UCLA Loneliness Scale-3, Activities of Daily Living (ADL), Instrumental ADL (IADL), Mini-Mental State Examination, and Neuropsychiatric Inventory (NPI) were administered. Caregivers' burden was also tested. Patients were categorized as non-frail, pre-frail, and frail according to the Fatigue, Resistance, Ambulation, Illness, and Loss of Weight scale. The sample included 165 subjects (61.9% women, mean age 79.5 ± 4.9 years). In the whole sample, the ADL, IADL, and NPI scores significantly declined between T0 and T2. There were no significative variations in functional and cognitive domains between the frail groups. During lockdown we recorded higher Depression Anxiety Stress Scales and Perceived Stress Scale scores in frail people. In multivariable logistic regression, frailty was associated with an increase in social isolation, and a loss of IADL. We observed a global deterioration in functional and neuro-psychiatric domains irrespective of the degree of frailty. Frailty was associated with the worsening of social isolation during lockdown. Frail patients and their caregivers seemed to experience more anxiety and stress disorders during SARS-CoV-2 pandemic.
Sections du résumé
BACKGROUND
BACKGROUND
The containment measures linked to the COVID-19 pandemic negatively affected the phyco-physical well-being of the population, especially older adults with neurocognitive disorders (NCDs). This study aims to evaluate whether the frailty of NCD patients was associated with different changes in multiple health domains, in particular in relation to loneliness and social isolation, pre- and post-lockdown.
MATERIALS AND METHODS
METHODS
Patients were recruited from 10 Italian Centers for Cognitive Disorders and Dementia. Data were collected in the pre-pandemic period (T0), during the pandemic lockdown (T1), and 6-9 months post-lockdown (T2). The UCLA Loneliness Scale-3, Activities of Daily Living (ADL), Instrumental ADL (IADL), Mini-Mental State Examination, and Neuropsychiatric Inventory (NPI) were administered. Caregivers' burden was also tested. Patients were categorized as non-frail, pre-frail, and frail according to the Fatigue, Resistance, Ambulation, Illness, and Loss of Weight scale.
RESULTS
RESULTS
The sample included 165 subjects (61.9% women, mean age 79.5 ± 4.9 years). In the whole sample, the ADL, IADL, and NPI scores significantly declined between T0 and T2. There were no significative variations in functional and cognitive domains between the frail groups. During lockdown we recorded higher Depression Anxiety Stress Scales and Perceived Stress Scale scores in frail people. In multivariable logistic regression, frailty was associated with an increase in social isolation, and a loss of IADL.
CONCLUSIONS
CONCLUSIONS
We observed a global deterioration in functional and neuro-psychiatric domains irrespective of the degree of frailty. Frailty was associated with the worsening of social isolation during lockdown. Frail patients and their caregivers seemed to experience more anxiety and stress disorders during SARS-CoV-2 pandemic.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1007-1018Informations de copyright
© 2023 The Authors. Psychogeriatrics published by John Wiley & Sons Australia, Ltd on behalf of Japanese Psychogeriatric Society.
Références
Pancani L, Marinucci M, Riva AN. Forced social isolation and mental health: a study on 1006 Italians under COVID-19 lockdown. Front Psychol 2021; 12: 663799. https://doi.org/10.3389/fpsyg.2021.663799.
Cagnin A, Di LR, Marra C et al. Behavioral and psychological effects of coronavirus Disease-19 quarantine in patients with dementia. Art Ther 2020; 11: 1. https://doi.org/10.3389/fpsyt.2020.578015.
Mendoza-Ruvalcaba NM, Gutiérrez-Herrera R, López C et al. Impact of quarantine due to COVID-19 pandemic on health and lifestyle conditions in older adults from Centro American countries. PloS One 2022; 17: e0264087. https://doi.org/10.1371/JOURNAL.PONE.0264087.
Orrù G, Ciacchin R, Gemignani A, Conversano C. Psychological intervention measures during the COVID-19 pandemic. Clin Neuropsychiatry 2020; 17: 76-79. Accessed November 2, 2022. https://arpi.unipi.it/retrieve/handle/11568/1039146/592302/PsychologicalinterventionmeasuresduringtheCOVID-19pandemic.pdf.
Müller I, Mancinetti M, Renner A et al. Frailty assessment for COVID-19 follow-up: a prospective cohort study. BMJ open Respir Res 2022; 9(1): e001227. https://doi.org/10.1136/BMJRESP-2022-001227.
Fried LP, Tangen CM, Walston J et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001; 56: M146-M157. https://doi.org/10.1093/GERONA/56.3.M146.
Fried LP, Hadley EC, Walston JD et al. From bedside to bench: research agenda for frailty. Sci Aging Knowledge Environ 2005; 2005(31): pe24. https://doi.org/10.1126/SAGEKE.2005.31.PE24.
