Recent research reveals how the COVID-19 lockdown has significantly impacted the progression of Alzheimer’s disease (AD) among older adults, with various levels of cognitive decline noted depending on the severity of the disease. This study, conducted by researchers at the Seoul National University Boramae Medical Center, involved 253 participants aged 55 and above diagnosed with mild cognitive impairment (MCI) or AD, with data collected from January 2018 to December 2022.
The findings highlight how social isolation during the pandemic exacerbated cognitive decline and impaired daily living activities, especially among patients with severe AD. The study divided participants using clinical dementia rating (CDR) scores: MCI, AD-CDR0.5, AD-CDR1, and AD-CDR2. The data analysis revealed troubling trends across the board, with cognitive function, functional abilities, and neuropsychiatric symptoms deteriorated over time.
The COVID-19 lockdown began on March 22, 2020, and researchers utilized linear mixed-effects models to assess the differences observed across the various severity groups of AD. The results indicated significant declines; MMSE scores, which gauge cognitive function, dropped on average by 0.137 points per year, and CDR-SB scores increased by 0.106, indicating worsening dementia severity.
Interestingly, participants with more advanced stages of AD exhibited greater declines. For the highest severity group (AD-CDR2), results indicated substantial declines during lockdown, prompting concerns about the heightened risks faced by such individuals. Specifically, the AD-CDR2 group saw declines not only in MMSE scores but also impairments in activities of daily living (ADL), solidifying the link between restriction measures and cognitive deterioration.
Meanwhile, the study's mediation analysis pointed to how instrumental activities of daily living (IADL) mediated the relationship between cognitive function and overall dementia severity across various severity groups. For patients classified as MCI, AD-CDR0.5, and AD-CDR1, IADL emerged as particularly important.
A concerning interaction was also noted among the moderate AD group (AD-CDR1), where worsening neuropsychiatric symptoms intensified cognitive decline, indicating how mental health factors interplay with cognitive health. These neuropsychiatric symptoms, assessed via the Neuropsychiatric Inventory (NPI), increased over time, reflecting declining behavioral health even as depressive symptoms remained stable over the assessment period.
These findings raise behind-the-scenes questions about the broader implications of AD management amid global crises. The overall trends suggest heightened vulnerability to the adverse effects of social isolation among patients with severe AD, with recommendations for targeted interventions to maintain cognitive function and psychological support during stressful periods strongly emphasized.
The research also underlines the significance of early screening and treatment for depressive symptoms, which were associated with lower ADL performance, higher NPI scores, and overall dementia severity, for taking proactive steps to combat cognitive decline. Limitations noted include the retrospective nature of the study, which may lack controls for all potential confounding factors, indicating areas for future research.
Given the growing prevalence of Alzheimer’s disease and the long-lasting impacts of events like COVID-19 lockdowns, these insights must shape clinical practices and future research, advocating for individualized, evidence-based interventions for patients and caregivers alike.