Literature Review (Grey)
Written by Dementia Panel
Elderly people, and especially patients with dementia, have been hit disproportionately hard by the pandemic. In itself, dementia is associated with higher rates of hospitalisation and mortality, but COVID-19 further exacerbates the vulnerability of those with cognitive impairment. As with other infections, patients with dementia often show an atypical presentation of COVID-19 infection with confusion, agitation, attentional disturbances and psychosis at onset. This may delay appropriate diagnosis and treatment and consequently, worsen their prognosis and survival. COVID-19 has had a dramatical impact in long-term care facilities, with high rates of infection and mortality. Moreover, social distancing and cancellation of cognitive stimulation programs may contribute to generate loneliness and worsening of behavioural and cognitive symptoms in patients with dementia. Multiple levels of dementia care have been impacted, including routine functioning of memory clinics, research programs and clinical trials. Patients who may be in a pre-dementia stage might also not receive a timely diagnosis, and interventions could be delayed. Telemedicine has been useful to counteract these phenomena, for example by addressing delays in new dementia diagnoses, helping the management of pharmacological treatment and clinical follow-up of patients with dementia and to perform evaluations in COVID-19 survivors to study possible long-term neuropsychiatric and cognitive complications.