Effectiveness of a Family Support Intervention on Caregiving Burden in Family of Elderly Patients With Cognitive Decline After the COVID-19 Lockdown

Background: The coronavirus disease 2019 (COVID-19) pandemic had a great impact on patients with cognitive decline or dementia. The lockdown period may exacerbate behavioral disorders and worsen distress of caregivers. The aim of this study is to evaluate the effectiveness of a family support intervention on the negative effects that the COVID-19 lockdown may have on patients and related caregivers.Methods: We recruited patients whose related caregivers had attended a family support course before the COVID-19 lockdown. The course was for family members of patients with cognitive decline or dementia and consisted in eight meetings during which the participants received information about the disease, the management of neuropsychiatric symptoms, and community resources and services available for patients with dementia. Data on cognitive decline, neuropsychiatric symptoms, and functional status had been collected before the course with the Mini-Mental State Examination (MMSE), the Neuropsychiatric Inventory (NPI), and the Instrumental (IADL) and Basic (BADL) Activities of Daily Living scales, respectively. The caregiving burden had been evaluated at the end of the course by means of the Zarit Burden Interview (ZBI). After the COVID-19 lockdown, a phone interview was made to compare neuropsychiatric symptoms, functional status, and caregiver's burden with the previous evaluation.Results: There were no significant changes before and after the COVID-19 lockdown in the mean NPI score. The IADL, BADL, and ZBI scores were significantly lower after lockdown than before. The BADL scores were inversely associated with ZBI scores. Thus, despite a worsening of patients' functional status, the caregivers' burden decreased significantly probably due to the positive effect of the family support intervention.Conclusions: Our study demonstrated that a complete family support intervention for caregivers of patients with cognitive decline or dementia can reduce the burden of care even in a particular negative period, such as the COVID-19 lockdown.

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Neuropsychiatric Symptoms in Mild Cognitive Impairment

The Canadian Journal of Psychiatry ◽

10.1177/0706743716648296 ◽

2017 ◽

Vol 62 (3) ◽

pp. 161-169 ◽

Cited By ~ 26

Author(s):

Damien Gallagher ◽

Corinne E. Fischer ◽

Andrea Iaboni

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Decline ◽

Neuropsychiatric Symptoms ◽

Later Life ◽

Neurocognitive Disorders ◽

Prognostic Indicators ◽

Neurocognitive Disorder ◽

Clinical Stages ◽

Before And After

Objective: Neuropsychiatric symptoms (NPS) may be the first manifestation of an underlying neurocognitive disorder. We undertook a review to provide an update on the epidemiology and etiological mechanisms of NPS that occur in mild cognitive impairment (MCI) and just before the onset of MCI. We discuss common clinical presentations and the implications for diagnosis and care. Method: The authors conducted a selective review of the literature regarding the emergence of NPS in late life, before and after the onset of MCI. We discuss recent publications that explore the epidemiology and etiological mechanisms of NPS in the earliest clinical stages of these disorders. Results: NPS have been reported in 35% to 85% of adults with MCI and also occur in advance of cognitive decline. The occurrence of NPS for the first time in later life should increase suspicion for an underlying neurocognitive disorder. The presenting symptom may provide a clue regarding the etiology of the underlying disorder, and the co-occurrence of NPS may herald a more accelerated cognitive decline. Conclusions: NPS are prevalent in the early clinical stages of neurocognitive disorders and can serve as both useful diagnostic and prognostic indicators. Recognition of NPS as early manifestations of neurocognitive disorders will become increasingly important as we move towards preventative strategies and disease-modifying treatments that may be most effective when deployed in the earliest stages of disease.

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Perceived Effects of Neuropsychiatric Symptoms on Functional Status in Early-stage Huntington Disease

Western Journal of Nursing Research ◽

10.1177/0193945921992545 ◽

2021 ◽

pp. 019394592199254

Author(s):

Jessie S. Gibson ◽

Bethany A. Rhoten ◽

Sheila H. Ridner ◽

Daniel O. Claassen

Keyword(s):

Functional Status ◽

Huntington Disease ◽

Social Withdrawal ◽

Early Stage ◽

Neuropsychiatric Symptoms ◽

Daily Activities ◽

Structured Interviews ◽

Negative Effects ◽

Perceived Effects ◽

Improved Function

Neuropsychiatric symptoms in Huntington disease (HD) are commonly encountered, but their effects on functional status are poorly understood. In this qualitative study guided by the Theory of Unpleasant Symptoms, 15 HD patients and caregivers completed semi-structured interviews regarding perceived effects of neuropsychiatric symptoms on functional status. Physical, cognitive, and social functional effects were reported, with negative effects on daily activities and social withdrawal being reported by the greatest number of subjects. Participants also reported improved function with intervention for neuropsychiatric symptoms. This study provides a novel description of the lived experiences of HD patients with neuropsychiatric symptoms.

