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Mohd Tohit NF, Haque M. Gerontology in Public Health: A Scoping Review of Current Perspectives and Interventions. Cureus 2024; 16:e65896. [PMID: 39092340 PMCID: PMC11292002 DOI: 10.7759/cureus.65896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2024] [Indexed: 08/04/2024] Open
Abstract
The intersection of gerontology and public health is increasingly vital due to the global aging population and its implications for health systems. This scoping review aims to map existing literature on gerontology within public health, identify current perspectives, and evaluate interventions tailored to the needs of older adults. A systematic search was performed using predefined keywords across multiple databases, including PubMed, Google Scholar, Scopus, and Web of Science. The review included 42 studies that employed various designs, all focusing on public health interventions targeting the aging population. Key findings indicate a pressing need to integrate gerontological principles into public health practice, recognizing the heterogeneous nature of older adults and the significance of social determinants of health. Interventions ranged from preventive health measures and chronic disease management programs to health promotion activities and caregiver support, including the application of technology to improve health outcomes. However, there was a notable lack of research on diverse populations and mental health interventions. The review also uncovered critical gaps in the literature, such as economic barriers to care access and the necessity for comprehensive policies addressing the aging population's diverse needs. In conclusion, this review emphasizes the importance of a multidimensional approach to effectively addressing older adults' health needs. While several effective interventions exist, there is an urgent need to tackle identified gaps, particularly concerning diverse populations and mental health, to enhance overall health strategies for the aging demographic.
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Affiliation(s)
- Nor Faiza Mohd Tohit
- Department of Community Health, Universiti Pertahanan Nasional Malaysia (National University of Defence Malaysia), Kuala Lumpur, MYS
| | - Mainul Haque
- Department of Research, Karnavati Scientific Research Center (KSRC) School of Dentistry, Karnavati University, Gandhinagar, IND
- Department of Pharmacology and Therapeutics, Universiti Pertahanan Nasional Malaysia (National University of Defence Malaysia), Kuala Lumpur, MYS
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Sullivan C, Vick JB, Decosimo K, Grubber J, Coffman CJ, Bruening R, Sperber N, Tucker M, Dadolf J, Boucher N, Wang V, Allen KD, Hastings SN, Van Houtven CH, Shepherd-Banigan M. "I've been doing this for years": the COVID-19 pandemic and family caregiver isolation and loneliness. FRONTIERS IN AGING 2024; 5:1376103. [PMID: 38881826 PMCID: PMC11176456 DOI: 10.3389/fragi.2024.1376103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 05/06/2024] [Indexed: 06/18/2024]
Abstract
Background Family caregivers are family members or friends of care recipients who assist with activities of daily living, medication management, transportation, and help with finances among other activities. As a result of their caregiving, family caregivers are often considered a population at risk of experiencing increased stress, isolation, and loneliness. During the COVID-19 pandemic in the US, social isolation and decrease in social activities were a top concern among older adults and their family caregivers. Using secondary analysis of survey data as part of a multi-site implementation trial of a caregiver skills training program, we describe differences in caregiver experiences of loneliness before and during the COVID-19 pandemic. Methods Health and wellbeing surveys of family caregivers were collected on 422 family caregivers of veterans before and during COVID-19. Logistic regression modeling examined whether the loneliness differed between caregiver groups pre vs during COVID-19, using the UCLA 3-item loneliness measure. Rapid directed qualitative content analysis of open-ended survey questions was used to explore the context of how survey responses were affected by the COVID-19 pandemic. Results There were no significant differences in loneliness between caregivers pre vs during COVID-19. In open-ended responses regarding effects of COVID-19, caregivers described experiencing loneliness and social isolation; why they were unaffected by the pandemic; and how caregiving equipped them with coping strategies to manage negative pandemic-related effects. Conclusion Loneliness did not differ significantly between pre vs during COVID-19 caregivers. Future research could assess what specific characteristics are associated with caregivers who have resiliency, and identify caregivers who are more susceptible to experiencing loneliness. Understanding caregiver loneliness could assist other healthcare systems in developing and implementing caregiver support interventions.
