Abstract
BackgroundThe public health emergency of coronavirus disease (COVID-19) is rapidly evolving worldwide; some countries, including Spain, have implemented restrictive measures. Populations that are vulnerable to this outbreak and its physical and mental health effects include community-dwelling older adults with mild cognitive impairment or mild dementia. Telehealth is a potential tool to deliver health care and decrease exposure risk.ObjectiveThe aims of this study were to explore the impact of confinement on the health and well-being of community-dwelling older adults with mild cognitive impairment or mild dementia, to provide television-based and telephone-based health and social support, and to study the effects of a television-based assistive integrated technology, TV-AssistDem (TeleVision-based ASSistive Integrated Service to supporT European adults living with mild DEMentia or mild cognitive impairment).MethodsA telephone-based survey was administered in Spain to 93 participants in the TV-AssistDem clinical trial from March 25 to April 6, 2020.ResultsOf the respondents, 60/93 (65%) were women. The mean age was 73.34 (SD 6.07), and 69/93 (74%) lived accompanied. Lockdown measures forced 17/93 respondents (18%) to change their living arrangements. Health status was found to be optimal in 89/93 respondents (96%), with no COVID-19 symptoms. Grocery and pharmacy outings were performed by family members of 68/93 participants (73%); 57 (61%) reported overall well-being, and 65 (70%) maintained their sleep quality. However, participants living alone reported greater negative feelings and more sleeping problems. Regarding leisure activities, 53/93 respondents (57%) took walks, 32 (35%) played memory games, 55 (60%) watched television, and 91 (98%) telephoned relatives. 58/93 (64%) respondents reported accessing moderate or too much COVID-19 information, 89 (97%) received it from television, and 56 (62%) stated that their understanding of the information was extreme. 39/93 (39%) respondents had contacted health and social services, while 29 (31%) requested information regarding these services during the telephone call. There were no significant differences in health and well-being between the intervention and control groups. Respondents with TV-AssistDem performed more memory exercises (24/93, 52% vs 8/93, 17.4%; P<.001) than control respondents.ConclusionsOur findings suggest that during COVID-19 confinement, the physical and mental health and well-being was optimal for the majority of our vulnerable population. However, those living alone reported greater negative psychological effects and sleeping problems. Measures adopted to address the negative experiences of confinement included keeping informed about the situation, accessing health and social services, having a support network that prevents risk of exposure to COVID-19 and guarantees food and medical supplies, a daily routine with maintained sleeping habits and leisure activities, staying physically and mentally active with cognitive stimulation exercises, and ensuring social connectedness using technology. Television sets were preferred technological devices to access COVID-19 information, watch television as a recreational activity, and perform memory exercises as an intellectual activity. Television-based telehealth support using TV-AssistDem demonstrated potential for cognitive stimulation.Trial RegistrationClinicalTrials.gov NCT03653234; https://clinicaltrials.gov/ct2/show/NCT03653234
Highlights
Coronavirus disease (COVID-19) has been declared a global emergency by the World Health Organization (WHO); this disease has created a rapidly evolving situation which has forced the implementation of unprecedented restrictions to control its viral spread and mitigate its impact [1]
Our findings suggest that during COVID-19 confinement, the physical and mental health and well-being was optimal for the majority of our vulnerable population
For 21/93 (22%) participants, caregivers were interviewed on behalf of people with mild cognitive impairment or mild dementia whose cognitive or emotional statuses were compromised
Summary
Coronavirus disease (COVID-19) has been declared a global emergency by the World Health Organization (WHO); this disease has created a rapidly evolving situation which has forced the implementation of unprecedented restrictions to control its viral spread and mitigate its impact [1]. In response to the outbreak, the Spanish government issued a royal decree (463/2020) to declare a 15-day national emergency, with the exceptional measure of a nationwide lockdown that started on March 15th and has been extended twice since [3]. This decree enforces social distancing, quarantine of people exposed to the disease, and home confinement of people who remain healthy, allowing only essential outings. This restriction of movement of daily life activities and separation from loved ones may be challenging and unpleasant. Telehealth is a potential tool to deliver health care and decrease exposure risk
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