Department of Neurology, Peruvian Institute of Neurosciences, Lima, Peru.
Unit for the Diagnosis of Cognitive Impairment and Dementia Prevention, Peruvian Institute of Neurosciences, Lima, Peru.
Curr Alzheimer Res. 2023;20(2):80-88. doi: 10.2174/1567205020666230417103216.
Neuropsychiatric symptoms (NPS) in patients with Alzheimer's disease (AD) worsened during the COVID-19 lockdowns, but their progression thereafter is unknown. We present the first longitudinal study tracking them before, during, and after restrictions.
To describe the effect of the COVID-19 mandatory lockdowns on Cognitive and Neuropsychiatric symptoms in patients with Mild Cognitive Impairment (MCI) and Alzheimer's Disease (AD).
Cohort of 48 patients with amnestic MCI and 38 with AD in Lima, Peru. They received three rounds of cognitive (RUDAS, CDR, M@T), behavioral (NPI), and functional (ADCS-ADL) assessments. We assessed the change in score means across the time points and for each domain of NPS and tracked the changes in individual patients.
RUDAS declined 0.9 (SD 1.0) from baseline to lockdown and 0.7 (SD 1.0) after restrictions. M@T declined 1.0 (SD 1.5) from baseline to lockdown and 1.4 (SD 2.0) after restrictions. CDR worsened in 72 patients (83.72%) from baseline to post-lockdown. NPI worsened by 10 (SD 8.3) from baseline to lockdown but improved by 4.8 (SD 6.4) after restrictions. Proportionally, 81.3% of all patients had worsened NPS during the lockdowns, but only 10.7% saw an increase thereafter. Improvement was statistically significant for specific NPS domains except hallucinations, delusions, and appetite changes. Anxiety, irritability, apathy, and disinhibition returned to baseline levels.
Following confinement, cognition continued to decline, but NPS demonstrated either stability or improvement. This highlights the role modifiable risk factors may have on the progression of NPS.
在 COVID-19 封锁期间，阿尔茨海默病（AD）患者的神经精神症状（NPS）恶化，但此后的进展情况尚不清楚。我们首次进行了一项纵向研究，在限制之前、期间和之后对其进行跟踪。
描述 COVID-19 强制性封锁对轻度认知障碍（MCI）和阿尔茨海默病（AD）患者认知和神经精神症状的影响。
这是在秘鲁利马进行的一项队列研究，共纳入 48 例有记忆障碍的 MCI 患者和 38 例 AD 患者。他们接受了三轮认知（RUDAS、CDR、M@T）、行为（NPI）和功能（ADCS-ADL）评估。我们评估了每个 NPS 域的分数均值在时间点上的变化，并跟踪了个体患者的变化。
RUDAS 从基线到封锁期下降了 0.9（SD 1.0），从封锁期到限制后下降了 0.7（SD 1.0）。M@T 从基线到封锁期下降了 1.0（SD 1.5），从封锁期到限制后下降了 1.4（SD 2.0）。CDR 在 72 名患者（83.72%）中从基线到封锁后恶化。NPI 从基线到封锁期增加了 10（SD 8.3），但在限制后改善了 4.8（SD 6.4）。从比例上看，81.3%的患者在封锁期间 NPS 恶化，但此后只有 10.7%的患者 NPS 增加。除幻觉、妄想和食欲变化外，特定 NPS 域的改善具有统计学意义。焦虑、易怒、冷漠和抑制恢复到基线水平。
在禁闭之后，认知继续下降，但 NPS 表现出稳定或改善。这突出了可改变的风险因素在 NPS 进展中的作用。
