More irritable, anxious, agitated. Sometimes, on the contrary, they are more immersed than usual in apathy. That’s what happened to the patients with dementia during the lockdown last spring, according to the results of a research conducted by the Stroke and Dementia Lab of the Sacco Hospital in Milan thanks to the Association for Research on Dementia (ARD Onlus) on one hundred elderly people and their caregivers.

Psycho-behavioral symptoms

Research shows that in most cases, patients already had some psycho-behavioral symptoms associated with dementia, but as it explains Leonardo Pantoni, director of the Sacco neurology unit and coordinator of the study, “The long period of isolation, despite 77 per cent receiving visits from other family members and 23 per cent being able to go outside, led to a slight worsening for many symptoms or the appearance of new disorders. Thus, at the end of the lockdown, 51 percent of patients showed apathy, 43 percent irritability, 38 percent aggression, 32 percent depression; one in four had seen at least one indicator worsen, one in three more than two. In the majority of cases we have observed an aggravation of pre-existing problems rather than the appearance of new ones; however, it was not possible to identify any elements capable of predicting the probability of a change for the worse in behavior.


Risks also for caregivers

“The pre-existing brain vulnerability related to dementia, associated with the lack of good cognitive reserve, could underlie this increased danger of neurological consequences, including further deterioration of cognitive function that could prove irreversible,” Pantoni notes. Unfortunately, even the caregivers have seen their well-being worsen, already precarious before confinement, and as the expert observes, “In nine cases out of ten, however, there are partners or children of the patient who are no longer very young, with 64 years on average, and who in two out of three cases they live alone with their loved one to care for, all elements that certainly contribute to creating difficulties to which are added the stress and discomfort of the pandemic ». To help them, the experts have drawn up some useful rules to better deal with the assistance of loved ones with dementia: the first is to be extremely careful to limit the risk of contagion, keeping the home of the elderly in a ‘safe area’ (for example, changing clothes returning from outside, sanitizing bags and cell phones, and so on), because patients with dementia have a greater risk of getting sick and having more serious consequences from the infection

The rules for managing patients

Other valuable tips concern stimulating activities for the elderly (for the body and mind, with simple indoor exercises or even cognitive activities such as card games), monitoring of physical and cognitive parameters, sessions of cognitive tele-rehabilitation and physical but above all the recommendations to manage the possible appearance of psycho-behavioral symptoms: “With the help of health professionals it is necessary to identify which situations trigger anxiety, agitation, irritability in order to avoid them”, says Pantoni. «It would also be useful to record the episodes, so as to discuss them with the healthcare professionals of reference for personalized advice; finally, it is good to have an easily accessible contact such as a nurse, family doctor or geriatrician to be able to consult in case of psycho-behavioral problems, as well as the emergency number to call if situations arise that cannot be managed alone as violent or self-harming gestures ».

March 29, 2021 (change March 29, 2021 | 12:52 pm)

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