Title:Impact of COVID-19 Mandatory Lockdown Measures on Cognitive and Neuropsychiatric Symptoms in Persons with Alzheimer's Disease in Lima,
Peru
Volume: 20
Issue: 2
Author(s): Nilton Custodio*, Marco Malaga, Rosa Montesinos, Diego Chambergo, Fiorella Baca, Sheila Castro, Juan C. Carbajal, Eder Herrera, David Lira, Monica M. Diaz and Serggio Lanata
Affiliation:
- Department of Neurology, Peruvian Institute of Neurosciences, Lima, Peru
- Unit for the Diagnosis of Cognitive
Impairment and Dementia Prevention, Peruvian Institute of Neurosciences, Lima, Peru
- Research Unit, Peruvian
Institute of Neurosciences, Lima, Peru
- Professional School of Human Medicine, San Juan Bautista Private University, Lima, Peru
Keywords:
Alzheimer Disease, neuropsychiatric symptoms, COVID-19, Quarantine, stay-at-home orders, mandatory lockdown.
Abstract:
Background: Neuropsychiatric symptoms (NPS) in patients with Alzheimer’s disease (AD)
worsened during the COVID-19 lockdowns, but their progression thereafter is unknown. We present
the first longitudinal study tracking them before, during, and after restrictions.
Objectives: To describe the effect of the COVID-19 mandatory lockdowns on Cognitive and Neuropsychiatric
symptoms in patients with Mild Cognitive Impairment (MCI) and Alzheimer’s Disease
(AD).
Methods: Cohort of 48 patients with amnestic MCI and 38 with AD in Lima, Peru. They received
three rounds of cognitive (RUDAS, CDR, M@T), behavioral (NPI), and functional (ADCS-ADL) assessments.
We assessed the change in score means across the time points and for each domain of NPS
and tracked the changes in individual patients.
Results: RUDAS declined 0.9 (SD 1.0) from baseline to lockdown and 0.7 (SD 1.0) after restrictions.
M@T declined 1.0 (SD 1.5) from baseline to lockdown and 1.4 (SD 2.0) after restrictions. CDR worsened
in 72 patients (83.72%) from baseline to post-lockdown. NPI worsened by 10 (SD 8.3) from
baseline to lockdown but improved by 4.8 (SD 6.4) after restrictions. Proportionally, 81.3% of all patients
had worsened NPS during the lockdowns, but only 10.7% saw an increase thereafter. Improvement
was statistically significant for specific NPS domains except hallucinations, delusions, and appetite
changes. Anxiety, irritability, apathy, and disinhibition returned to baseline levels.
Conclusion: Following confinement, cognition continued to decline, but NPS demonstrated either
stability or improvement. This highlights the role modifiable risk factors may have on the progression
of NPS.