Impact of COVID-19 restrictions on behavioural and psychological symptoms in home-dwelling people with dementia: a prospective cohort study (PAN.DEM)
Objectives To investigate the impact of the COVID-19 restrictions on behavioural and psychological symptoms of dementia (BPSD).Design Prospective cohort study (PAN.DEM) nested within the halted parent trial (LIVE@Home.Path).Setting Households in Norway immediate before and 6–9 weeks into the COVID-1...
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BMJ Publishing Group
2022-01-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/1/e050628.full |
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| author | Maarja Vislapuu Mala Naik Bettina S Husebø Marie H Gedde Ipsit V Vahia Janne Mannseth Line I Berge |
| author_facet | Maarja Vislapuu Mala Naik Bettina S Husebø Marie H Gedde Ipsit V Vahia Janne Mannseth Line I Berge |
| author_sort | Maarja Vislapuu |
| collection | DOAJ |
| description | Objectives To investigate the impact of the COVID-19 restrictions on behavioural and psychological symptoms of dementia (BPSD).Design Prospective cohort study (PAN.DEM) nested within the halted parent trial (LIVE@Home.Path).Setting Households in Norway immediate before and 6–9 weeks into the COVID-19 restrictions.Participants 104 dyads (persons with mild to moderate dementia aged ≥65 and their informal carers) completed both prepandemic and pandemic assessments, among 237 in the parent trial. Mini-Mental Status Examination score 15–26 or Functional Assessment Staging score 3–7 covered dementia severity.Main outcome measures Neuropsychiatric Inventory (NPI-12) total (range 0–144), psychosis (range 0–24), hyperactive behaviour (range 0–60) and mood subsyndrome (range 0–48) scores; Cornell Scale for Depression in Dementia (CSDD) total score (range 0–38).Results We found an overall increase in BPSD by NPI-12 total score comparing prepandemic to pandemic levels (median 16 IQR (4.5–29) to 20 (7–32.5), p=0.03) over a mean of 86 days (SD 19). NPI-12 total score worsened in 57 (55%) of people with dementia and was associated with postponed or averted contacts with healthcare professionals (logistic regression, OR 3.96, 95% CI 1.05 to 14.95). Psychosis subsyndrome levels increased (0 (0–3) to 0.5 (0–6), p=0.01) in 37 (36%) persons; this worsening was associated with partial insight (9.57, 1.14 to 80.71) and reduced informal carer contact (4.45, 1.01 to 19.71). Moreover, depressive symptoms increased as assessed by CSDD total score (5 (3–9) to 7 (4–12), p=0.01) and worsened for 56 (54%), which was inversely associated with psychotropic drugs on-demand (0.16, 0.03 to 0.75).Conclusions BPSD worsened during the first months of the COVID-19 restrictions, most pronounced for psychosis and depression. These BPSD exacerbations have implications for pandemic policies, emphasising that restrictions must balance COVID-19 morbidity and mortality against dementia deterioration.Trial registration number NCT04043364; Results. |
| format | Article |
| id | doaj-art-b0ab19b9fb8445e4a1255ccaa16a8731 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-01-01 |
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| spelling | doaj-art-b0ab19b9fb8445e4a1255ccaa16a87312025-02-01T16:35:09ZengBMJ Publishing GroupBMJ Open2044-60552022-01-0112110.1136/bmjopen-2021-050628Impact of COVID-19 restrictions on behavioural and psychological symptoms in home-dwelling people with dementia: a prospective cohort study (PAN.DEM)Maarja Vislapuu0Mala Naik1Bettina S Husebø2Marie H Gedde3Ipsit V Vahia4Janne Mannseth5Line I Berge6Centre for Elderly and Nursing Home Medicine, Department of Global Public Health Primary Care, Faculty of Medicine, University of Bergen, Bergen, NorwayDepartment of Clinical Science, University of Bergen, Bergen, NorwayBergen Municipality, Bergen, NorwayHaraldsplass