Department of Medicine (DIMED), Geriatrics Division, University of Padova, Padova, Italy.
Department of General Psychology, University of Padova, Padova, Italy.
Psychogeriatrics. 2023 Nov;23(6):1007-1018. doi: 10.1111/psyg.13021. Epub 2023 Sep 7.
The containment measures linked to the COVID-19 pandemic negatively affected the phyco-physical well-being of the population, especially older adults with neurocognitive disorders (NCDs). This study aims to evaluate whether the frailty of NCD patients was associated with different changes in multiple health domains, in particular in relation to loneliness and social isolation, pre- and post-lockdown.
Patients were recruited from 10 Italian Centers for Cognitive Disorders and Dementia. Data were collected in the pre-pandemic period (T0), during the pandemic lockdown (T1), and 6-9 months post-lockdown (T2). The UCLA Loneliness Scale-3, Activities of Daily Living (ADL), Instrumental ADL (IADL), Mini-Mental State Examination, and Neuropsychiatric Inventory (NPI) were administered. Caregivers' burden was also tested. Patients were categorized as non-frail, pre-frail, and frail according to the Fatigue, Resistance, Ambulation, Illness, and Loss of Weight scale.
The sample included 165 subjects (61.9% women, mean age 79.5 ± 4.9 years). In the whole sample, the ADL, IADL, and NPI scores significantly declined between T0 and T2. There were no significative variations in functional and cognitive domains between the frail groups. During lockdown we recorded higher Depression Anxiety Stress Scales and Perceived Stress Scale scores in frail people. In multivariable logistic regression, frailty was associated with an increase in social isolation, and a loss of IADL.
We observed a global deterioration in functional and neuro-psychiatric domains irrespective of the degree of frailty. Frailty was associated with the worsening of social isolation during lockdown. Frail patients and their caregivers seemed to experience more anxiety and stress disorders during SARS-CoV-2 pandemic.
与 COVID-19 大流行相关的遏制措施对人口的身心福祉产生了负面影响，尤其是患有神经认知障碍 (NCD) 的老年人。本研究旨在评估 NCD 患者的脆弱性是否与多个健康领域的不同变化相关，特别是与孤独和社会隔离有关，在封锁前后。
患者从意大利 10 个认知障碍和痴呆中心招募。数据在大流行前（T0）、大流行封锁期间（T1）和封锁后 6-9 个月（T2）收集。使用 UCLA 孤独量表-3、日常生活活动（ADL）、工具性日常生活活动（IADL）、简易精神状态检查和神经精神问卷（NPI）进行评估。还测试了照顾者的负担。根据疲劳、抵抗力、活动、疾病和体重减轻量表，患者被分为非脆弱、脆弱前期和脆弱。
样本包括 165 名受试者（61.9%为女性，平均年龄 79.5±4.9 岁）。在整个样本中，ADL、IADL 和 NPI 评分在 T0 和 T2 之间显著下降。在脆弱组之间，功能和认知领域没有明显的变化。在封锁期间，我们记录到脆弱人群的抑郁焦虑压力量表和感知压力量表评分更高。在多变量逻辑回归中，脆弱与社会隔离增加和 IADL 丧失相关。
我们观察到功能和神经精神领域的全面恶化，与脆弱程度无关。脆弱与封锁期间社会隔离的恶化有关。在 SARS-CoV-2 大流行期间，脆弱患者及其照顾者似乎经历了更多的焦虑和压力障碍。