Leng S, Chen X, Mao G. Frailty syndrome: an overview. Clin Interv Aging 2014; 9: 433-441. https://doi.org/10.2147/CIA.S45300.
Killgore WDS, Cloonan SA, Taylor EC, Dailey NS. Loneliness: a signature mental health concern in the era of COVID-19. Psychiatry Res 2020; 290: 113117. https://doi.org/10.1016/J.PSYCHRES.2020.113117.
Bunt S, Steverink N, Olthof J, van der Schans CP, Hobbelen JSM. Social frailty in older adults: a scoping review. Eur J Ageing 2017; 14: 323-334. https://doi.org/10.1007/S10433-017-0414-7.
Coin A, Devita M, Trevisan C et al. Psychological well-being of older adults with cognitive deterioration during quarantine: preliminary results from the GeroCovid initiative. Front Med 2021; 8: 8. https://doi.org/10.3389/FMED.2021.715294.
Pinquart M, Sörensen S. Influences on loneliness in older adults: a meta-analysis. Basic Appl Soc Psych 2001; 23: 245-266. https://doi.org/10.1207/S15324834BASP2304_2.
Smith L, Bloska J, Jacob L et al. Is loneliness associated with mild cognitive impairment in low- and middle-income countries? Int J Geriatr Psychiatry 2021; 36: 1345-1353. https://doi.org/10.1002/GPS.5524.
Vernuccio L, Sarà D, Inzerillo F et al. Effect of COVID-19 quarantine on cognitive, functional and neuropsychiatric symptoms in patients with mild cognitive impairment and dementia. Aging Clin Exp Res 2022; 34: 1187-1194. https://doi.org/10.1007/s40520-022-02113-z.
Simonetti A, Pais C, Jones M et al. Neuropsychiatric symptoms in elderly with dementia during COVID-19 pandemic: definition, treatment, and future directions. Front Psychiatry 2020; 11: 579842. https://doi.org/10.3389/FPSYT.2020.579842/FULL.
Devita M, Bordignon A, Sergi G, Coin A. The psychological and cognitive impact of Covid-19 on individuals with neurocognitive impairments: research topics and remote intervention proposals. Aging Clin Exp Res 2021; 33: 733-736. https://doi.org/10.1007/S40520-020-01637-6.
Kotwal AA, Holt-Lunstad J, Newmark RL et al. Social isolation and loneliness among San Francisco Bay Area older adults during the COVID-19 shelter-in-place orders. J Am Geriatr Soc 2021; 69: 20-29. https://doi.org/10.1111/JGS.16865.
Schippinger W. Comprehensive geriatric assessment. Wien Med Wochenschr 2022; 172: 122-125. https://doi.org/10.1007/S10354-021-00905-Y.
Magni E, Binetti G, Bianchetti A, Rozzini R, Trabucchi M. Mini-mental state examination: a normative study in Italian elderly population. Eur J Neurol 1996; 3: 198-202. https://doi.org/10.1111/J.1468-1331.1996.TB00423.X.
Cummings J. The neuropsychiatric inventory: development and applications. J Geriatr Psychiatry Neurol 2020; 33: 73-84. https://doi.org/10.1177/0891988719882102.
Katz S, Downs TD, Cash HR, Grotz RC. Progress in development of the index of ADL. Gerontologist 1970; 10: 20-30. https://doi.org/10.1093/geront/10.1_Part_1.20.
Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 1969; 9: 179-186. https://doi.org/10.1093/geront/9.3_Part_1.179.
Russell DW. UCLA loneliness scale (version 3): reliability, validity, and factor structure. J Pers Assess 1996; 66: 20-40. https://doi.org/10.1207/S15327752JPA6601_2.
Bottesi G, Ghisi M, Altoè G, Conforti E, Melli G, Sica C. The Italian version of the depression anxiety stress Scales-21: factor structure and psychometric properties on community and clinical samples. Compr Psychiatry 2015; 60: 170-181. https://doi.org/10.1016/J.COMPPSYCH.2015.04.005.
The Social Psychology of Health. Open Library, Accessed November 6, 2022. 1988. https://openlibrary.org/books/OL2404670M/The_social_psychology_of_health.
Carver CS. You want to measure coping but your protocol's too long: consider the brief COPE. Int J Behav Med 1997; 4: 92-100. https://doi.org/10.1207/S15327558IJBM0401_6.
Savla J, Roberto KA, Blieszner R, McCann BR, Hoyt E, Knight AL. Dementia caregiving during the “stay-at-home” phase of COVID-19 pandemic. J Gerontol B Psychol Sci Soc Sci 2021; 76: E241-E245. https://doi.org/10.1093/GERONB/GBAA129.
Novak M, Guest C. Application of a multidimensional caregiver burden inventory. Gerontologist 1989; 29: 798-803. https://doi.org/10.1093/GERONT/29.6.798.
