Impact of COVID-19 on functional, cognitive, neuropsychiatric, and health-related outcomes in patients with dementia: A systematic review

doi:10.1016/j.ensci.2024.100539

Review

. 2024 Nov 21:38:100539.

doi: 10.1016/j.ensci.2024.100539. eCollection 2025 Mar.

Impact of COVID-19 on functional, cognitive, neuropsychiatric, and health-related outcomes in patients with dementia: A systematic review

Lucia Crivelli¹, Andrea Winkler^{2

3

4}, Greta Keller¹, Simone Beretta⁵, Ismael Luis Calandri¹, Wouter De Groote⁶, Arianna Fornari⁷, Jennifer Frontera⁸, Miia Kivipelto^{9

10

11

12

13}, Ana Sabsil Lopez-Rocha¹⁴, Francesca Mangialasche^{9

15}, Daniel Munblit^{16

17

18}, Katie Palmer^{9

10}, Alla Guekht¹⁸, Ricardo Allegri¹

Affiliations

¹ Department of Cognitive Neurology, Fleni, Montañeses 2325 (C1428AQK), Buenos Aires, Argentina.
² Department of Neurology, Center for Global Health, School of Medicine and Health, Technical University of Munich, Munich, Germany.
³ Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Postboks 1130 Blindern, 0318 Oslo, Norway.
⁴ Department of Global Health and Social Medicine, Harvard Medical School, 25 Shattuck Street, 02115 Boston, MA, USA.
⁵ Department of Neurology, Fondazione IRCCS San Gerardo dei Tintori Monza, University of Milano Bicocca, Via G. B. Pergolesi, 33, 20900 Monza, MB, Italy.
⁶ WHO Rehabilitation Programme, Avenue Appia 20, 1211 Geneva, Switzerland.
⁷ Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Giovanni Celoria, 11, 20133 Milano, MI, Italy.
⁸ NYU School of Medicine, 550 First Avenue, New York, USA.
⁹ Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 171 77 Stockholm, Sweden.
¹⁰ FINGERS Brain Health Institute, 22, 112 19 Stockholm, Sweden.
¹¹ Medical Unit Aging, Karolinska University Hospital, 171 77 Stockholm, Sweden.
¹² Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, St Dunstan's Road, London, United Kingdom.
¹³ Institute of Public Health and Clinical Nutrition and Institute of Clinical Medicine, Neurology, University of Eastern Finland, Yliopistonrinne 3, Kuopio, Finland.
¹⁴ Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, 171 77 Stockholm, Karolinska Institutet, Sweden.
¹⁵ Theme Inflammation and Aging, Medical Unit Aging, Karolinska University Hospital, 171 77 Stockholm, Sweden.
¹⁶ Care for Long Term Conditions Division, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, James Clerk Maxwell Building 57 Waterloo Road, London, United Kingdom.
¹⁷ Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Trubetskaya street, Russia.
¹⁸ Moscow Research and Clinical Center for Neuropsychiatry, Pirogov Russian National Research Medical University, Ulitsa Ostrovityanova, 1, 117997 Moscow, Russia.

PMID: 39720103
PMCID: PMC11663964
DOI: 10.1016/j.ensci.2024.100539

Review

Impact of COVID-19 on functional, cognitive, neuropsychiatric, and health-related outcomes in patients with dementia: A systematic review

Lucia Crivelli et al. eNeurologicalSci. 2024.

. 2024 Nov 21:38:100539.

doi: 10.1016/j.ensci.2024.100539. eCollection 2025 Mar.

