Neuropsychiatric Symptoms in Patients with Dementia Associated with Increased Psychological Distress in Caregivers During the COVID-19 Pandemic.

Publisher: IOS Press Country of Publication: Netherlands NLM ID: 9814863 Publication Model: Print Cited Medium: Internet ISSN: 1875-8908 (Electronic) Linking ISSN: 13872877 NLM ISO Abbreviation: J Alzheimers Dis Subsets: MEDLINE

Original Publication: Amsterdam ; Washington : IOS Press, c1998-

Psychological Distress*; COVID-19/*psychology ; Caregivers/*psychology ; Dementia/*psychology ; Mental Disorders/*psychology ; 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

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.

Keywords: Alzheimer’s disease; COVID-19; Sars-Cov-2; dementia; mental health; social isolation

Date Created: 20210301 Date Completed: 20210503 Latest Revision: 20210503

20221213

10.3233/JAD-201513

33646168