PMID- 35074810
OWN - NLM
STAT- MEDLINE
DCOM- 20220131
LR  - 20220131
IS  - 2044-6055 (Electronic)
IS  - 2044-6055 (Linking)
VI  - 12
IP  - 1
DP  - 2022 Jan 24
TI  - Impact of COVID-19 restrictions on behavioural and psychological symptoms in 
      home-dwelling people with dementia: a prospective cohort study (PAN.DEM).
PG  - e050628
LID - 10.1136/bmjopen-2021-050628 [doi]
LID - e050628
AB  - OBJECTIVES: To investigate the impact of the COVID-19 restrictions on behavioural 
      and psychological symptoms of dementia (BPSD). DESIGN: Prospective cohort study 
      (PAN.DEM) nested within the halted parent trial (LIVE@Home.Path). SETTING: 
      Households in Norway immediate before and 6-9 weeks into the COVID-19 
      restrictions. PARTICIPANTS: 104 dyads (persons with mild to moderate dementia 
      aged >/=65 and their informal carers) completed both prepandemic and pandemic 
      assessments, among 237 in the parent trial. Mini-Mental Status Examination score 
      15-26 or Functional Assessment Staging score 3-7 covered dementia severity. MAIN 
      OUTCOME MEASURES: Neuropsychiatric Inventory (NPI-12) total (range 0-144), 
      psychosis (range 0-24), hyperactive behaviour (range 0-60) and mood subsyndrome 
      (range 0-48) scores; Cornell Scale for Depression in Dementia (CSDD) total score 
      (range 0-38). RESULTS: We found an overall increase in BPSD by NPI-12 total score 
      comparing prepandemic to pandemic levels (median 16 IQR (4.5-29) to 20 (7-32.5), 
      p=0.03) over a mean of 86 days (SD 19). NPI-12 total score worsened in 57 (55%) 
      of people with dementia and was associated with postponed or averted contacts 
      with healthcare professionals (logistic regression, OR 3.96, 95% CI 1.05 to 
      14.95). Psychosis subsyndrome levels increased (0 (0-3) to 0.5 (0-6), p=0.01) in 
      37 (36%) persons; this worsening was associated with partial insight (9.57, 1.14 
      to 80.71) and reduced informal carer contact (4.45, 1.01 to 19.71). Moreover, 
      depressive symptoms increased as assessed by CSDD total score (5 (3-9) to 7 
      (4-12), p=0.01) and worsened for 56 (54%), which was inversely associated with 
      psychotropic drugs on-demand (0.16, 0.03 to 0.75). CONCLUSIONS: BPSD worsened 
      during the first months of the COVID-19 restrictions, most pronounced for 
      psychosis and depression. These BPSD exacerbations have implications for pandemic 
      policies, emphasising that restrictions must balance COVID-19 morbidity and 
      mortality against dementia deterioration. TRIAL REGISTRATION NUMBER: NCT04043364; 
      Results.
CI  - (c) Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Gedde, Marie H
AU  - Gedde MH
AUID- ORCID: 0000-0002-8423-6402
AD  - Haraldsplass Deaconess Hospital, Bergen, Norway marie.gedde@uib.no.
AD  - Centre for Elderly and Nursing Home Medicine, Department of Global Public Health 
      Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway.
FAU - Husebo, Bettina S
AU  - Husebo BS
AD  - Centre for Elderly and Nursing Home Medicine, Department of Global Public Health 
      Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway.
AD  - Bergen Municipality, Bergen, Norway.
FAU - Vahia, Ipsit V
AU  - Vahia IV
AD  - McLean Hospital, Belmont, Massachusetts, USA.
AD  - Harvard Medical School, Boston, Massachusetts, USA.
FAU - Mannseth, Janne
AU  - Mannseth J
AD  - Section for Epidemiology and Medical Statistic, Department of Global Public 
      Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, 
      Norway.
FAU - Vislapuu, Maarja
AU  - Vislapuu M
AD  - Centre for Elderly and Nursing Home Medicine, Department of Global Public Health 
      Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway.
FAU - Naik, Mala
AU  - Naik M
AD  - Haraldsplass Deaconess Hospital, Bergen, Norway.
AD  - Department of Clinical Science, Faculty of Medicine, University of Bergen, 
      Bergen, Norway.
FAU - Berge, Line I
AU  - Berge LI
AD  - Centre for Elderly and Nursing Home Medicine, Department of Global Public Health 
      Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway.
AD  - NKS Olaviken Gerontopsychiatric Hospital, Askoy, Norway.
LA  - eng
SI  - ClinicalTrials.gov/NCT04043364
PT  - Journal Article
DEP - 20220124
PL  - England
TA  - BMJ Open
JT  - BMJ open
JID - 101552874
SB  - IM
MH  - *COVID-19
MH  - Caregivers
MH  - *Dementia
MH  - Humans
MH  - Prospective Studies
MH  - SARS-CoV-2
PMC - PMC8787843
OTO - NOTNLM
OT  - COVID-19
OT  - dementia
OT  - health policy
OT  - old age psychiatry
OT  - primary care
COIS- Competing interests: All authors have completed the ICMJE uniform disclosure form 
      at www.icmje.org/coi_disclosure.pdf and declare: MHG, MV, JM and LIB had 
      financial support from the Research Council of Norway (grant number 273581), for 
      the submitted work; no financial relationships with any organisations that might 
      have an interest in the submitted work in the previous three years; IVV reports 
      receiving honorarium as editor of the American Journal of Geriatric Psychiatry.
EDAT- 2022/01/26 06:00
MHDA- 2022/02/01 06:00
PMCR- 2022/01/24
CRDT- 2022/01/25 05:47
PHST- 2022/01/25 05:47 [entrez]
PHST- 2022/01/26 06:00 [pubmed]
PHST- 2022/02/01 06:00 [medline]
PHST- 2022/01/24 00:00 [pmc-release]
AID - bmjopen-2021-050628 [pii]
AID - 10.1136/bmjopen-2021-050628 [doi]
PST - epublish
SO  - BMJ Open. 2022 Jan 24;12(1):e050628. doi: 10.1136/bmjopen-2021-050628.