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Affiliation(s)
- Caitlin Sullivan
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, NC, United States
| | - Judith B. Vick
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, NC, United States
- Department of Medicine, Duke University, Durham, NC, United States
| | - Kasey Decosimo
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, NC, United States
| | - Janet Grubber
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, NC, United States
- Veterans Affairs Boston Healthcare System, Cooperative Studies Program Coordinating Center, Boston, MA, United States
| | - Cynthia J. Coffman
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, NC, United States
- Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC, United States
| | - Rebecca Bruening
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, NC, United States
| | - Nina Sperber
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, NC, United States
- Department of Population Health Sciences, Duke University Medical Center, Durham, NC, United States
| | - Matthew Tucker
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, NC, United States
| | - Joshua Dadolf
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, NC, United States
| | - Nathan Boucher
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, NC, United States
- Department of Population Health Sciences, Duke University Medical Center, Durham, NC, United States
- Duke University, Sanford School of Public Policy, Durham, NC, United States
| | - Virginia Wang
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, NC, United States
- Department of Medicine, Duke University, Durham, NC, United States
- Department of Population Health Sciences, Duke University Medical Center, Durham, NC, United States
| | - Kelli D. Allen
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, NC, United States
- The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - S. Nicole Hastings
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, NC, United States
- Department of Medicine, Duke University, Durham, NC, United States
- Department of Population Health Sciences, Duke University Medical Center, Durham, NC, United States
- Center for the Study of Aging and Human Development, Duke University, Durham, NC, United States
- Geriatrics Research, Education, and Clinical Center, Durham VA Health Care System, Durham, NC, United States
| | - Courtney H. Van Houtven
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, NC, United States
- Department of Population Health Sciences, Duke University Medical Center, Durham, NC, United States
- Duke Margolis Center for Health Policy, Durham, NC, United States
| | - Megan Shepherd-Banigan
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, NC, United States
- Department of Population Health Sciences, Duke University Medical Center, Durham, NC, United States
- Duke Margolis Center for Health Policy, Durham, NC, United States
- Durham VA Medical Center Mental Illness Research Education and Clinical Center, Durham, NC, United States
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Chan VWK, Zhou JHS, Li L, Tse MTH, You JJ, Wong MS, Liu JYW, Lo KKH. Reproducibility and Relative Validity of a Short Food Frequency Questionnaire for Chinese Older Adults in Hong Kong. Nutrients 2024; 16:1132. [PMID: 38674823 PMCID: PMC11054710 DOI: 10.3390/nu16081132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 04/05/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
Changes in an individual's digestive system, hormones, senses of smell and taste, and energy requirement accompanying aging could lead to impaired appetite, but older adults may not notice their risk of nutrient deficiency. When assessing the dietary intake of older adults, it was found that they had more difficulties with short-term recall and open-ended recall and would experience greater fatigue and frustration when compared to younger individuals when completing a lengthy questionnaire. There is a need to develop a brief dietary assessment tool to examine the nutritional needs of older adults. In this study, we aimed to assess the diet of Hong Kong older adults using the short FFQ and examine its reproducibility and relative validity as a dietary assessment tool. Dietary data of 198 older adults were collected via FFQs and three-day dietary records. Correlation analyses, cross-tabulation, one-sample t-tests, and linear regression analyses were used to evaluate the relative validity of the short FFQ. In general, the short FFQ was accurate in assessing the intake of phosphorus, water, grains, and wine, as shown by a significant correlation (>0.7) between values reported in the FFQs and dietary records; good agreement (more than 50% of observations belonged to the same quartile) and insignificant differences detected with the one-sample t-tests and linear regression analyses were observed for the above four variables. Additionally, the intake of proteins, carbohydrates, total fat, magnesium, and eggs in terms of the values reported in the FFQs and dietary records showed good agreement.
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Affiliation(s)
- Vicky Wai-ki Chan
- Department of Food Science and Nutrition, The Hong Kong Polytechnic University, Hong Kong SAR, China; (V.W.-k.C.); (L.L.); (M.-s.W.)
| | - Joson Hao-shen Zhou
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China;
| | - Liz Li
- Department of Food Science and Nutrition, The Hong Kong Polytechnic University, Hong Kong SAR, China; (V.W.-k.C.); (L.L.); (M.-s.W.)
| | - Michael Tsz-hin Tse
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China;
| | - Jane Jia You
- Department of Computing, The Hong Kong Polytechnic University, Hong Kong SAR, China;
| | - Man-sau Wong
- Department of Food Science and Nutrition, The Hong Kong Polytechnic University, Hong Kong SAR, China; (V.W.-k.C.); (L.L.); (M.-s.W.)
| | - Justina Yat-wa Liu
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China;
| | - Kenneth Ka-hei Lo
- Department of Food Science and Nutrition, The Hong Kong Polytechnic University, Hong Kong SAR, China; (V.W.-k.C.); (L.L.); (M.-s.W.)
