Behavioral and Psychological Effects of Coronavirus Disease-19 Quarantine in Patients With Dementia. in Frontiers in psychiatry / Front Psychiatry. 2020 Sep 9;11:578015. doi: 10.3389/fpsyt.2020.578015. eCollection 2020.
2020
AOU Città della Salute di Torino
Tipo pubblicazione
Journal Article
Autori/Collaboratori (24)Vedi tutti...
Cagnin A
Department of Neuroscience (DNS), University of Padua, Padua, Italy.
Di Lorenzo R
Regional Neurogenetic Centre, Department of Primary Care, ASP-CZ, Catanzaro, Italy.
Marra C
Memory Clinic, Fondazione Policlinico Gemelli, IRCCS Università, Cattolica del Sacro Cuore, Rome, Italy.
et alii...
Abstract
BACKGROUND: In March 2020, the World Health Organization declared a global pandemic due to the novel coronavirus SARS-CoV-2 and several governments planned a national quarantine in order to control the virus spread. Acute psychological effects of quarantine in frail elderly subjects with special needs, such as patients with dementia, have been poorly investigated. The aim of this study was to assess modifications of neuropsychiatric symptoms during quarantine in patients with dementia and their caregivers. METHODS: This is a sub-study of a multicenter nation-wide survey. A structured telephone interview was delivered to family caregivers of patients with diagnosis of Alzheimer disease (AD), dementia with Lewy bodies (DLB), frontotemporal dementia (FTD), and vascular dementia (VD), followed regularly at 87 Italian memory clinics. Variations in behavioral and psychological symptoms (BPSD) were collected after 1 month since quarantine declaration and associations with disease type, severity, gender, and caregiver's stress burden were analyzed. RESULTS: A total of 4,913 caregivers participated in the survey. Increased BPSD was reported in 59.6% of patients as worsening of preexisting symptoms (51.9%) or as new onset (26%), and requested drug modifications in 27.6% of these cases. Irritability, apathy, agitation, and anxiety were the most frequently reported worsening symptoms and sleep disorder and irritability the most frequent new symptoms. Profile of BPSD varied according to dementia type, disease severity, and patients' gender. Anxiety and depression were associated with a diagnosis of AD (OR 1.35, CI: 1.12-1.62), mild to moderate disease severity and female gender. DLB was significantly associated with a higher risk of worsening hallucinations (OR 5.29, CI 3.66-7.64) and sleep disorder (OR 1.69, CI 1.25-2.29), FTD with wandering (OR 1.62, CI 1.12-2.35), and change of appetite (OR 1.52, CI 1.03-2.25). Stress-related symptoms were experienced by two-thirds of caregivers and were associated with increased patients' neuropsychiatric burden (p<0.0001). CONCLUSION: Quarantine induces a rapid increase of BPSD in approximately 60% of patients and stress-related symptoms in two-thirds of caregivers. Health services need to plan a post-pandemic strategy in order to address these emerging needs.
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PMID : 33033486
DOI : 10.3389/fpsyt.2020.578015
Keywords
mental stress; multiinfarct dementia; observational study; mental disease; male; major clinical study; irritability; human; high risk patient; health service; hallucination; gender; frontotemporal dementia; follow up; female; disease severity; disease exacerbation; disease classification; disease burden; disease association; diffuse Lewy body disease; depression; dementia; coronavirus disease 2019; controlled study; caregiver burden; caregiver; attitude assessment; article; appetite; apathy; anxiety disorder; anxiety; Alzheimer disease; agitation; aged; quarantine; sleep disorder; structured interview; symptom assessment; telephone interview; treatment planning; wandering behavior;