Abstract
Background: The coronavirus disease 2019 (COVID-19) pandemic had a great impact on patients with cognitive decline or dementia. The lockdown period may exacerbate behavioral disorders and worsen distress of caregivers. The aim of this study is to evaluate the effectiveness of a family support intervention on the negative effects that the COVID-19 lockdown may have on patients and related caregivers.Methods: We recruited patients whose related caregivers had attended a family support course before the COVID-19 lockdown. The course was for family members of patients with cognitive decline or dementia and consisted in eight meetings during which the participants received information about the disease, the management of neuropsychiatric symptoms, and community resources and services available for patients with dementia. Data on cognitive decline, neuropsychiatric symptoms, and functional status had been collected before the course with the Mini-Mental State Examination (MMSE), the Neuropsychiatric Inventory (NPI), and the Instrumental (IADL) and Basic (BADL) Activities of Daily Living scales, respectively. The caregiving burden had been evaluated at the end of the course by means of the Zarit Burden Interview (ZBI). After the COVID-19 lockdown, a phone interview was made to compare neuropsychiatric symptoms, functional status, and caregiver's burden with the previous evaluation.Results: There were no significant changes before and after the COVID-19 lockdown in the mean NPI score. The IADL, BADL, and ZBI scores were significantly lower after lockdown than before. The BADL scores were inversely associated with ZBI scores. Thus, despite a worsening of patients' functional status, the caregivers' burden decreased significantly probably due to the positive effect of the family support intervention.Conclusions: Our study demonstrated that a complete family support intervention for caregivers of patients with cognitive decline or dementia can reduce the burden of care even in a particular negative period, such as the COVID-19 lockdown.
Highlights
The coronavirus disease 2019 (COVID-19) pandemic had a great impact on the global population
Considering that specific psychoeducational interventions can reduce the stress of caregivers, the purpose of this study is to evaluate the effectiveness of a family support intervention on the caregivers’ burden after the COVID-19 lockdown
Zarit Burden Interview (ZBI) delta score was negatively associated with Basic Activity of Daily Living (BADL) delta score (β = −0.603, t = −3.811, p = 0.001), meaning that higher disability on basic activities of daily life was associated with higher caregiving burden (Figure 1)
Summary
The coronavirus disease 2019 (COVID-19) pandemic had a great impact on the global population. The high risk of mortality following COVID-19 infection in the elderly population is well-known, whereas the impact that the lockdown restrictive measures have had on the general population and on frail elderly people in particular is not yet completely clear. It was observed that the COVID-19 lockdown-related restrictions had a great impact on patients with mild cognitive impairment (MCI) or dementia [2] with worsening of the behavioral and psychological symptoms of dementia, called neuropsychiatric symptoms [3, 4]. Neuropsychiatric symptoms are a frequent reason for institutionalization [8], have a high prevalence in residents of long-term care homes [9], are associated with increased mortality risk, and cause considerable suffering for individuals with dementia and their caregivers [10]. The coronavirus disease 2019 (COVID-19) pandemic had a great impact on patients with cognitive decline or dementia. The aim of this study is to evaluate the effectiveness of a family support intervention on the negative effects that the COVID-19 lockdown may have on patients and related caregivers
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