Alzheimer's Disease Research Group, Instituto de Investigación Sanitaria La Fe, Valencia, Spain.
Division of Neurology, Hospital Universitari I Politècnic La Fe, Valencia, Spain.
J Neurol. 2023 Oct;270(10):4585-4592. doi: 10.1007/s00415-023-11899-5. Epub 2023 Jul 28.
Recently, many aspects of daily life have changed due to the COVID-19 pandemic. Patients with Alzheimer Disease (AD) could be more vulnerable to those daily life changes as experts expected. Mainly, the lockdown involved reduced social contact and cognitive stimulation. So, it could affect the AD expression, increasing the patients' disabilities development.
The aim of this study is to evaluate the effect of COVID-19 lockdown on cognitive impairment progression in early AD patients.
The participants were patients with mild cognitive impairment due to AD (MCI-AD) from the Neurology Unit (La Fe Hospital), who were neuropsychologically evaluated (cognitive impairment, daily activity tests) twice over 2 years. They were classified into a case group (n = 21), evaluated before and after lockdown condition, and a control group (n = 20), evaluated entirely before the lockdown condition.
All the participants showed increasing cognitive impairment and functional deterioration over the 2-year period of evaluation (p < 0.05). However, a faster worsening was not observed as a consequence of the COVID-19 pandemic and the lockdown condition. In fact, the statistical significance observed between the two study groups for daily life activities showed that the worsening was even lesser in the group evaluated under the lockdown condition.
Medium-term effects of COVID-19 lockdown could not involve an acceleration of the cognitive decline in MCI-AD patients in a 2-year evaluation period. In addition, the least worsening observed for daily living activities in the case group was probably due to the change in routines. Therefore, the common assumption of cognitive worsening of AD progression due to the lockdown in comparison with normal disease progression was not demonstrated in this study, at least for MCI-AD cases. However, more longitudinal studies are required to evaluate long-term effects in these patients.
最近，由于 COVID-19 大流行，日常生活的许多方面都发生了变化。专家预计，阿尔茨海默病（AD）患者可能更容易受到这些日常生活变化的影响。主要是封锁减少了社交接触和认知刺激。因此，它可能会影响 AD 的表达，增加患者的残疾发展。
本研究旨在评估 COVID-19 封锁对早期 AD 患者认知障碍进展的影响。
参与者为来自神经病学系（La Fe 医院）的轻度认知障碍（MCI-AD）患者，他们在 2 年内接受了两次神经心理学评估（认知障碍、日常活动测试）。他们被分为病例组（n=21），在封锁前后进行评估，和对照组（n=20），在封锁前完全进行评估。
所有参与者在 2 年的评估期间都表现出认知障碍和功能恶化的增加（p<0.05）。然而，没有观察到由于 COVID-19 大流行和封锁条件而导致的恶化加快。事实上，两组研究对象在日常生活活动方面的统计学意义表明，在封锁条件下评估的组恶化程度甚至更小。
在 2 年的评估期内，COVID-19 封锁的中期影响不可能导致 MCI-AD 患者的认知衰退加速。此外，病例组日常生活活动的恶化程度最小，可能是由于日常生活习惯的改变。因此，与正常疾病进展相比，由于封锁导致 AD 进展的认知恶化的普遍假设在本研究中并未得到证明，至少对于 MCI-AD 病例而言。然而，需要更多的纵向研究来评估这些患者的长期影响。
