COVID-19 restrictions – protection or also harm for people with dementia

The COVID-19 pandemic has disrupted lives globally, affecting individuals of all age groups. However, the impact on elderly individuals, especially those with dementia, has been profound. Elderly individuals, especially those with underlying health conditions, have been found to be at increased risk for severe COVID-19 outcomes, including hospitalization and death. For elderly patients with dementia, the risks may be further amplified. Routine healthcare visits, cognitive therapy sessions, and other essential treatments for dementia patients were disrupted due to lockdown measures, overwhelming of the healthcare system, and fear of exposure to the virus. This can exacerbate cognitive decline or other associated symptoms. In a new study published in the Journal of Alzheimer’s Disease by Dr. Michaela Defrancesco, Dr. Eberhard Deisenhammer, Timo Schurr PhD,  and Markus Ortner from the University Hospital of Psychiatry I at Medical University of Innsbruck in Austria discussed the various aspects of the COVID-19 pandemic’s effects on elderly individuals with cognitive decline, focusing on cognitive, social, and physical aspects, as well as the use of digital communication technologies.

The study highlighted the growing evidence of SARS-CoV-2’s potential to cause neuropsychiatric complications, particularly in elderly dementia patients. These patients face an increased risk of fatal outcomes and exacerbated cognitive and behavioral symptoms due to COVID-19. Throughout the pandemic, numerous reports have documented the worsening of cognitive functions and neuropsychiatric symptoms in dementia patients. Additionally, SARS-CoV-2 may increase the risk of developing psychiatric and mental disorders, such as dementia or depressive symptoms, especially among the elderly population.

Social isolation emerged as a critical factor that amplified the negative consequences of the pandemic on older people. Social interactions play a crucial role in reducing neuropsychiatric symptoms in dementia patients, while social isolation is known to increase the risk of dementia in older individuals. The pandemic exacerbated this isolation due to social distancing, quarantine measures, and the limited access to medical and psychological support, including telemedicine services and digital communication technologies.

The authors emphasized the importance of digital communication technologies in combating social isolation among older adults. While these tools have the potential to alleviate feelings of loneliness, they remain underutilized among older individuals, particularly those with dementia. This is due to factors such as limited internet usage and lower familiarity with social media platforms. Even though pandemic-related restrictions aimed at saving lives, their potentially negative impact on personal networks and the well-being of older adults, including dementia patients, cannot be ignored. They also examined the sources of information regarding the COVID-19 pandemic among different diagnostic groups, revealing varying patterns. Patients with dementia primarily relied on caregivers and television news, while cognitively intact individuals and those with mild cognitive impairment (MCI) sought information from newspapers and the internet. This divergence highlights the challenges faced by dementia patients in accessing and comprehending information provided through digital channels. Furthermore, the researchers highlighted that only a small number of patients with MCI or dementia adopted digital communication tools after the onset of the pandemic, even though such tools could have helped mitigate social isolation. The authors’ findings underline the need to bridge the digital divide among older individuals, especially those with cognitive impairments, and make digital communication technologies more accessible and user-friendly.

The authors demonstrated an increase in both physical and psychological symptoms among elderly participants within the first year of the pandemic. Sleep disturbances, motor issues, and vertigo were the most prevalent physical symptoms reported. This suggests that the pandemic’s restrictive measures, including social isolation, may have negatively impacted cognitive function and behavior, potentially exacerbating neuropsychiatric symptoms. According to the authors, caregiver reports revealed a significant increase in emotional and behavioral symptoms among elderly participants during the pandemic. Sadness, loneliness, anxiety, and helplessness were among the most frequently reported symptoms. The findings indicated that caregivers who did not live with the participants reported higher rates of these symptoms, emphasizing the importance of caregiving support and close monitoring during periods of social distancing and isolation. They also highlighted the burden on caregivers, particularly those living separately from the participants. These caregivers expressed concerns about the participants falling ill or dying from COVID-19, which added to their emotional strain. Additionally, caregivers reported increased efforts in providing care during the pandemic. The burden on caregivers was further associated with the participants’ cognitive deficits and depressive moods.

In conclusion, Dr. Michaela Defrancesco and colleagues provided valuable insights into the multifaceted impact of the COVID-19 pandemic on elderly individuals, especially those with dementia. Their study highlighted the importance of addressing the digital divide and promoting digital communication technologies to combat social isolation. Additionally, their findings emphasized on the need for enhanced support for caregivers and tailored interventions for elderly individuals with cognitive impairments during periods of crisis.