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR, China
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Chaudhary R, Rohilla M, Chauhan S, Saini M, Aman S, Singla H, bibi A, Ahmed S, Shriwastav S, Kaur N, Dev J, Chalotra R, Singh TG, Mehta S. The pandemic's unseen wounds: COVID-19's profound effects on mental health. Ann Med Surg (Lond) 2023; 85:4954-4963. [PMID: 37811101 PMCID: PMC10552974 DOI: 10.1097/ms9.0000000000001223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 08/12/2023] [Indexed: 10/10/2023] Open
Abstract
Objective This review aims to explore the impact of the COVID-19 pandemic on mental health, with a focus on the physiological and psychological consequences, including comorbidities. The goal is to understand the direct and indirect populations affected by mental distress and identify potential interventions. Methodology A comprehensive literature search was conducted using various databases, including Google Scholar, ResearchGate, ScienceDirect, PubMed, PLoS One, and Web of Science. The search utilized relevant keywords to investigate the direct and indirect impacts of COVID-19 on mental health. The selected articles were critically evaluated and analyzed to identify key findings and insights. Main findings Mental health, being an intrinsic component of overall well-being, plays a vital role in physiological functioning. The COVID-19 pandemic, caused by the emergence of the novel SARS-CoV-2 virus, has had a devastating global impact. Beyond the respiratory symptoms, individuals recovering from COVID-19 commonly experience additional ailments, such as arrhythmia, depression, anxiety, and fatigue. Healthcare professionals on the frontlines face an elevated risk of mental illness. However, it is crucial to recognize that the general population also grapples with comparable levels of mental distress. Conclusion The COVID-19 pandemic has underscored the significance of addressing mental health concerns. Various strategies can help mitigate the impact, including counselling, fostering open lines of communication, providing mental support, ensuring comprehensive patient care, and administering appropriate medications. In severe cases, treatment may involve the supplementation of essential vitamins and antidepressant therapy. By understanding the direct and indirect impacts of COVID-19 on mental health, healthcare providers and policymakers can develop targeted interventions to support individuals and communities affected by the pandemic. Continued research and collaborative efforts are essential to address this pervasive issue effectively.
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Affiliation(s)
| | - Manni Rohilla
- Chitkara College of Pharmacy, Chitkara University
- Swami Vivekanand College of Pharmacy, Rajpura, Punjab
| | | | - Monika Saini
- M.M. College of Pharmacy
- Swami Vivekanand College of Pharmacy, Rajpura, Punjab
| | - Shahbaz Aman
- Department of Microbiology, M.M. Institute of Medical Science and Research, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana
| | | | | | | | - Shalini Shriwastav
- Department of Microbiology, M.M. Institute of Medical Science and Research, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana
| | - Narinder Kaur
- Department of Microbiology, M.M. Institute of Medical Science and Research, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana
| | - Jai Dev
- Department of Microbiology, M.M. Institute of Medical Science and Research, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana
| | - Rishabh Chalotra
- Department of Pharmacology, Central University of Punjab, Bathinda, India
| | | | - Sachin Mehta
- Birat Medical college Teaching Hospital, Kathmandu University, Nepal
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Naparstek S, Yeh AK, Mills-Finnerty C. Transcutaneous Vagus Nerve Stimulation (tVNS) applications in cognitive aging: a review and commentary. Front Aging Neurosci 2023; 15:1145207. [PMID: 37496757 PMCID: PMC10366452 DOI: 10.3389/fnagi.2023.1145207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 06/12/2023] [Indexed: 07/28/2023] Open
Abstract
Differentiating healthy from pathological aging trajectories is extremely timely, as the global population faces an inversion where older adults will soon outnumber younger 5:1. Many cognitive functions (e.g., memory, executive functions, and processing speed) decline with age, a process that can begin as early as midlife, and which predicts subsequent diagnosis with dementia. Although dementia is a devastating and costly diagnosis, there remains limited evidence for medications, therapies, and devices that improve cognition or attenuate the transition into dementia. There is an urgent need to intervene early in neurodegenerative processes leading to dementia (e.g., depression and mild cognitive impairment). In this targeted review and commentary, we highlight transcutaneous Vagus Nerve Stimulation (tVNS) as a neurostimulation method with unique opportunities for applications in diseases of aging, reviewing recent literature, feasibility of use with remote data collection methods/telehealth, as well as limitations and conflicts in the literature. In particular, small sample sizes, uneven age distributions of participants, lack of standardized protocols, and oversampling of non-representative groups (e.g., older adults with no comorbid diagnoses) limit our understanding of the potential of this method. We offer recommendations for how to improve representativeness, statistical power, and generalizability of tVNS research by integrating remote data collection techniques.
