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Behavioral and Psychological Effects of Coronavirus Disease-19 Quarantine in Patients With Dementia
Cagnin A, Di Lorenzo R, Marra C, Bonanni L, Cupidi C, Laganà V, Rubino E, Vacca A et al.. Frontiers in psychiatry, 2020-09-09
Topic: Risk, prevention and care in population studies
Background In March 2020, the World Health Organization declared a global pandemic due to the novel coronavirus SARS-CoV-2 and several governments planned a national quarantine in order to control the virus spread. Acute psychological effects of quarantine in frail elderly subjects with special needs, such as patients with dementia, have been poorly investigated. The aim of this study was to assess modifications of neuropsychiatric symptoms during quarantine in patients with dementia and their caregivers. Methods This is a sub-study of a multicenter nation-wide survey. A structured telephone interview was delivered to family caregivers of patients with diagnosis of Alzheimer disease (AD), dementia with Lewy bodies (DLB), frontotemporal dementia (FTD), and vascular dementia (VD), followed regularly at 87 Italian memory clinics. Variations in behavioral and psychological symptoms (BPSD) were collected after 1 month since quarantine declaration and associations with disease type, severity, gender, and caregiver's stress burden were analyzed. Results A total of 4,913 caregivers participated in the survey. Increased BPSD was reported in 59.6% of patients as worsening of preexisting symptoms (51.9%) or as new onset (26%), and requested drug modifications in 27.6% of these cases. Irritability, apathy, agitation, and anxiety were the most frequently reported worsening symptoms and sleep disorder and irritability the most frequent new symptoms. Profile of BPSD varied according to dementia type, disease severity, and patients' gender. Anxiety and depression were associated with a diagnosis of AD (OR 1.35, CI: 1.12-1.62), mild to moderate disease severity and female gender. DLB was significantly associated with a higher risk of worsening hallucinations (OR 5.29, CI 3.66-7.64) and sleep disorder (OR 1.69, CI 1.25-2.29), FTD with wandering (OR 1.62, CI 1.12-2.35), and change of appetite (OR 1.52, CI 1.03-2.25). Stress-related symptoms were experienced by two-thirds of caregivers and were associated with increased patients' neuropsychiatric burden (p Conclusion Quarantine induces a rapid increase of BPSD in approximately 60% of patients and stress-related symptoms in two-thirds of caregivers. Health services need to plan a post-pandemic strategy in order to address these emerging needs.
Key findings
- Results A total of 4,913 caregivers participated in the survey.
- Anxiety and depression were associated with a diagnosis of AD (OR 1.35, CI: 1.12-1.62), mild to moderate disease severity and female gender.
- DLB was significantly associated with a higher risk of worsening hallucinations (OR 5.29, CI 3.66-7.64) and sleep disorder (OR 1.69, CI 1.25-2.29), FTD with wandering (OR 1.62, CI 1.12-2.35), and change of appetite (OR 1.52, CI 1.03-2.25).
- Stress-related symptoms were experienced by two-thirds of caregivers and were associated with increased patients' neuropsychiatric burden (p Conclusion Quarantine induces a rapid increase of BPSD in approximately 60% of patients and stress-related symptoms in two-thirds of caregivers.
Why it matters
This survey of caregivers found that during COVID-19 quarantine, behavioral and psychological symptoms worsened in many patients with dementia, with different patterns depending on the type of dementia. It does not test any treatment or cure for Alzheimer's disease; it documents how an external stress like lockdown affected symptoms and caregiver stress.
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Study details
- Participants4,913
- Effect size59.6%; 51.9%; 27.6%
- Evidence strengthLow
How this study scored 59/100
Published in a peer-reviewed journal. Scored zero for study design and randomised / blinded because the record does not state it. We have no data on senior author's track record, so that was left out: it earned 57 of the 96 points we could judge it on, which is 59 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Frontiers in psychiatry) |
| Journal's citation record | 2 / 4 | Frontiers in Psychiatry: journal h-index 194 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2020 — within 10 year(s) of the newest study here |
| Sample size | 3 / 4 | 4,913 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 369 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 46.1 citations a year over 8 year(s) since 2020 |
| Impact for its field and year | 5 / 6 | Cited 30.9× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 3 other studies in this library |
| Still being cited | 2 / 4 | Cited 38 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | 1 / 3 | University of Padua: institution h-index 1,158 (OpenAlex) |
| Multi-centre collaboration | 3 / 3 | OpenAlex lists 14 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 33033486) |
| Free to read | 2 / 2 | Free to read |
| Points | 57 / 96 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 57 of the 96 points we could judge it on is 59 out of 100. |
| Total | 59 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.3389/fpsyt.2020.578015
- PubMed: 33033486
- Original source →
- Free full text: Frontiers in Psychiatry →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Cagnin, A., Di Lorenzo, R., Marra, C., Bonanni, L., Cupidi, C., Laganà, V., et al. (2020). Behavioral and Psychological Effects of Coronavirus Disease-19 Quarantine in Patients With Dementia. Frontiers in psychiatry. https://doi.org/10.3389/fpsyt.2020.578015
Vancouver
Cagnin A, Di Lorenzo R, Marra C, Bonanni L, Cupidi C, Laganà V, et al. Behavioral and Psychological Effects of Coronavirus Disease-19 Quarantine in Patients With Dementia. Frontiers in psychiatry. 2020. doi:10.3389/fpsyt.2020.578015. PMID: 33033486.
BibTeX
@article{cagnin2020-33033486,
author = {Cagnin, A. and Di Lorenzo, R. and Marra, C. and Bonanni, L. and Cupidi, C. and Laganà, V. and Rubino, E. and Vacca, A. and others},
title = {{Behavioral and Psychological Effects of Coronavirus Disease-19 Quarantine in Patients With Dementia}},
journal = {Frontiers in psychiatry},
year = {2020},
doi = {10.3389/fpsyt.2020.578015},
pmid = {33033486},
url = {https://doi.org/10.3389/fpsyt.2020.578015}
}
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