Effects of the COVID-19 Pandemic on the Number of New Dementia Diagnoses and the Quality of Dementia Diagnostics and Treatment

M. T. Hoang, P. G. Jurado, T. Abzhandadze, S. Mostafaei, M. Mo, M. Åkerman, K. Vestling, C. Chen, H. Xu, M. Eriksdotter, Sara Garcia-Ptacek
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Abstract

Background

Care trajectories were disrupted during the COVID-19 pandemic. However, how COVID-19 influenced the number of new dementia diagnoses, and the quality of dementia work-ups, and treatment is understudied.

Objective

To investigate the change in new dementia registrations, diagnostics, and treatment in the pre-, COVID-19 and post-COVID-19 pandemic periods.

Design

A nationwide cohort study.

Setting

This population-based study used data from the Swedish Registry for Cognitive/Dementia disorders - SveDem, and other nationwide registries in Sweden.

Participants

Persons with dementia diagnosed between 2019 and 2021 were divided into three groups based on the date of diagnosis

the pre-COVID-19 period (01 January 2019 – 29 February 2020), the COVID-19 period (01 March 2020 – 31 December 2020), and the post-COVID-19 period (01 January 2021 – 31 August 2021).

Measurements

Outcomes included dementia diagnostics and treatments.

Results

The monthly average number of new dementia cases registered in SveDem was 595, 415 and 470, respectively in the pre-COVID-19, COVID-19 and post-COVID-19 period. Compared to the pre-COVID-19 period, the monthly number of registrations decreased, but provision of the basic diagnostic work-up, its individual tests, and the use of cholinesterase inhibitors, memantine and antipsychotics were not significantly different in the COVID-19 period. Compared to the pre-COVID-19 period, new dementia diagnoses continued to be low in the post-COVID-19 period, but diagnosed individuals were more likely to receive the complete basic diagnostic work-up (OR 1.14, 95% CI 1.00–1.29), blood analysis (OR 1.88, 95% CI 1.44–2.49), computed tomography and magnetic resonance imaging (OR 1.22, 95% CI 1.01–1.48), occupational therapy assessment (OR 1.13, 95% CI 1.04–1.22), and memantine (OR 1.19, 95% CI 1.07–1.31).

Conclusion

The quantity of new dementia registrations in SveDem decreased in the COVID-19 period and has not returned to pre-COVID-19 levels, but the quality of the work-ups which were conducted and registered in SveDem was similar or higher than in the pre-COVID-19 period. It is imperative to implement policies to increase SveDem registration with the aim of matching or exceeding pre-COVID-19 levels.

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COVID-19 大流行对新诊断出的痴呆症数量以及痴呆症诊断和治疗质量的影响
背景在 COVID-19 大流行期间,护理轨迹被打乱。目标调查 COVID-19 流行前、COVID-19 流行后和 COVID-19 流行后新痴呆症登记、诊断和治疗的变化。参与者2019年至2021年期间确诊的痴呆症患者根据确诊日期分为三组:COVID-19前时期(2019年1月1日至2020年2月29日)、COVID-19时期(2020年3月1日至2020年12月31日)和COVID-19后时期(2021年1月1日至2021年8月31日)。结果在 COVID-19 之前、COVID-19 期间和 COVID-19 之后,SveDem 登记的新痴呆病例月平均数量分别为 595 例、415 例和 470 例。与 COVID-19 前相比,每月登记的病例数有所减少,但在 COVID-19 期间,基本诊断工作的提供、单项检测以及胆碱酯酶抑制剂、美金刚和抗精神病药物的使用均无显著差异。与 COVID-19 前相比,COVID-19 后新诊断出的痴呆症患者人数仍然较少,但已确诊的患者更有可能接受完整的基本诊断检查(OR 1.14,95% CI 1.00-1.29)、血液分析(OR 1.88,95% CI 1.44-2.49)、计算机断层扫描和磁共振成像(OR 1.22,95% CI 1.01-1.48)、职业治疗评估(OR 1.88,95% CI 1.44-2.49)。结论在 COVID-19 期间,SveDem 中新登记的痴呆症患者数量有所减少,且尚未恢复到 COVID-19 之前的水平,但在 SveDem 中进行和登记的工作检查的质量与 COVID-19 之前的水平相似或更高。当务之急是执行增加 SveDem 登记的政策,以达到或超过 19 年前的水平。
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来源期刊
The Journal of Prevention of Alzheimer's Disease
The Journal of Prevention of Alzheimer's Disease Medicine-Psychiatry and Mental Health
CiteScore
9.20
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期刊介绍: The JPAD Journal of Prevention of Alzheimer’Disease will publish reviews, original research articles and short reports to improve our knowledge in the field of Alzheimer prevention including: neurosciences, biomarkers, imaging, epidemiology, public health, physical cognitive exercise, nutrition, risk and protective factors, drug development, trials design, and heath economic outcomes.JPAD will publish also the meeting abstracts from Clinical Trial on Alzheimer Disease (CTAD) and will be distributed both in paper and online version worldwide.We hope that JPAD with your contribution will play a role in the development of Alzheimer prevention.
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