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. 2021 Jan 18:12:625781.
doi: 10.3389/fnagi.2020.625781. eCollection 2020.

The Impact of COVID-19 Quarantine on Patients With Dementia and Family Caregivers: A Nation-Wide Survey

Innocenzo Rainero  1   2 , Amalia C Bruni  3 , Camillo Marra  4 , Annachiara Cagnin  5 , Laura Bonanni  6 , Chiara Cupidi  7 , Valentina Laganà  3 , Elisa Rubino  2 , Alessandro Vacca  1 , Raffaele Di Lorenzo  3 , Paolo Provero  8   9 , Valeria Isella  10 , Nicola Vanacore  11 , Federica Agosta  12   13 , Ildebrando Appollonio  10 , Paolo Caffarra  14 , Cinzia Bussè  5 , Renato Sambati  15   16 , Davide Quaranta  4 , Valeria Guglielmi  4 , Giancarlo Logroscino  15   16 , Massimo Filippi  12   13 , Gioacchino Tedeschi  17 , Carlo Ferrarese  10 ; SINdem COVID-19 Study Group
Collaborators, Affiliations

The Impact of COVID-19 Quarantine on Patients With Dementia and Family Caregivers: A Nation-Wide Survey

Innocenzo Rainero et al. Front Aging Neurosci. .

Abstract

Introduction: Previous studies showed that quarantine for pandemic diseases is associated with several psychological and medical effects. The consequences of quarantine for COVID-19 pandemic in patients with dementia are unknown. We investigated the clinical changes in patients with Alzheimer's disease and other dementias, and evaluated caregivers' distress during COVID-19 quarantine.

Methods: The study involved 87 Italian Dementia Centers. Patients with Alzheimer's Disease (AD), Dementia with Lewy Bodies (DLB), Frontotemporal Dementia (FTD), and Vascular Dementia (VD) were eligible for the study. Family caregivers of patients with dementia were interviewed by phone in April 2020, 45 days after quarantine declaration. Main outcomes were patients' changes in cognitive, behavioral, and motor symptoms. Secondary outcomes were effects on caregivers' psychological features.

Results: 4913 patients (2934 females, 1979 males) fulfilled the inclusion criteria. Caregivers reported a worsening in cognitive functions in 55.1% of patients, mainly in subjects with DLB and AD. Aggravation of behavioral symptoms was observed in 51.9% of patients. In logistic regression analysis, previous physical independence was associated with both cognitive and behavioral worsening (odds ratio 1.85 [95% CI 1.42-2.39], 1.84 [95% CI 1.43-2.38], respectively). On the contrary, pandemic awareness was a protective factor for the worsening of cognitive and behavioral symptoms (odds ratio 0.74 [95% CI 0.65-0.85]; and 0.72 [95% CI 0.63-0.82], respectively). Approximately 25.9% of patients showed the onset of new behavioral symptoms. A worsening in motor function was reported by 36.7% of patients. Finally, caregivers reported a high increase in anxiety, depression, and distress.

Conclusion: Our study shows that quarantine for COVID-19 is associated with an acute worsening of clinical symptoms in patients with dementia as well as increase of caregivers' burden. Our findings emphasize the importance to implement new strategies to mitigate the effects of quarantine in patients with dementia.

Keywords: Alzheimer’s disease; BPSD; COVID-19; caregiver burden; dementia; quarantine.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Regional distribution of the Dementia Centers involved in the SINdem COVID-19 study. Within brackets, the number of Centers in each city.
FIGURE 2
FIGURE 2
Spider-plot of changes in cognitive function during quarantine; dots mark the mean proportion of each symptom.
FIGURE 3
FIGURE 3
Spider-plot of variations in both clusters (changes and new onset) of behavioral and psychological symptoms; dots mark the mean increase of each behavior.
See this image and copyright information in PMC

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