Impact of the COVID-19 Pandemic on People with Dementia and their Caregivers: A Multiphase Observational Study from India.

Abstract

Introduction: The COVID-19 pandemic has had multifaceted and enduring impacts on people with dementia and their caregivers; however, our understanding of the long-term outcomes remains limited. We aimed to explore the long-term effects of the COVID-19 pandemic on cognitive symptoms and vaccination rates in people living with dementia.

Method: This study was conducted as a part of a longitudinal study design in two specialized hospitals in South India. In this study, patients with dementia and their caregivers assessed in earlier phases ('period of lockdown with phased relaxations - phase-I' and 'cluster of cases transmission phase - phase-II') were telephonically interviewed. We adopted a quantitative approach to understand disease progression during the three-year course of the pandemic. Changes in cognition and disease severity were measured using the Clinical Dementia Rating (CDR) scale. In brief, semistructured interviews were carried out with caregivers of people with dementia to gain insights into vaccination rates. Data obtained from the current study (phase III) were compared against phase I data, which served as the baseline. Among the 72 participants contacted in the current phase, 59 (81·9%) could be reevaluated for dementia severity and vaccination status, whereas 13 (18·0%) had died. Among the 59 participants, 33 (55·9%) had severe dementia (CDR 3). This is in contrast to phases I and II, when 17·6% and 19·2% of the participants, respectively, were classified as CDR 3.

Result: A significant difference in dementia severity between the two phases (phases I and III) was observed. In addition, we observed vaccination hesitancy among caregivers of patients with dementia. This study would provide valuable insights into the long-term impact of the COVID-19 pandemic on the cognitive outcomes and vaccination status of patients with dementia.

Conclusion: This overall longitudinal study has compared dementia severity between different phases throughout the pandemic, with implications for future studies to tailor home-based support and healthcare interventions in order to meet these evolving needs.