Innocenzo Rainero1,2, Amalia C Bruni3, Camillo Marra4, Annachiara Cagnin5, Laura Bonanni6, Chiara Cupidi7, Valentina Laganà3, Elisa Rubino2, Alessandro Vacca1, Raffaele Di Lorenzo3, Paolo Provero8,9, Valeria Isella10, Nicola Vanacore11, Federica Agosta12,13, Ildebrando Appollonio10, Paolo Caffarra14, Cinzia Bussè5, Renato Sambati15,16, Davide Quaranta4, Valeria Guglielmi4, Giancarlo Logroscino15,16, Massimo Filippi12,13, Gioacchino Tedeschi17, Carlo Ferrarese10. 1. Aging Brain and Memory Clinic, Department of Neuroscience "Rita Levi Montalcini", University of Torino, Turin, Italy. 2. Department of Neuroscience and Mental Health, AOU Città della Salute e della Scienza di Torino, Turin, Italy. 3. Regional Neurogenetic Centre, Department of Primary Care, ASP-CZ, Catanzaro, Italy. 4. Memory Clinic, Fondazione Policlinico Agostino Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy. 5. Department of Neuroscience, University of Padua, Padua, Italy. 6. Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy. 7. CDCD Ospedale del Delta, AUSL Ferrara, Ferrara, Italy. 8. Department of Neuroscience "Rita Levi Montalcini", University of Torino, Turin, Italy. 9. Center for Omics Sciences, IRCCS S. Raffaele Scientific Institute, Milan, Italy. 10. Department of Medicine and Surgery and Milan Center for Neuroscience (NeuroMi), University of Milano-Bicocca, Monza, Italy. 11. National Institute of Health, Rome, Italy. 12. Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy. 13. Neurology Unit, Neurorehabilitation Unit, and Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy. 14. Unit of Neuroscience, University of Parma, Parma, Italy. 15. Department of Clinical Research in Neurology, Center for Neurodegenerative Diseases and the Aging Brain, University of Bari, Bari, Italy. 16. Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy. 17. Department of Medical and Surgical Sciences, University of Campania "L. Vanvitelli", Naples, Italy.
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.
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.
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