Impact of COVID-19 Mandatory Lockdown Measures on Cognitive and Neuropsychiatric Symptoms in Persons with Alzheimer's Disease in Lima, Peru.

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY

Current Alzheimer research Pub Date : 2023-01-01 DOI:10.2174/1567205020666230417103216

Nilton Custodio, Marco Malaga, Rosa Montesinos, Diego Chambergo, Fiorella Baca, Sheila Castro, Juan Carlos Carbajal, Eder Herrera, David Lira, Monica Diaz, Serggio Lanata

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引用次数: 0

Abstract

Background: Neuropsychiatric symptoms (NPS) in patients with Alzheimer's disease (AD) worsened during the COVID-19 lockdowns, but their progression thereafter is unknown. We present the first longitudinal study tracking them before, during, and after restrictions.

Objectives: To describe the effect of the COVID-19 mandatory lockdowns on Cognitive and Neuropsychiatric symptoms in patients with Mild Cognitive Impairment (MCI) and Alzheimer's Disease (AD).

Methods: Cohort of 48 patients with amnestic MCI and 38 with AD in Lima, Peru. They received three rounds of cognitive (RUDAS, CDR, M@T), behavioral (NPI), and functional (ADCS-ADL) assessments. We assessed the change in score means across the time points and for each domain of NPS and tracked the changes in individual patients.

Results: RUDAS declined 0.9 (SD 1.0) from baseline to lockdown and 0.7 (SD 1.0) after restrictions. M@T declined 1.0 (SD 1.5) from baseline to lockdown and 1.4 (SD 2.0) after restrictions. CDR worsened in 72 patients (83.72%) from baseline to post-lockdown. NPI worsened by 10 (SD 8.3) from baseline to lockdown but improved by 4.8 (SD 6.4) after restrictions. Proportionally, 81.3% of all patients had worsened NPS during the lockdowns, but only 10.7% saw an increase thereafter. Improvement was statistically significant for specific NPS domains except hallucinations, delusions, and appetite changes. Anxiety, irritability, apathy, and disinhibition returned to baseline levels.

Conclusion: Following confinement, cognition continued to decline, but NPS demonstrated either stability or improvement. This highlights the role modifiable risk factors may have on the progression of NPS.

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秘鲁利马COVID-19强制封锁措施对阿尔茨海默病患者认知和神经精神症状的影响

背景:阿尔茨海默病(AD)患者的神经精神症状(NPS)在COVID-19封锁期间恶化，但此后的进展尚不清楚。我们提出了第一个纵向研究，在限制之前，期间和之后跟踪他们。目的:探讨COVID-19强制封锁对轻度认知障碍(MCI)和阿尔茨海默病(AD)患者认知和神经精神症状的影响。方法:对秘鲁利马48例遗忘型轻度认知损伤患者和38例AD患者进行队列研究。他们接受了三轮认知(RUDAS, CDR, M@T)，行为(NPI)和功能(ADCS-ADL)评估。我们评估了不同时间点和每个NPS域的评分平均值的变化，并跟踪了个体患者的变化。结果:从基线到封锁，RUDAS下降了0.9 (SD 1.0)，限制后下降了0.7 (SD 1.0)。M@T从基线到封锁下降了1.0 (SD 1.5)，限制后下降了1.4 (SD 2.0)。从基线到封城后，72例(83.72%)患者CDR恶化。从基线到封锁，NPI恶化了10 (SD 8.3)，但在限制后改善了4.8 (SD 6.4)。按比例计算，在封锁期间，81.3%的患者新冠肺炎病情恶化，但此后只有10.7%的患者新冠肺炎发病率上升。除幻觉、妄想和食欲改变外，特定NPS领域的改善在统计学上是显著的。焦虑、易怒、冷漠和去抑制恢复到基线水平。结论:禁闭后认知能力持续下降，但NPS表现出稳定或改善。这突出了可改变的风险因素可能对NPS进展的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Alzheimer research 医学-神经科学

CiteScore

4.00

自引率

4.80%

发文量

审稿时长

4-8 weeks

期刊介绍： Current Alzheimer Research publishes peer-reviewed frontier review, research, drug clinical trial studies and letter articles on all areas of Alzheimer’s disease. This multidisciplinary journal will help in understanding the neurobiology, genetics, pathogenesis, and treatment strategies of Alzheimer’s disease. The journal publishes objective reviews written by experts and leaders actively engaged in research using cellular, molecular, and animal models. The journal also covers original articles on recent research in fast emerging areas of molecular diagnostics, brain imaging, drug development and discovery, and clinical aspects of Alzheimer’s disease. Manuscripts are encouraged that relate to the synergistic mechanism of Alzheimer''s disease with other dementia and neurodegenerative disorders. Book reviews, meeting reports and letters-to-the-editor are also published. The journal is essential reading for researchers, educators and physicians with interest in age-related dementia and Alzheimer’s disease. Current Alzheimer Research provides a comprehensive ''bird''s-eye view'' of the current state of Alzheimer''s research for neuroscientists, clinicians, health science planners, granting, caregivers and families of this devastating disease.