AUTHOR=Cagnin Annachiara , Di Lorenzo Raffaele , Marra Camillo , Bonanni Laura , Cupidi Chiara , Laganà Valentina , Rubino Elisa , Vacca Alessandro , Provero Paolo , Isella Valeria , Vanacore Nicola , Agosta Federica , Appollonio Ildebrando , Caffarra Paolo , Pettenuzzo Ilaria , Sambati Renato , Quaranta Davide , Guglielmi Valeria , Logroscino Giancarlo , Filippi Massimo , Tedeschi Gioacchino , Ferrarese Carlo , Rainero Innocenzo , Bruni Amalia C. , SINdem COVID-19 Study Group , Gallo Erica , Grassini Alberto , Marcinnò Andrea , Roveta Fausto , De Martino Paola , Frangipane Francesca , Puccio Gianfranco , Colao Rosanna , Mirabelli Maria , Martellacci Noemi , Lino Federica , Mozzetta Stefano , Bussè Cinzia , Camporese Giulia , Sacco Simona , Lechiara Maria Carmela , Carrarini Claudia , Russo Mirella , Casalena Alfonsina , Sucapane Patrizia , Tiraboschi Pietro , Caroppo Paola , Redaelli Veronica , Di Fede Giuseppe , Coppa Daniela , Peluso Lenino , Insarda Pasqualina , De Bartolo Matteo , Esposito Sabrina , Iavarone Alessandro , Orsini Anna Vittoria Marta , Salvatore Elena , Criscuolo Chiara , Sambati Luisa , Santoro Rossella , Gragnaniello Daniela , Pedriali Ilaria , Ludovico Livia , Chiari Annalisa , Fabbo Andrea , Bevilacqua Petra , Galli Chiara , Magarelli Silvia , Perini Marta , Spalletta Gianfranco , Banaj Nerisa , Porcari Desirée Estela , Caruso Giulia , Cipollini Virginia , Casini Anna Rosa , Ursini Francesca , Bruno Giuseppe , Rozzini Renzo , Brambilla Michela , Magnani Giuseppe , Caso Francesca , Spinelli Edoardo G. , Ramusino Matteo Cotta , Perini Giulia , Luzzi Simona , Cacchiò Gabriella , Angeloni Rossano , Giuli Cinzia , Fabi Katia , Guidi Marco , Paci Cristina , Castellano Annaelisa , Carapelle Elena , Petrucci Rossella , Accogli Miriam , Calabrese Gianluigi , Trevisi Giovanna Nicoletta , Coluccia Brigida , Giuliano Antonella Vasquez , Caggiula Marcella , Da Re Fulvio , Milia Antonio , Pilia Giuseppina , Mascia Maria Giuseppina , Putzu Valeria , Piccoli Tommaso , Cuffaro Luca , Monastero Roberto , Battaglia Antonella , Blandino Valeria , Lupo Federica , Cumbo Eduardo , Antonina Luca , Caravaglios Giuseppe , Vezzosi Annalisa , Bessi Valentina , Tognoni Gloria , Calsolaro Valeria , Mossello Enrico , Amici Serena , Trequattrini Alberto , Pezzuto Salvatore , Mecocci Patrizia , Fichera Giulia , Pradelli Samantha , Formilan Marino , Coin Alessandra , Detogni Laura , Sala Francesca , Sandri Giulia , Gallucci Maurizio , Mazzarolo Anna Paola , Bergamelli Cristina TITLE=Behavioral and Psychological Effects of Coronavirus Disease-19 Quarantine in Patients With Dementia JOURNAL=Frontiers in Psychiatry VOLUME=11 YEAR=2020 URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2020.578015 DOI=10.3389/fpsyt.2020.578015 ISSN=1664-0640 ABSTRACT=Background

In March 2020, the World Health Organization declared a global pandemic due to the novel coronavirus SARS-CoV-2 and several governments planned a national quarantine in order to control the virus spread. Acute psychological effects of quarantine in frail elderly subjects with special needs, such as patients with dementia, have been poorly investigated. The aim of this study was to assess modifications of neuropsychiatric symptoms during quarantine in patients with dementia and their caregivers.

Methods

This is a sub-study of a multicenter nation-wide survey. A structured telephone interview was delivered to family caregivers of patients with diagnosis of Alzheimer disease (AD), dementia with Lewy bodies (DLB), frontotemporal dementia (FTD), and vascular dementia (VD), followed regularly at 87 Italian memory clinics. Variations in behavioral and psychological symptoms (BPSD) were collected after 1 month since quarantine declaration and associations with disease type, severity, gender, and caregiver’s stress burden were analyzed.

Results

A total of 4,913 caregivers participated in the survey. Increased BPSD was reported in 59.6% of patients as worsening of preexisting symptoms (51.9%) or as new onset (26%), and requested drug modifications in 27.6% of these cases. Irritability, apathy, agitation, and anxiety were the most frequently reported worsening symptoms and sleep disorder and irritability the most frequent new symptoms. Profile of BPSD varied according to dementia type, disease severity, and patients’ gender. Anxiety and depression were associated with a diagnosis of AD (OR 1.35, CI: 1.12–1.62), mild to moderate disease severity and female gender. DLB was significantly associated with a higher risk of worsening hallucinations (OR 5.29, CI 3.66–7.64) and sleep disorder (OR 1.69, CI 1.25–2.29), FTD with wandering (OR 1.62, CI 1.12–2.35), and change of appetite (OR 1.52, CI 1.03–2.25). Stress-related symptoms were experienced by two-thirds of caregivers and were associated with increased patients’ neuropsychiatric burden (p<0.0001).

Conclusion

Quarantine induces a rapid increase of BPSD in approximately 60% of patients and stress-related symptoms in two-thirds of caregivers. Health services need to plan a post-pandemic strategy in order to address these emerging needs.