Authors

Affiliations

¹ Department of Cognitive Neurology, Fleni, Montañeses 2325 (C1428AQK), Buenos Aires, Argentina.
² Department of Neurology, Center for Global Health, School of Medicine and Health, Technical University of Munich, Munich, Germany.
³ Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Postboks 1130 Blindern, 0318 Oslo, Norway.
⁴ Department of Global Health and Social Medicine, Harvard Medical School, 25 Shattuck Street, 02115 Boston, MA, USA.
⁵ Department of Neurology, Fondazione IRCCS San Gerardo dei Tintori Monza, University of Milano Bicocca, Via G. B. Pergolesi, 33, 20900 Monza, MB, Italy.
⁶ WHO Rehabilitation Programme, Avenue Appia 20, 1211 Geneva, Switzerland.
⁷ Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Giovanni Celoria, 11, 20133 Milano, MI, Italy.
⁸ NYU School of Medicine, 550 First Avenue, New York, USA.
⁹ Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 171 77 Stockholm, Sweden.
¹⁰ FINGERS Brain Health Institute, 22, 112 19 Stockholm, Sweden.
¹¹ Medical Unit Aging, Karolinska University Hospital, 171 77 Stockholm, Sweden.
¹² Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, St Dunstan's Road, London, United Kingdom.
¹³ Institute of Public Health and Clinical Nutrition and Institute of Clinical Medicine, Neurology, University of Eastern Finland, Yliopistonrinne 3, Kuopio, Finland.
¹⁴ Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, 171 77 Stockholm, Karolinska Institutet, Sweden.
¹⁵ Theme Inflammation and Aging, Medical Unit Aging, Karolinska University Hospital, 171 77 Stockholm, Sweden.
¹⁶ Care for Long Term Conditions Division, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, James Clerk Maxwell Building 57 Waterloo Road, London, United Kingdom.
¹⁷ Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Trubetskaya street, Russia.
¹⁸ Moscow Research and Clinical Center for Neuropsychiatry, Pirogov Russian National Research Medical University, Ulitsa Ostrovityanova, 1, 117997 Moscow, Russia.

PMID: 39720103
PMCID: PMC11663964
DOI: 10.1016/j.ensci.2024.100539

Abstract

Background: This systematic review analyzes the impact of COVID-19 on dementia patients' functional, cognitive, neuropsychiatric, and health related outcomes. It hypothesizes that dementia patients infected with SARS-CoV-2experience more pronounced deterioration compared to those who are uninfected.

Methods: Research from 01/03/2020 to 07/10/2023 was conducted using Medline, Web of Science, and Embase databases, and adhering to PRISMA guidelines and the PICO framework. The study aimed to determine if SARS-CoV-2 infection is associated with worse outcomes in dementia patients. The protocol is registered in PROSPERO (CRD42022352481), and bias was evaluated using the Newcastle-Ottawa Scale.

Results: Among 198 studies reviewed, only three met the criteria. Chen et al. (2023) identified higher mortality in SARS-CoV-2-infected dementia patients, while Merla et al. (2023) observed faster cognitive decline in infected individuals with increased hospital admissions. Additionally, Cascini et al. (2022) reported an increased risk of infection and significantly elevated mortality in dementia patients, highlighting comorbidities and antipsychotic medication use as key risk factors.

Conclusion: These limited data suggest higher mortality and cognitive decline in dementia patients following COVID-19, underscoring the need for extensive research in this area.

Keywords: COVID-19; Dementia; Mild cognitive impairment; Mortality rate; SARS-CoV-2; functioning.

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Conflict of interest statement

Nothing to report.

Figures

**Fig. 1**
PRISMA flow chart describing the screening and selection of articles.

See this image and copyright information in PMC

References

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1. Beghi E., Giussani G., Westenberg E., Allegri R., Garcia-Azorin D., Guekht A., Frontera J., Kivipelto M., Mangialasche F., Mukaetova-Ladinska E.B., Prasad K., Chowdhary N., Winkler A.S. Acute and post-acute neurological manifestations of COVID-19: present findings, critical appraisal, and future directions. J. Neurol. 2022;269(5):2265–2274. doi: 10.1007/s00415-021-10848-4. - DOI - PMC - PubMed
1. Shi L., Guo T., Lv J., Hu C., Han Y., Ren H., Yang G. The long-term sequelae of COVID-19 pneumonia: three-month follow-up study of pulmonary function, exercise capacity, and CT findings. Radiology. 2020;296(2):87–96. doi: 10.1148/radiol.2020200823. - DOI - PubMed
1. Rass V., Beer R., Schiefecker A.J., Lindner A., Kofler M., Ianosi B.A., Mahlknecht P., Heim B., Peball M., Carbone F., Limmert V., Kindl P., Putnina L., Fava E., Sahanic S., Sonnweber T., Löscher W.N., Wanschitz J.V., Zamarian L., Djamshidian A., Helbok R. Neurological outcomes 1 year after COVID-19 diagnosis: a prospective longitudinal cohort study. Eur. J. Neurol. 2022;29(6):1685–1696. doi: 10.1111/ene.15307. - DOI - PMC - PubMed
1. Zhang J.J., Dong X., Liu G.H., Gao Y.D. Risk and protective factors for COVID-19 morbidity, severity, and mortality. Clin. Rev. Allergy Immunol. 2023;64(1):90–107. doi: 10.1007/s12016-022-08921-5. - DOI - PMC - PubMed

