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The impact of COVID-19 on health status of home-dwelling elderly patients with dementia in East Lombardy, Italy: results from COVIDEM network

2020; Springer Science+Business Media; Volume: 32; Issue: 10 Linguagem: Inglês

10.1007/s40520-020-01676-z

1720-8319

Salvatore Caratozzolo, Alberto Zucchelli, Marinella Turla, Maria Sofia Cotelli, Sara Fascendini, Mara Zanni, Angelo Bianchetti, Matteo Peli Psy, Renzo Rozzini, Stefano Boffelli, Melania Cappuccio, Federica Gottardi Psy, Chiara Vecchi Psy, Daniele Bellandi, Claudia Caminati, Simona Gentile, Elena Lucchi Psy, Ignazio Di Fazio, Marina Zanetti Psy, Giuliana Vezzadini, Chiara Forlani Psy, Maura Cosseddu Psy, Rosanna Turrone Psy, Silvia Pelizzari Psy, Andrea Scalvini, Marco Di Cesare, Marta Grigolo Psy, Lina Falanga, Nives Medici, Nives Palamini, Elisa Zanacchi Psy, Eleonora Grossi Psy, Giuseppe Bellelli, Alessandra Marengoni, Marco Trabucchi, Alessandro Padovani,

COVID-19 and Mental Health

Abstract Background COVID-19 outbreak has led to severe health burden in the elderly. Age, morbidity and dementia have been associated with adverse outcome. Aims To evaluate the impact of COVID-19 on health status in home-dwelling patients. Methods 848 home-dwelling outpatients with dementia contacted from April 27 to 30 and evaluated by a semi-structured interview to evaluate possible health complication due to COVID-19 from February 21 to April 30. Age, sex, education, clinical characteristics (including diagnosis of dementia) and flu vaccination history were obtained from previous medical records. Items regarding change in health status and outcome since the onset of the outbreak were collected. COVID-19 was diagnosed in patients who developed symptoms according to WHO criteria or tested positive at nasal/throat swab if hospitalized. Unplanned hospitalization, institutionalization and mortality were recorded. Results Patients were 79.7 years old (SD 7.1) and 63.1% were females. Ninety-five (11.2%) patients developed COVID-19-like symptoms. Non COVID-19 and COVID-19 patients differed for frequency of diabetes (18.5% vs. 37.9%, p < 0.001), COPD (7.3% vs. 18.9%, p < 0.001), and previous flu vaccination (56.7% vs. 37.9%, p < 0.001). Diabetes and COPD were positively associated with COVID-19, whereas higher dementia severity and flu vaccination showed an inverse association. Among COVID-19 patients, 42 (44.2%) were hospitalized while 32 (33.7%) died. Non COVID-19 patients’ hospitalization and mortality rate were 1.9% and 1.2%, respectively. COVID-19 and COPD were significantly associated with the rate of mortality. Discussion/conclusions A high proportion of adverse outcome related to COVID-19 was observed in home-dwelling elderly patients with dementia. Active monitoring though telehealth programs would be useful particularly for those at highest risk of developing COVID-19 and its adverse outcomes.