Geriatrics, Unit of Respiratory Pathophysiology, Campus Bio-Medico University and Teaching Hospital, Rome, Italy.
Pulmonary Rehabilitation, IRCCS San Raffaele Pisana Scientific Institute, Rome, Italy.
COPD. 2021 Aug;18(4):443-448. doi: 10.1080/15412555.2021.1941834. Epub 2021 Jun 28.
Since the outbreak of the SARS-CoV-2 pandemic in 2020, many governments have been imposing confinement and physical distancing measures. No data exist on the effects of lockdowns on the health status of patients affected by chronic pathologies, specifically those with Chronic Obstructive Pulmonary Disease (COPD). Our study aims to establish variations across the psychological and cognitive profile of patients during the isolation period in Italy, in a cohort of patients affected by COPD, between February and May 2020. Forty patients with established COPD were comprehensively evaluated by geriatric multidimensional assessment before the spread of the epidemic in Italy, and submitted to a second evaluation during the subsequent lockdown. We assessed functional ability, basic and instrumental Activities of Daily Living (ADL and IADL), cognition and mood status. We compared the scores obtained at baseline against those obtained during the pandemic, and used mean differences for correlation with major clinical and functional indexes. The score differences from MMSE, ADL and IADL were statistically significant. Such differences were correlated to the presence of a caregiver and to the total number of family members living together. Remarkably, the loneliness dimension, more than the restrictions themselves, seemed to represent the major determinant of altered health status and depressed psycho-cognitive profile in our population. Also remarkably, we detected no correlation between the score variation and the respiratory function indexes of disease severity. The isolation measures adopted during the SARS-CoV-2 pandemic have triggered the classic clinical string associated to geriatric isolation, which leads to a deterioration of cognitive functions, independence and frailty levels in a population affected by a chronic degenerative disease, such as COPD. If considered from a multidimensional geriatric point of view, the individual benefit of isolation measures could be small or non-existent.
自 2020 年 SARS-CoV-2 大流行爆发以来，许多政府一直在实施禁闭和保持社交距离措施。目前尚无关于封锁对患有慢性疾病（尤其是慢性阻塞性肺疾病（COPD））的患者健康状况影响的数据。我们的研究旨在确定意大利隔离期间 COPD 患者心理和认知状况的变化，研究对象为 2020 年 2 月至 5 月期间的 40 名确诊 COPD 患者。在意大利疫情爆发之前，40 名确诊 COPD 患者接受了全面的老年多维评估，并在随后的封锁期间进行了第二次评估。我们评估了他们的功能能力、基本和工具性日常生活活动（ADL 和 IADL）、认知和情绪状况。我们将基线时获得的分数与大流行期间获得的分数进行了比较，并使用均值差异与主要临床和功能指标进行了相关性分析。MMSE、ADL 和 IADL 的得分差异具有统计学意义。这些差异与照顾者的存在和共同居住的家庭成员总数有关。值得注意的是，与限制本身相比，孤独维度似乎是导致我们人群健康状况和心理认知状况改变的主要决定因素。同样值得注意的是，我们没有检测到评分变化与疾病严重程度的呼吸功能指标之间的相关性。在 SARS-CoV-2 大流行期间采取的隔离措施引发了与老年隔离相关的经典临床综合征，这导致了患有慢性退行性疾病（如 COPD）的人群认知功能、独立性和脆弱性水平的恶化。如果从多维老年学的角度考虑，隔离措施的个体获益可能很小或不存在。