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Psychological and Neurophysiological Effects of Robot Assisted Activity in Elderly People With Cognitive Decline

Gerontology and Geriatric Medicine ◽

10.1177/2333721420969601 ◽

2020 ◽

Vol 6 ◽

pp. 233372142096960

Author(s):

Akio Goda ◽

Takaki Shimura ◽

Shin Murata ◽

Takayuki Kodama ◽

Hideki Nakano ◽

...

Keyword(s):

Cognitive Decline ◽

Elderly People ◽

Positive Emotions ◽

Psychological Symptoms ◽

Pharmacological Therapy ◽

Control Group ◽

Robot Assisted ◽

Before And After ◽

Communication Robot ◽

State Examination

Robot-assisted activity (RAA) is a non-pharmacological therapy used to treat behavioral and psychological symptoms of dementia. This study investigated the immediate effects of RAA on psychological and neurophysiological indices. Twenty-eight elderly people were assigned to the cognitive decline group ( n = 11) or control group ( n = 17) based on their Mini-Mental State Examination scores. After 5-min RAA sessions that involved patients interacting with a communication robot, patient emotions and mood states were measured, and resting-state EEG activity and salivary cortisol were assessed before and after RAA. We found that compared with those in the control group, participants in the cognitive decline group did not enjoy RAA using the communication robot. This was corroborated by EEG findings indicating decreased relaxation immediately after RAA exposure. These results suggested that participants with cognitive decline had difficulty understanding the contents of communication with the robot. Our results indicated that elderly people who have cognitive decline and use day-service centers are less likely to experience the immediate benefits of RAA, including positive emotions and mental relaxation. To conduct effective RAA for such populations, it may be useful to select a method that is better understood and enjoyed by participants.

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Effects of COVID-19 Pandemic Confinement in Patients With Cognitive Impairment

Frontiers in Neurology ◽

10.3389/fneur.2020.589901 ◽

2020 ◽

Vol 11 ◽

Author(s):

Ainara Barguilla ◽

Aida Fernández-Lebrero ◽

Isabel Estragués-Gázquez ◽

Greta García-Escobar ◽

Irene Navalpotro-Gómez ◽

...

Keyword(s):

Cognitive Impairment ◽

Cognitive Decline ◽

Ad Hoc ◽

Neuropsychiatric Symptoms ◽

Medical Attention ◽

State Of Emergency ◽

Dementia Patients ◽

Before And After ◽

Global Status ◽

Restrictive Measures

Introduction: State of emergency caused by COVID-19 pandemic and subsequent lockdown hit Spain on 14th March 2020 and lasted until 21st June 2020. Social isolation measures were applied. Medical attention was focused on COVID-19. Primary and social care were mainly performed by telephone. This exceptional situation may affect especially vulnerable patients such as people living with dementia. Our aim was to describe the influence of restrictive measures on patients living with mild cognitive decline and dementia evaluating SARS-CoV2 infection, changes in routines, cognitive decline stage, neuropsychiatric symptoms, delirium, falls, caregiver stress, and access to sanitary care.Materials and Methods: We gathered MCI and dementia patients with clinical follow-up before and after confinement from DegMar registry (Hospital del Mar). A telephone ad-hoc questionnaire was administered. Global status was assessed using CDR scale. Changes in neuropsychiatric symptoms were assessed by Neuropsychiatric Inventory (NPI) and retrospective interview for pre-confinement base characteristics.Results: We contacted a total of 60 patients, age 75.4 years ± 5,192. 53.3% were women. Alzheimer's Disease (41.7%) and Mild Cognitive Impairment (25%) were the most prevalent diagnosis. Remaining cases included different dementia disorders. A total of 10% of patients had been diagnosed with SARS-CoV-2. During confinement 70% of patients abandoned previous daily activities, 60% had cognitive worsening reported by relatives/caretakers, 15% presented delirium episodes, and 13% suffered increased incidence of falls. Caregivers reported an increased burden in 41% cases and burnout in 11% cases. 16% reported difficulties accessing medical care, 33% received medical phone assistance, 20% needed emergency care and 21% had changes in psychopharmacological therapies. Neuropsychiatric profile globally worsened (p < 0.000), also in particular items like agitation (p = 0.003), depression (p < 0.000), anxiety (p < 0.000) and changes in appetite (p = 0.004).Conclusion: SARS-CoV2-related lockdown resulted in an important effect over social and cognitive spheres and worsening of neuropsychiatric traits in patients living with mild cognitive decline and dementia. Although the uncertainty regarding the evolution of the pandemic makes strategy difficult, we need to reach patients and caregivers and develop adequate strategies to reinforce and adapt social and health care.

