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Frailty,psychological well-being,and social isolation in older adults with cognitive impairment during the SARS-CoV-2 pandemic: data from the GeroCovid initiative
Authors:Camilla Terziotti  Chiara Ceolin  Maria Devita  Cecilia Raffaelli  Sara Antenucci  Salvatore Bazzano  Andrea Capasso  Manuela Castellino  Stefania Del Signore  Francesca Lubian  Mariangela Maiotti  Fiammetta Monacelli  Maria Teresa Mormile  Claudia Sgarito  Filomena Vella  Giuseppe Sergi  Pietro Gareri  Caterina Trevisan  Andrea Bellio  Filippo Fini  Alba Malara  Enrico Mossello  Stefano Fumagalli  Stefano Volpato  Fabio Monzani  Giuseppe Bellelli  Gianluca Zia  Raffaele Antonelli Incalzi  Alessandra Coin
Affiliation:1. Department of Medicine (DIMED), Geriatrics Division, University of Padova, Padova, Italy;2. Psychogeriatric Outpatient Clinic, Ortona, Italy;3. Geriatrics Unit, Azienda ULSS 16, Padova, Italy;4. Territorial Care Department, ASL NA2 Nord, Naples, Italy;5. “B.V. Consolata” Rehabilitation Hospital-Fatebenefratelli, San Maurizio Canavese, Italy;6. Bluecompanion, Ldt, London, UK;7. Geriatrics Unit, Memory Clinic, Bozen Hospital, Bozen, Italy;8. Clinical Neuropsychology, S.Giovanni Battista Hospital, Foligno, Italy;9. Section of Geriatrics, Department of Internal Medicine and Medical Specialties (DIMI), University of Genoa, Genoa, Italy;10. CDCD DS 46 and 47, ASL Napoli 2 Nord, Naples, Italy;11. UOC Involutive Degenerative Diseases, Territorial Psychogeriatrics, ASP of Agrigento, Agrigento, Italy;12. CDCD, District 2, Trieste, Italy;13. Center for Cognitive Disorders and Dementia-Catanzaro Lido ASP, Catanzaro, Italy;14. Department of Medicine (DIMED), Geriatrics Division, University of Padova, Padova, Italy

Department of Medical Sciences, University of Ferrara, Ferrara, Italy;15. ANASTE Humanitas Foundation, Rome, Italy;16. Geriatric Intensive Care Unit, Department of Experimental and Clinical Medicine, University of Firenze, Firenze, Italy;17. Department of Medical Sciences, University of Ferrara, Ferrara, Italy;18. Geriatrics Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy;19. School of Medicine and Surgery, Acute Geriatric Unit, University of Milano-Bicocca, San Gerardo Hospital, Monza, Italy;20. Unit of Geriatrics, Department of Medicine, Campus Bio-Medico University and Teaching Hospital, Rome, Italy

Abstract:

Background

The containment measures linked to the COVID-19 pandemic negatively affected the phyco-physical well-being of the population, especially older adults with neurocognitive disorders (NCDs). This study aims to evaluate whether the frailty of NCD patients was associated with different changes in multiple health domains, in particular in relation to loneliness and social isolation, pre- and post-lockdown.

Materials and Methods

Patients were recruited from 10 Italian Centers for Cognitive Disorders and Dementia. Data were collected in the pre-pandemic period (T0), during the pandemic lockdown (T1), and 6–9 months post-lockdown (T2). The UCLA Loneliness Scale-3, Activities of Daily Living (ADL), Instrumental ADL (IADL), Mini-Mental State Examination, and Neuropsychiatric Inventory (NPI) were administered. Caregivers' burden was also tested. Patients were categorized as non-frail, pre-frail, and frail according to the Fatigue, Resistance, Ambulation, Illness, and Loss of Weight scale.

Results

The sample included 165 subjects (61.9% women, mean age 79.5 ± 4.9 years). In the whole sample, the ADL, IADL, and NPI scores significantly declined between T0 and T2. There were no significative variations in functional and cognitive domains between the frail groups. During lockdown we recorded higher Depression Anxiety Stress Scales and Perceived Stress Scale scores in frail people. In multivariable logistic regression, frailty was associated with an increase in social isolation, and a loss of IADL.

Conclusions

We observed a global deterioration in functional and neuro-psychiatric domains irrespective of the degree of frailty. Frailty was associated with the worsening of social isolation during lockdown. Frail patients and their caregivers seemed to experience more anxiety and stress disorders during SARS-CoV-2 pandemic.
Keywords:frailty  NPI  older adults  SARS-CoV-2  social isolation  UCLA
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