Morley JE, Malmstrom TK, Miller DK. A simple frailty questionnaire (FRAIL) predicts outcomes in middle aged African Americans. J Nutr Health Aging 2012; 16: 601-608. https://doi.org/10.1007/S12603-012-0084-2.
Cohen SA, Kunicki ZJ, Drohan MM, Greaney ML. Exploring changes in caregiver burden and caregiving intensity due to COVID-19. Gerontol Geriatr Med 2021; 7: 7. https://doi.org/10.1177/2333721421999279.
Canevelli M, Valletta M, Toccaceli Blasi M et al. Facing dementia during the COVID-19 outbreak. J Am Geriatr Soc 2020; 68: 1673-1676. https://doi.org/10.1111/JGS.16644.
Park SS. Caregivers' mental health and somatic symptoms during COVID-19. J Gerontol B Psychol Sci Soc Sci 2021; 76: E235-E240. https://doi.org/10.1093/GERONB/GBAA121.
Koyama Y, Nawa N, Yamaoka Y et al. Interplay between social isolation and loneliness and chronic systemic inflammation during the COVID-19 pandemic in Japan: results from U-CORONA study. Brain Behav Immun 2021; 94: 51-59. https://doi.org/10.1016/J.BBI.2021.03.007.
Lang PJ, Bradley MM, Cuthbert BN. Emotion, motivation, and anxiety: brain mechanisms and psychophysiology. Biol Psychiatry 1998; 44: 1248-1263.
Okun MA, Keith VM. Effects of positive and negative social exchanges with various sources on depressive symptoms in younger and older adults. Journals Gerontol-Ser B Psychol Sci Soc Sci 1998; 53: P4-P20. https://doi.org/10.1093/GERONB/53B.1.P4.
Smith TO, Belderson P, Dainty JR et al. Impact of COVID-19 pandemic social restriction measures on people with rheumatic and musculoskeletal diseases in the UK: a mixed-methods study. BMJ Open 2021; 11: 1-12. https://doi.org/10.1136/bmjopen-2021-048772.
Sardella A, Chiara E, Alibrandi A et al. Changes in cognitive and functional status and in quality of life of older outpatients during the COVID-19 pandemic. Gerontology 2022; 68: 1285-1290. https://doi.org/10.1159/000525041.
Ismail II, Kamel WA, Al-Hashel JY. Association of COVID-19 pandemic and rate of cognitive decline in patients with dementia and mild cognitive impairment: a cross-sectional study. Gerontol Geriatr Med 2021; 7: 23337214211005224. https://doi.org/10.1177/23337214211005223.
Chen Z-C, Liu S, Gan J et al. The impact of the COVID-19 pandemic and lockdown on mild cognitive impairment, Alzheimer's disease and dementia with Lewy bodies in China: a 1-year follow-up study. Front Psych 2021; 12: 711658. https://doi.org/10.3389/fpsyt.2021.711658.
Sugimoto T, Ono R, Kimura A et al. Physical frailty correlates with behavioral and psychological symptoms of dementia and caregiver burden in Alzheimer's disease. J Clin Psychiatry 2018; 79: 8633. https://doi.org/10.4088/JCP.17M11991.
Bergh S, Engedal K, Røen I, Selbaek G. The course of neuropsychiatric symptoms in patients with dementia in Norwegian nursing homes. Int Psychogeriatr 2011; 23: 1231-1239. https://doi.org/10.1017/S1041610211001177.
Eikelboom WS, van den Berg E, Singleton EH et al. Neuropsychiatric and cognitive symptoms across the Alzheimer disease clinical spectrum: cross-sectional and longitudinal associations. Neurology 2021; 97: e1276-e1287. https://doi.org/10.1212/WNL.0000000000012598.
Vik-Mo AO, Giil LM, Borda MG, Ballard C, Aarsland D. The individual course of neuropsychiatric symptoms in people with Alzheimer's and Lewy body dementia: 12-year longitudinal cohort study. Br J Psychiatry 2020; 216: 43-48. https://doi.org/10.1192/bjp.2019.195.
Manini A, Brambilla M, Maggiore L, Pomati S, Pantoni L. The impact of lockdown during SARS-CoV-2 outbreak on behavioral and psychological symptoms of dementia. Neurol Sci 2021; 42: 825-833. https://doi.org/10.1007/S10072-020-05035-8.
Fried LP, Tangen CM, Walston J et al. Frailty in older adults: evidence for a phenotype. J Gerontol Med Sci Copyr 2001; 56: 146-156. Accessed November 2, 2022. https://academic.oup.com/biomedgerontology/article/56/3/M146/545770.
Scriven H, Doherty DP, Ward EC. Evaluation of a multisite telehealth group model for persistent pain management for rural/remote participants. Rural Remote Health 2019; 19(1): 4710. https://doi.org/10.22605/RRH4710.