The effect of Covid-19 isolation measures on the cognition and mental health of people living with dementia: a rapid systematic review of one year of evidence.
Background: Covid-19 control policies have entailed lockdowns and confinement. Although these isolation measures are thought to be particularly hard and possibly harmful to people with dementia, their specific impact during the pandemic has not yet been synthesised. We aimed to examine and summarise the global research evidence describing the effect of Covid-19 isolation measures on the health of people living with dementia. Method: We searched Pubmed, PsycINFO and CINAHL up to February 2021 for peer-reviewed quantitative studies of the effects of isolation measures during Covid-19 on cognitive, psychological and functional symptoms of people with any kind of dementia or mild cognitive impairment. We summarised the findings of included papers following current guidelines for rapid reviews. Results: We identified 15 eligible papers, examining a total of 6,442 people with dementia. 13/15 were conducted in people living in the community and 2 in care homes. 60% (9/15) studies reported changes in cognition with 77% (7/9) of them describing declined cognition by >50% of respondents. 93% (14/15) of studies reported worsening or new onset of behavioural and psychological symptoms. 46% (7/15) studies reported changes in daily function, 6 of them reporting a functional decline in a variable proportion of the population studied. Conclusion: Lockdowns and confinement measures brought about by the pandemic have damaged the cognitive and psychological health and functional abilities of people with dementia across the world. It is urgent that infection control measures applied to people with dementia are balanced against the principles of non-maleficence. This systematic review makes 4 specific calls for action.