Abstract
Background: The lockdown strategies adopted to limit the spread of COVID-19 infection may lead to adopt unhealthy lifestyles which may impact on the mental well-being and future risk of dementia. Older adults with mild cognitive impairment (MCI) or subjective cognitive decline (SCD) may suffer important mental health consequences from measures of quarantine and confinement.Aims: The study aimed to explore the effects of COVID-19 and quarantine measures on lifestyles and mental health of elderly at increased risk of dementia.Methods: One hundred and twenty six community-dwelling seniors with MCI or SCD were phone-interviewed and assessed with questions regarding variables related to COVID-19 pandemic, lifestyle changes and scales validated for the assessment of depression, anxiety, and apathy.Results: The sample included 55.6% patients with MCI and 56 people with SCD. Over 1/3 of the sample reduced their physical activity and nearly 70% reported an increase in idle time. Adherence to the Mediterranean diet decreased in almost 1/3 of respondents and over 35% reported weight gain. Social activities were abolished and 1/6 of participants also decreased productive and mental-stimulating activities. 19.8% were depressed, 9.5% anxious, and 9.5% apathetic. A significant association existed between depression and living alone or having a poor relation with cohabitants and between anxiety and SCD, cold or flu symptoms, and reduction in productive leisure activities.Conclusions: Seniors with SCD and MCI underwent lifestyle changes that are potentially harmful to their future cognitive decline, even if, with the exception of leisure activities, they do not appear to be cross-sectionally associated with psychiatric symptoms.
Highlights
The lockdown strategies adopted to limit the spread of COVID-19 infection may lead to adopt unhealthy lifestyles which may impact on the mental well-being and future risk of dementia
Inclusion criteria were: age ≥ 60 years; having undergone the last study visit in the preceeding 18 months; absence of a significant functional impairment in the last study visit, that was operationalized as a score < 9 in the Functional Assessment Questionnaire (FAQ) or as a loss < 20% in the Instrumental Abilities of Daily Living (IADL); diagnosis of mild cognitive impairment (MCI) according to the International Working Group criteria [32] and cognitive impairment operationalized as a MMSE score ≥ 20 and ≤ 26 or as a score under the normative cut-off in at least one domain-specific cognitive test from an extensive neuropsychological battery [33]
The final sample consisted of 126 participants (71.59% of the interviewable seniors at risk) aged between 60 and 87 years; the sample was mainly composed of females (81.00%) and included 70 (55.55%) patients with MCI and 56 people with subjective cognitive decline (SCD) (Table 1A)
Summary
The lockdown strategies adopted to limit the spread of COVID-19 infection may lead to adopt unhealthy lifestyles which may impact on the mental well-being and future risk of dementia. Older adults with mild cognitive impairment (MCI) or subjective cognitive decline (SCD) may suffer important mental health consequences from measures of quarantine and confinement. COVID-19 can have direct and indirect effects on physical and mental health of the aged people. The SARS-CoV-2 virus which causes COVID-19 may affect central and peripheral nervous system [3, 4], having potential effects on the development and progression of neurodegenerative diseases [5]. SARS-CoV2 may affect the cells of the intestinal mucosa, triggering intestinal inflammation and dysbiosis and potentially causing short and long-term alterations of gut microbiota, which have demonstrated strong associations with, neuroinflammation and neurodegenerative diseases [6, 7]
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