The Influence of Telemedicine Care on the Management of Behavioral and Psychological Symptoms in Dementia (BPSD) Risk Factors Induced or Exacerbated During the COVID-19 Pandemic.

Walter Barbalho Soares,Amannda Melo De Oliveira Lima,Ingrid Tinôco Silvestre,Katie Moraes De Almondes

doi:10.3389/fpsyt.2020.577629

Abstract

The number of people with dementia worldwide is expected to increase to approximately 1.3 billion in 2050. Almost 90% of patients diagnosed with dementia suffer from behavioral and psychological symptoms of dementia (BPSD). BPSD causes and risk factors are multiple and complex and can be responsible for hospitalizations in long-term institutions, psychiatric hospitalizations and search for health services. Recently, the world imposition of social distance and self-isolation as the best preventive measures for the COVID-19 pandemic has created challenges in the health care and management of this population, which may trigger or aggravate BPSD, and most caregivers are not prepared to address it. In face of this actual social distancing, telemedicine comes to be a tool for improving the management of these acute symptoms and mental care. In this article, we discuss and disseminate recommendations on this important alternative of assistance, especially considering the cases of BPSD. In this context of a pandemic, even patients with BPSD and caregivers require more frequent and updated guidance, considering the difficult context to social distance. Telemedicine can reduce the risk for the development of negative outcomes in mental health precipitated by the reduction of social contact and less access to health services, improving dementia symptom management, mainly BPSD.

Highlights

Dementia, according to the Diagnostic and Statistical Manual of Mental Disorders 5th edition, is a neurocognitive disorder defined as a chronic and gradually developing decline of cognitive functions that results in occupational and social dysfunctions [1]
Even if behavioral and psychological symptoms of dementia (BPSD) During the COVID-19 Pandemic cognitive symptoms are commonly considered the hallmark feature of dementia, patients usually present a wide variety of “non-cognitive” neuropsychiatric symptoms, and they are important disease manifestations [4, 5]
A preliminary study rated BPSD in 124 patients with Alzheimer’s disease and found that the prevalence of neuropsychiatric symptoms in this population was higher for apathy (51%), dysphoria (50%), and irritability (38%) [11], while another study with 408 patients evaluating a 5-year period prevalence of neuropsychiatric symptoms in dementia found that this was greatest for depression (77%), apathy (71%), and anxiety (62%) [13]

Summary

INTRODUCTION

Dementia, according to the Diagnostic and Statistical Manual of Mental Disorders 5th edition, is a neurocognitive disorder defined as a chronic and gradually developing decline of cognitive functions that results in occupational and social dysfunctions [1]. BPSD During the COVID-19 Pandemic cognitive symptoms are commonly considered the hallmark feature of dementia, patients usually present a wide variety of “non-cognitive” neuropsychiatric symptoms, and they are important disease manifestations [4, 5]. The world imposition of social distance and selfisolation as the best preventive measures for COVID-19 has created challenges in health care and management, especially for elderly people [17]. In this context, telemedicine, a remote medical practice using telecommunication and information technologies, appeared to be a viable alternative to face-to-face consultations [18]. We aim to discuss the worsening of BPSD in elderly people with dementia during the pandemic and defend how telemedicine can be an important alternative for the current context

ELDERLY PEOPLE AND THEIR HIGH RISK FOR SOCIAL ISOLATION

THE PANDEMIC CAN INCREASE RISK FACTORS FOR WORSENING BEHAVIORAL SYMPTOMS

TELEMEDICINE AS A VIABLE ALTERNATIVE TOOL FOR ELDERLY MENTAL HEALTHCARE

TELEMEDICINE CHALLENGES

Findings

DISCUSSION