A Systematic Review of Telemedicine for Older Adults With Dementia During COVID-19: An Alternative to In-person Health Services?

Introduction: Older adults with dementia have been significantly at more risk for not receiving the care needed and for developing further mental health problems during COVID-19. Although the rise in telemedicine adoption in the healthcare system has made it possible for patients to connect with their healthcare providers virtually, little is known about its use and effects among older adults with dementia and their mental health.Objective: This systematic review aimed to explore the use, accessibility, and feasibility of telemedicine in older adults with dementia, as well as examine the potential mental health impacts of these technologies, through reviewing evidence from studies conducted during COVID-19.Methods: PubMed, Scopus, and Web of Science databases were searched with the following keywords: (COVID* OR SARS-CoV-2 OR Coronavirus) AND (“mental health” OR Depression OR Stress) AND (Dementia OR Multi-Infarct Dementia OR Vascular Dementia OR Frontotemporal Dementia) AND (elder OR Aging OR Aging OR Aged) AND (Telemedicine OR “Remote Consultation” OR telehealth OR technology).Results: A total of 7 articles from Asia, Europe, and the United States were included in this review. Throughout the studies cognitive and mental health assessments (e.g., MoCA, FAST, etc.) were performed. Despite the barriers, telemedicine was noted as a feasible approach to assist individuals with dementia in connecting with their service providers and family while reducing complications related to travel (e.g., difficulty moving, traffic, distance).Conclusions: Due to the COVID-19 pandemic, finding alternative ways to provide services to older adults with dementia through technology may continue to become more necessary as time goes on.

High site-fidelity in common bottlenose dolphins despite low salinity exposure and associated indicators of compromised health

More than 2,000 common bottlenose dolphins (Tursiops truncatus) inhabit the Barataria Bay Estuarine System in Louisiana, USA, a highly productive estuary with variable salinity driven by natural and man-made processes. It was unclear whether dolphins that are long-term residents to specific areas within the basin move in response to fluctuations in salinity, which at times can decline to 0 parts per thousand in portions of the basin. In June 2017, we conducted health assessments and deployed satellite telemetry tags on dolphins in the northern portions of the Barataria Bay Estuarine System Stock area (9 females; 4 males). We analyzed their fine-scale movements relative to modeled salinity trends compared to dolphins tagged near the barrier islands (higher salinity environments) from 2011 to 2017 (37 females; 21 males). Even though we observed different movement patterns among individual dolphins, we found no evidence that tagged dolphins moved coincident with changes in salinity. One tagged dolphin spent at least 35 consecutive days, and 75 days in total, in salinity under 5 parts per thousand. Health assessments took place early in a seasonal period of decreased salinity. Nonetheless, we found an increased prevalence of skin lesions, as well as abnormalities in serum biochemical markers and urine:serum osmolality ratios for dolphins sampled in lower salinity areas. This study provides essential information on the likely behavioral responses of dolphins to changes in salinity (e.g., severe storms or from the proposed Mid-Barataria Sediment Diversion project) and on physiological markers to inform the timing and severity of impacts from low salinity exposure.

The recording of mental health consultations by patients: clinical, ethical and legal considerations

Summary The topic of patients recording healthcare consultations has been previously debated in the literature, but little consideration has been given to the risks and benefits of such recordings in the context of mental health assessments and treatment. This issue is of growing importance given the increasing use of technology in healthcare and the recent increase in online healthcare services, largely accelerated by the COVID-19 pandemic. We discuss the clinical, ethical and legal considerations relevant to audio or visual recordings of mental health consultations by patients, with reference to existing UK guidance and the inclusion of a patient's perspective.