Abstract
The COVID-19 pandemic was particularly problematic for vulnerable populations. Elderly individuals with cognitive disabilities were a particularly high-risk group. The present review utilized the findings of previous studies to examine the implications of COVID-19 on the lives of elderly populations living with cognitive disabilities, such as mild cognitive impairment (MCI), dementia, Alzheimer's disease, and Parkinson's disease. The findings of this literature review revealed significant changes in psychological and cognitive health, as well as the mortality rate of patients with cognitive disabilities. Analysis of the study results suggested that the effects of COVID-19-induced isolation led to notable adverse changes in the psychological and cognitive health of those presenting with mild cognitive impairment, dementia, Alzheimer's disease, and Parkinson's disease. Additionally, findings revealed the substantial impact of the COVID-19 virus infection on the mortality of these populations. In many cases, COVID-19 led to a worsening of emotional, behavioral, and cognitive symptoms and to an increase in mortality.
TopCovid-19 Lockdown’S Effect On Mental Health: Psychological And Psychiatric Changes
A common theme in the present literature included the impact of the COVID-19 lockdown on one’s psychological health. One of the first studies to emerge on COVID-19 and elderly populations with cognitive decline included a 2020 study of patients with Alzheimer’s Disease who were facing lockdown in retirement homes in France (El Haj, et al. 2020). The study recorded the patients’ levels of anxiety and depression before and during the COVID-19 lockdown. Previous records of cognitive states, measured by a “Mini Mental State Exam” prior to COVID-19, were used for a Pre-Covid analysis of cognitive state. A self-assessment using the Hospital Anxiety and Depression Scale (Zigmond and Snaith 1983), which was completed with the assistance of caregivers, was used to determine the patients’ cognitive state during Covid. Even without the presence of COVID-19 related effects, individuals with cognitive impairment or with a disability were more predisposed to an increase in anxiety and depression due to their diagnosis. Studies revealed that throughout the course of Alzheimer’s disease, anxiety was experienced by 25 to 71 percent of individuals (El Haj, et al. 2020, as cited in Mintzer et al. 2005) and depression occurred within 50 percent of patients (El Haj, et al. 2020, as cited in Starkstein et al., 2005). Therefore, the disruption of these individuals’ everyday routines and the isolation due to COVID-19, certainly exacerbated these previously prevalent emotional experiences, while often inducing others, as well. The results of the study indicated a substantial difference in pre and post self-assessment scores of patient anxiety and depression levels before and during COVID-19; anxiety and depression levels of patients with Alzheimer’s Disease were higher during the lockdown than they had been before (El Haj, et al. 2020). Similarly, Tsapanou, et al. (2020) discussed the psychological decline of 204 patients with Mild Cognitive Impairment (MCI)/dementia in Greece. Through caregiver self-report questionnaire responses on their patients, studies’ results revealed a significant decline in the patients’ communication, mood, movement, and compliance with COVID-19 measures. Patients’ psychological health and wellness were disrupted by the lockdown.
Key Terms in this Chapter
Alzheimer’s Disease: Progressive mental deterioration that can occur in middle or old age, due to generalized degeneration of the brain. It is the most common cause of premature senility.
Mild Cognitive Impairment (MCI): The stage between the expected cognitive decline of normal aging and the more serious decline of dementia. It's characterized by problems with memory, language, thinking or judgment.
Neuropsychological: The study of the relationship between behavior, emotion, and cognition on the one hand, and brain function on the other.
Cognition: The mental action or process of acquiring knowledge and understanding through thought, experience, and the senses.
Parkinson’s Disease (PD): Parkinson's disease is a progressive nervous system disorder that affects movement. Symptoms start gradually, sometimes starting with a barely noticeable tremor in just one hand. Tremors are common, but the disorder also commonly causes stiffness or slowing of movement.
Apathy: Feeling indifferent or lacking emotion, often resulting in a lack of interest in activities.
Dementia: A chronic and progressive syndrome that is characterized by cognitive impairment and loss of memory, orientation, comprehension, language, and judgment, and is accompanied by a decline in the ability to perform daily activities.
Delirium: A serious disturbance in mental abilities that results in confused thinking and reduced awareness of one’s environment.
Mini-Mental State Examination (MMSE): The Mini-Mental State Exam (MMSE) is a widely used test of cognitive function among the elderly; it includes tests of orientation, attention, memory, language and visual-spatial skills.