tetano
Editor, Senior Moderator
J Clin Med
. 2023 Feb 25;12(5):1845.
doi: 10.3390/jcm12051845.
COVID-19 Accelerated Cognitive Decline in Elderly Patients with Pre-Existing Dementia Followed up in an Outpatient Memory Care Facility
Lucia Merla[SUP] 1 [/SUP], Maria Cristina Montesi[SUP] 2 [/SUP], Jessica Ticali[SUP] 2 [/SUP], Bruno Bais[SUP] 3 [/SUP], Alessandro Cavarape[SUP] 1 [/SUP], GianLuca Colussi[SUP] 1 4 [/SUP]
Affiliations
Abstract
Introduction: Coronavirus disease 2019 (COVID-19) may affect the cognitive function and activities of daily living (ADL) of elderly patients. This study aimed to establish the COVID-19 effect on cognitive decline and the velocity of cognitive function and ADL changes in elderly patients with dementia followed up in an outpatient memory care facility.
Methods: In total, 111 consecutive patients (age 82 ± 5 years, 32% males) with a baseline visit before infection were divided into those who had or did not have COVID-19. Cognitive decline was defined as a five-point loss of Mini-Mental State Examination (MMSE) score and ADL comprising basic and instrumental ADL indexes (BADL and IADL, respectively). COVID-19 effect on cognitive decline was weighted for confounding variables by the propensity score, whereas the effect on change in the MMSE score and ADL indexes was analyzed using multivariate mixed-effect linear regression.
Results: COVID-19 occurred in 31 patients and a cognitive decline in 44. Cognitive decline was about three and a half times more frequent in patients who had COVID-19 (weighted hazard ratio 3.56, 95% confidence interval 1.50-8.59, p = 0.004). The MMSE score lowered on average by 1.7 points/year, independently of COVID-19, but it lowered twice faster in those who had COVID-19 (3.3 vs. 1.7 points/year, respectively, p < 0.050). BADL and IADL indexes lowered on average less than 1 point/year, independently of COVID-19 occurrence. Patients who had COVID-19 had a higher incidence of new institutionalization than those who did not have the disease (45% versus 20%, p = 0.016, respectively).
Conclusions: COVID-19 had a significant impact on cognitive decline and accelerated MMSE reduction in elderly patients with dementia.
Keywords: SARS-CoV-2; activities of daily living; dementia tests; mental status; observational study; propensity score.
. 2023 Feb 25;12(5):1845.
doi: 10.3390/jcm12051845.
COVID-19 Accelerated Cognitive Decline in Elderly Patients with Pre-Existing Dementia Followed up in an Outpatient Memory Care Facility
Lucia Merla[SUP] 1 [/SUP], Maria Cristina Montesi[SUP] 2 [/SUP], Jessica Ticali[SUP] 2 [/SUP], Bruno Bais[SUP] 3 [/SUP], Alessandro Cavarape[SUP] 1 [/SUP], GianLuca Colussi[SUP] 1 4 [/SUP]
Affiliations
- PMID: 36902632
- DOI: 10.3390/jcm12051845
Abstract
Introduction: Coronavirus disease 2019 (COVID-19) may affect the cognitive function and activities of daily living (ADL) of elderly patients. This study aimed to establish the COVID-19 effect on cognitive decline and the velocity of cognitive function and ADL changes in elderly patients with dementia followed up in an outpatient memory care facility.
Methods: In total, 111 consecutive patients (age 82 ± 5 years, 32% males) with a baseline visit before infection were divided into those who had or did not have COVID-19. Cognitive decline was defined as a five-point loss of Mini-Mental State Examination (MMSE) score and ADL comprising basic and instrumental ADL indexes (BADL and IADL, respectively). COVID-19 effect on cognitive decline was weighted for confounding variables by the propensity score, whereas the effect on change in the MMSE score and ADL indexes was analyzed using multivariate mixed-effect linear regression.
Results: COVID-19 occurred in 31 patients and a cognitive decline in 44. Cognitive decline was about three and a half times more frequent in patients who had COVID-19 (weighted hazard ratio 3.56, 95% confidence interval 1.50-8.59, p = 0.004). The MMSE score lowered on average by 1.7 points/year, independently of COVID-19, but it lowered twice faster in those who had COVID-19 (3.3 vs. 1.7 points/year, respectively, p < 0.050). BADL and IADL indexes lowered on average less than 1 point/year, independently of COVID-19 occurrence. Patients who had COVID-19 had a higher incidence of new institutionalization than those who did not have the disease (45% versus 20%, p = 0.016, respectively).
Conclusions: COVID-19 had a significant impact on cognitive decline and accelerated MMSE reduction in elderly patients with dementia.
Keywords: SARS-CoV-2; activities of daily living; dementia tests; mental status; observational study; propensity score.