Deaconess Hospital, Bergen, NorwayMcLean Hospital, Belmont, Massachusetts, USASection for Epidemiology and Medical Statistic, Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, NorwayCentre for Elderly and Nursing Home Medicine, Department of Global Public Health Primary Care, Faculty of Medicine, University of Bergen, Bergen, NorwayObjectives To investigate the impact of the COVID-19 restrictions on behavioural and psychological symptoms of dementia (BPSD).Design Prospective cohort study (PAN.DEM) nested within the halted parent trial (LIVE@Home.Path).Setting Households in Norway immediate before and 6–9 weeks into the COVID-19 restrictions.Participants 104 dyads (persons with mild to moderate dementia aged ≥65 and their informal carers) completed both prepandemic and pandemic assessments, among 237 in the parent trial. Mini-Mental Status Examination score 15–26 or Functional Assessment Staging score 3–7 covered dementia severity.Main outcome measures Neuropsychiatric Inventory (NPI-12) total (range 0–144), psychosis (range 0–24), hyperactive behaviour (range 0–60) and mood subsyndrome (range 0–48) scores; Cornell Scale for Depression in Dementia (CSDD) total score (range 0–38).Results We found an overall increase in BPSD by NPI-12 total score comparing prepandemic to pandemic levels (median 16 IQR (4.5–29) to 20 (7–32.5), p=0.03) over a mean of 86 days (SD 19). NPI-12 total score worsened in 57 (55%) of people with dementia and was associated with postponed or averted contacts with healthcare professionals (logistic regression, OR 3.96, 95% CI 1.05 to 14.95). Psychosis subsyndrome levels increased (0 (0–3) to 0.5 (0–6), p=0.01) in 37 (36%) persons; this worsening was associated with partial insight (9.57, 1.14 to 80.71) and reduced informal carer contact (4.45, 1.01 to 19.71). Moreover, depressive symptoms increased as assessed by CSDD total score (5 (3–9) to 7 (4–12), p=0.01) and worsened for 56 (54%), which was inversely associated with psychotropic drugs on-demand (0.16, 0.03 to 0.75).Conclusions BPSD worsened during the first months of the COVID-19 restrictions, most pronounced for psychosis and depression. These BPSD exacerbations have implications for pandemic policies, emphasising that restrictions must balance COVID-19 morbidity and mortality against dementia deterioration.Trial registration number NCT04043364; Results.https://bmjopen.bmj.com/content/12/1/e050628.full |
| spellingShingle | Maarja Vislapuu Mala Naik Bettina S Husebø Marie H Gedde Ipsit V Vahia Janne Mannseth Line I Berge Impact of COVID-19 restrictions on behavioural and psychological symptoms in home-dwelling people with dementia: a prospective cohort study (PAN.DEM) BMJ Open |
| title | Impact of COVID-19 restrictions on behavioural and psychological symptoms in home-dwelling people with dementia: a prospective cohort study (PAN.DEM) |
| title_full | Impact of COVID-19 restrictions on behavioural and psychological symptoms in home-dwelling people with dementia: a prospective cohort study (PAN.DEM) |
| title_fullStr | Impact of COVID-19 restrictions on behavioural and psychological symptoms in home-dwelling people with dementia: a prospective cohort study (PAN.DEM) |
| title_full_unstemmed | Impact of COVID-19 restrictions on behavioural and psychological symptoms in home-dwelling people with dementia: a prospective cohort study (PAN.DEM) |
| title_short | Impact of COVID-19 restrictions on behavioural and psychological symptoms in home-dwelling people with dementia: a prospective cohort study (PAN.DEM) |
| title_sort | impact of covid 19 restrictions on behavioural and psychological symptoms in home dwelling people with dementia a prospective cohort study pan dem |
| url | https://bmjopen.bmj.com/content/12/1/e050628.full |
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