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740-P: Effect of Family Support Intervention on Support Roles and Impact of Support on HbA1c among Adults with Type 2 DM

Diabetes ◽

10.2337/db20-740-p ◽

2020 ◽

Vol 69 (Supplement 1) ◽

pp. 740-P

Author(s):

MARGARET ZUPA ◽

MICHELE HEISLER ◽

JOHN PIETTE ◽

RANAK B. TRIVEDI ◽

SHELLEY C. STOLL ◽

...

Keyword(s):

Family Support ◽

Support Intervention ◽

Type 2 Dm

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Long-term trajectories of decline in cognition and daily functioning before and after stroke

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2021-326043 ◽

2021 ◽

pp. jnnp-2021-326043

Author(s):

Alis Heshmatollah ◽

Lisanne J. Dommershuijsen ◽

Lana Fani ◽

Peter J. Koudstaal ◽

M. Arfan Ikram ◽

...

Keyword(s):

Continuous Monitoring ◽

Mini Mental State Examination ◽

Functional Decline ◽

Population Based ◽

Daily Functioning ◽

Linear Mixed Effects ◽

Before And After ◽

State Examination

ObjectiveAlthough knowledge on poststroke cognitive and functional decline is increasing, little is known about the possible decline of these functions before stroke. We determined the long-term trajectories of cognition and daily functioning before and after stroke.MethodsBetween 1990 and 2016, we repeatedly assessed cognition (Mini-Mental State Examination (MMSE), 15-Word Learning, Letter–Digit Substitution, Stroop, Verbal Fluency, Purdue Pegboard) and basic and instrumental activities of daily living (BADL and IADL) in 14 712 participants within the population-based Rotterdam Study. Incident stroke was assessed through continuous monitoring of medical records until 2018. We matched participants with incident stroke to stroke-free participants (1:3) based on sex and birth year. Trajectories of cognition and daily functioning of patients who had a stroke 10 years before and 10 years after stroke and the corresponding trajectories of stroke-free individuals were constructed using adjusted linear mixed effects models.ResultsDuring a mean follow-up of 12.5±6.8 years, a total of 1662 participants suffered a first-ever stroke. Patients who had a stroke deviated from stroke-free controls up to 10 years before stroke diagnosis in cognition and daily functioning. Significant deviations before stroke were seen in scores of MMSE (6.4 years), Stroop (5.7 years), Purdue Pegboard (3.8 years) and BADL and IADL (2.2 and 3.0 years, respectively).ConclusionPatients who had a stroke have steeper declines in cognition and daily functioning up to 10 years before their first-ever stroke compared with stroke-free individuals. Our findings suggest that accumulating intracerebral pathology already has a clinical impact before stroke.

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Cognitive decline before and after a first‐ever stroke in Africans

Acta Neurologica Scandinavica ◽

10.1111/ane.13442 ◽

2021 ◽

Author(s):

Akin Ojagbemi ◽

Toyin Bello ◽

Mayowa Owolabi ◽

Olusegun Baiyewu

Keyword(s):

Cognitive Decline ◽

Before And After

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Cognitive decline and alcohol consumption adjusting for functional status over a 3-year period in French speaking community living older adults

Journal of Public Health ◽

10.1093/pubmed/fdy126 ◽

2018 ◽

Vol 41 (2) ◽

pp. e177-e184 ◽

Cited By ~ 1

Author(s):

Helen-Maria Vasiliadis ◽

Marie-Christine Payette ◽

Djamal Berbiche ◽

Sébastien Grenier ◽

Carol Hudon

Keyword(s):

Older Adults ◽

Alcohol Consumption ◽

Cognitive Decline ◽

Functional Status ◽

Repeated Measures ◽

Service Use ◽

High Functioning ◽

French Speaking ◽

Changing Patterns

AbstractBackgroundThe effect of alcohol consumption on cognitive decline is not clear. We aimed to study the association between alcohol consumption and cognitive functioning controlling for functional heath status.MethodsA total of 1610 older adults with a score ≥26 on the Mini-Mental State Examination (MMSE) were followed to assess the change in scores at the 3-year follow-up. Information on alcohol consumption as well as socio-demographic, lifestyle, psychosocial and clinical factors, as well as health service use were assessed at baseline and 3-year follow-up interviews. Linear mixed models with repeated measures were used stratifying by functional status.ResultsClose to 73% reported consuming alcohol in the past 6 months, of which 11% were heavy drinkers (≥11 and ≥16 drinks for women and men). A significant decrease in MMSE scores was observed in low functioning non-drinkers (−1.48; 95% CI: −2.06, −0.89) and light to moderate drinkers (−0.99; 95% CI: −1.54, −0.44) and high functioning non-drinkers (−0.51; 95% CI: −0.91, −0.10).ConclusionsAlcohol consumption did not contribute to cognitive decline. Cognitive decline was greater in individuals reporting low functional status. Research should focus on the interaction between changing patterns of alcohol consumption and social participation in individuals with low and high functioning status.

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