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[1] Dhama K., Sharun K., Tiwari R., Dadar M., Malik Y.S., Singh K.P., Chaicumpa W. COVID-19, an emerging coronavirus infection: advances and prospects in designing and developing vaccines, immunotherapeutics, and therapeutics. Hum. Vaccin. Immunother. 2020;16(6):1232–1238. doi: 10.1080/21645515.2020.1735227. - DOI - PMC - PubMed

[2] Dhama K., Sharun K., Tiwari R., Dadar M., Malik Y.S., Singh K.P., Chaicumpa W. COVID-19, an emerging coronavirus infection: advances and prospects in designing and developing vaccines, immunotherapeutics, and therapeutics. Hum. Vaccin. Immunother. 2020;16(6):1232–1238. doi: 10.1080/21645515.2020.1735227. - DOI - PMC - PubMed

[3] Beghi E., Giussani G., Westenberg E., Allegri R., Garcia-Azorin D., Guekht A., Frontera J., Kivipelto M., Mangialasche F., Mukaetova-Ladinska E.B., Prasad K., Chowdhary N., Winkler A.S. Acute and post-acute neurological manifestations of COVID-19: present findings, critical appraisal, and future directions. J. Neurol. 2022;269(5):2265–2274. doi: 10.1007/s00415-021-10848-4. - DOI - PMC - PubMed

[4] Beghi E., Giussani G., Westenberg E., Allegri R., Garcia-Azorin D., Guekht A., Frontera J., Kivipelto M., Mangialasche F., Mukaetova-Ladinska E.B., Prasad K., Chowdhary N., Winkler A.S. Acute and post-acute neurological manifestations of COVID-19: present findings, critical appraisal, and future directions. J. Neurol. 2022;269(5):2265–2274. doi: 10.1007/s00415-021-10848-4. - DOI - PMC - PubMed

[5] Shi L., Guo T., Lv J., Hu C., Han Y., Ren H., Yang G. The long-term sequelae of COVID-19 pneumonia: three-month follow-up study of pulmonary function, exercise capacity, and CT findings. Radiology. 2020;296(2):87–96. doi: 10.1148/radiol.2020200823. - DOI - PubMed

[6] Shi L., Guo T., Lv J., Hu C., Han Y., Ren H., Yang G. The long-term sequelae of COVID-19 pneumonia: three-month follow-up study of pulmonary function, exercise capacity, and CT findings. Radiology. 2020;296(2):87–96. doi: 10.1148/radiol.2020200823. - DOI - PubMed

[7] Rass V., Beer R., Schiefecker A.J., Lindner A., Kofler M., Ianosi B.A., Mahlknecht P., Heim B., Peball M., Carbone F., Limmert V., Kindl P., Putnina L., Fava E., Sahanic S., Sonnweber T., Löscher W.N., Wanschitz J.V., Zamarian L., Djamshidian A., Helbok R. Neurological outcomes 1 year after COVID-19 diagnosis: a prospective longitudinal cohort study. Eur. J. Neurol. 2022;29(6):1685–1696. doi: 10.1111/ene.15307. - DOI - PMC - PubMed

[8] Rass V., Beer R., Schiefecker A.J., Lindner A., Kofler M., Ianosi B.A., Mahlknecht P., Heim B., Peball M., Carbone F., Limmert V., Kindl P., Putnina L., Fava E., Sahanic S., Sonnweber T., Löscher W.N., Wanschitz J.V., Zamarian L., Djamshidian A., Helbok R. Neurological outcomes 1 year after COVID-19 diagnosis: a prospective longitudinal cohort study. Eur. J. Neurol. 2022;29(6):1685–1696. doi: 10.1111/ene.15307. - DOI - PMC - PubMed

[9] Zhang J.J., Dong X., Liu G.H., Gao Y.D. Risk and protective factors for COVID-19 morbidity, severity, and mortality. Clin. Rev. Allergy Immunol. 2023;64(1):90–107. doi: 10.1007/s12016-022-08921-5. - DOI - PMC - PubMed

[10] Zhang J.J., Dong X., Liu G.H., Gao Y.D. Risk and protective factors for COVID-19 morbidity, severity, and mortality. Clin. Rev. Allergy Immunol. 2023;64(1):90–107. doi: 10.1007/s12016-022-08921-5. - DOI - PMC - PubMed

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Impact of COVID-19 on functional, cognitive, neuropsychiatric, and health-related outcomes in patients with dementia: A systematic review

Affiliations

Impact of COVID-19 on functional, cognitive, neuropsychiatric, and health-related outcomes in patients with dementia: A systematic review

Authors

Affiliations

Abstract

Conflict of interest statement

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