AUTHOR=Rainero Innocenzo , Bruni Amalia C. , Marra Camillo , Cagnin Annachiara , Bonanni Laura , Cupidi Chiara , Laganà Valentina , Rubino Elisa , Vacca Alessandro , Di Lorenzo Raffaele , Provero Paolo , Isella Valeria , Vanacore Nicola , Agosta Federica , Appollonio Ildebrando , Caffarra Paolo , Bussè Cinzia , Sambati Renato , Quaranta Davide , Guglielmi Valeria , Logroscino Giancarlo , Filippi Massimo , Tedeschi Gioacchino , Ferrarese Carlo , the SINdem COVID-19 Study Group , Gallo Erica , Grassini Alberto , Marcinnò Andrea , Roveta Fausto , Martino Paola De , Frangipane Francesca , Puccio Gianfranco , Colao Rosanna , Mirabelli Maria , Terracciano Chiara , Lino Federica , Mozzetta Stefano , Gazzola Gianmarco , Camporese Giulia , Sacco Simona , Lechiara Maria Carmela , Carrarini Claudia , Russo Mirella , lena Alfonsina Casa , Sucapane Patrizia , Tiraboschi Pietro , Caroppo Paola , Redaelli Veronica , Fede Giuseppe Di , Coppa Daniela , Peluso Lenino , Insarda Pasqualina , Bartolo Matteo De , Esposito Sabrina , Iavarone Alessandro , Fuschillo Carmine , Salvatore Elena , Criscuolo Chiara , Sambati Luisa , Santoro Rossella , Gragnaniello Daniela , Pedriali Ilaria , Ludovico Livia , Chiari Annalisa , Fabbo Andrea , Bevilacqua Petra , Galli Chiara , Magarelli Silvia , Spalletta Gianfranco , Banaj Nerisa , Caruso Giulia , Porcari Desirée Estela , Giubilei Franco , Casini Anna Rosa , Ursini Francesca , Bruno Giuseppe , Boffelli Stefano , Brambilla Michela , Magnani Giuseppe , Caso Francesca , Spinelli Edoardo G. , Sinforiani Elena , Costa Alfredo , Luzzi Simona , Cacchiò Gabriella , Parma A.I.M.A. –sez , Perini Marta , Angeloni Rossano , Giuli Cinzia , Fabi Katia , Guidi Marco , Paci Cristina , Castellano Annaelisa , Carapelle Elena , Petrucci Rossella , Accogli Miriam , Trevisi Giovanna Nicoletta , Renna Serena , Giuliano Antonella Vasquez , Re Fulvio Da , Milia Antonio , Pilia Giuseppina , Mascia Maria Giuseppina , Putzu Valeria , Piccoli Tommaso , Cuffaro Luca , Monastero Roberto , Battaglia Antonella , Blandino Valeria , Lupo Federica , Cumbo Eduardo , Luca Antonina , Caravaglios Giuseppe , Vezzosi Annalisa , Bessi Valentina , Tognoni Gloria , Calsolaro Valeria , Lucarelli Giulia , Amici Serena , Trequattrini Alberto , Pezzuto Salvatore , Mecocci Patrizia , Caironi Giulia , Boselli Barbara , Formilan Marino , Coin Alessandra , Togni Laura De , Sala Francesca , Sandri Giulia , Gallucci Maurizio , Mazzarolo Anna Paola , Bergamelli Cristina , Passoni Serena TITLE=The Impact of COVID-19 Quarantine on Patients With Dementia and Family Caregivers: A Nation-Wide Survey JOURNAL=Frontiers in Aging Neuroscience VOLUME=12 YEAR=2021 URL=https://www.frontiersin.org/journals/aging-neuroscience/articles/10.3389/fnagi.2020.625781 DOI=10.3389/fnagi.2020.625781 ISSN=1663-4365 ABSTRACT=Introduction

Previous studies showed that quarantine for pandemic diseases is associated with several psychological and medical effects. The consequences of quarantine for COVID-19 pandemic in patients with dementia are unknown. We investigated the clinical changes in patients with Alzheimer’s disease and other dementias, and evaluated caregivers’ distress during COVID-19 quarantine.

Methods

The study involved 87 Italian Dementia Centers. Patients with Alzheimer’s Disease (AD), Dementia with Lewy Bodies (DLB), Frontotemporal Dementia (FTD), and Vascular Dementia (VD) were eligible for the study. Family caregivers of patients with dementia were interviewed by phone in April 2020, 45 days after quarantine declaration. Main outcomes were patients’ changes in cognitive, behavioral, and motor symptoms. Secondary outcomes were effects on caregivers’ psychological features.

Results

4913 patients (2934 females, 1979 males) fulfilled the inclusion criteria. Caregivers reported a worsening in cognitive functions in 55.1% of patients, mainly in subjects with DLB and AD. Aggravation of behavioral symptoms was observed in 51.9% of patients. In logistic regression analysis, previous physical independence was associated with both cognitive and behavioral worsening (odds ratio 1.85 [95% CI 1.42–2.39], 1.84 [95% CI 1.43–2.38], respectively). On the contrary, pandemic awareness was a protective factor for the worsening of cognitive and behavioral symptoms (odds ratio 0.74 [95% CI 0.65–0.85]; and 0.72 [95% CI 0.63–0.82], respectively). Approximately 25.9% of patients showed the onset of new behavioral symptoms. A worsening in motor function was reported by 36.7% of patients. Finally, caregivers reported a high increase in anxiety, depression, and distress.

Conclusion

Our study shows that quarantine for COVID-19 is associated with an acute worsening of clinical symptoms in patients with dementia as well as increase of caregivers’ burden. Our findings emphasize the importance to implement new strategies to mitigate the effects of quarantine in patients with dementia.