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Affiliation(s)
- Sharon Naparstek
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
| | - Ashley K. Yeh
- Department of Molecular, Cellular, and Developmental Biology, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Colleen Mills-Finnerty
- VA Palo Alto Health Care System, Palo Alto, CA, United States
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, United States
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Tsen C, Andreatto CADA, Aily JB, Pelicioni PHS, Neto DB, Mattiello SM, Gomes GADO, de Andrade LP. Effects of telehealth on functional capacity, mental health and quality of life among older people with dementia: LAPESI telehealth protocol for a randomized controlled trial. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2023; 28:e1981. [PMID: 36445170 DOI: 10.1002/pri.1981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 08/17/2022] [Accepted: 10/09/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Telehealth can be an alternative action at a distance that can help as a form of motor intervention, alleviating the deleterious effects arising from social distancing on functional capacity, mental health and quality of life among older people with dementia during the COVID-19 pandemic. PURPOSE We aim to analyze the effects of a telehealth program on functional capacity, mental health and quality of life among older people with dementia and their caregivers. METHODS seventy-eight individuals with mild and moderate dementia and their caregivers will answer an anamnesis and be evaluated through Clinical Dementia Assessment Score. They will also be evaluated by blinded examiners in terms of functional capacity (Activities of Daily Living Questionnaire and World Health Organization Disability Assessment Schedule 2.0), mental health (Mini-Mental State Examination, Clock Drawing Test, Verbal Fluency test and the Neuropsychiatric Inventor) and quality of life (Quality of Life in Alzheimer's Disease scale). Afterward, the volunteers will be randomized into the telehealth training group and the control group. The TR will perform systematic physical and cognitive exercises in 50-min sessions three times a week with professional monitoring, while the CG will receive non-systematized guidance, both for 12 weeks. Participants will be evaluated at baseline, immediately after the three-month interventions and with a 12-week follow- up. DISCUSSION Technological approaches such as telehealth can be a viable alternative in home care service during times of pandemic. We expect that older people with dementia and their caregivers have high adherence to the telehealth program and improve their functional capacity, mental health and quality of life of older people with dementia. Telehealth is an alternative that can contribute to public policies and the development of effective intervention strategies that neutralize adverse outcomes. It can also be presented as an alternative to home care services, which could reduce demands for health resources.
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Affiliation(s)
- Carolina Tsen
- Department of Physiotherapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | | | - Jéssica Bianca Aily
- Department of Physiotherapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Paulo Henrique Silva Pelicioni
- School of Health Sciences, University of New South Wales, Randwick, New South Wales, Australia
- Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Décio Bueno Neto
- Department of Physiotherapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Stela Márcia Mattiello
- Department of Physiotherapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
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Viviani CBRDMA, Ordonez TN, Pereira AR, Jardim KDS, Borges JDH, Mota LAP, Santos GD, Moreira APB, Verga CER, Ishibashi GA, Silva GAD, Moraes LCD, Lessa PP, Gutierrez BAO, Brucki SMD, Silva TBLD. Subjective impacts of computerized cognitive training for healthy older adults in the context of the COVID-19 pandemic. ARQUIVOS DE NEURO-PSIQUIATRIA 2023; 81:240-247. [PMID: 37059433 PMCID: PMC10104751 DOI: 10.1055/s-0043-1767823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
BACKGROUND Computerized cognitive training programs may have benefited the self-assessment of memory, quality of life, and mood among older adults during the coronavirus disease 2019 (COVID-19) pandemic. OBJECTIVE To determine the subjective impacts of computerized cognitive training on mood, frequency of forgetfulness, memory complaints, and quality of life in the elderly using an online platform. METHODS In total, 66 elderly participants of USP 60 + , a program for the elderly offered by Universidade de São Paulo, who voluntarily enrolled in the study were selected and randomized with an allocation ratio of 1:1 into 2 groups: the training group (n = 33) and the control group (n = 33). After signing the free and informed consent form, they answered a protocol which included a sociodemographic questionnaire, the Memory Complaints Questionnaire (MAC-Q), the McNair and Kahn's Frequency of Forgetfulness Scale, the Geriatric Depression Scale (GDS-15), the Geriatric Anxiety Inventory (GAI), and the Control, Autonomy, Self-Realization, and Pleasure (CASP-19) questionnaire. The training cognitive game platform aimed to stimulate various cognitive aspects, including memory, attention, language, executive functions (reasoning, logical thinking), and visual and spatial skills. RESULTS The participants of the training group showed a reduction in the MAC-Q, MacNair and Kahn, and GAI scores in the pre- and posttest comparison. Significant differences were identified between the groups regarding the total scores of the MAC-Q in the post-test, which was also evidenced by the logistic regression. CONCLUSION Participation in a computerized cognitive intervention promoted reductions in memory complaints, frequency of forgetfulness, and anxiety symptoms, in addition to improving self-reported quality of life.
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Affiliation(s)
| | - Tiago Nascimento Ordonez
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, Departamento de Gerontologia, São Paulo SP, Brazil
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, Grupo de Estudos de Treinamento Cognitivo, São Paulo SP, Brazil
| | - Andreia Rodrigues Pereira
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, Departamento de Gerontologia, São Paulo SP, Brazil
| | - Karen de Souza Jardim
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, Departamento de Gerontologia, São Paulo SP, Brazil
| | - Jonatas da Hora Borges
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, Departamento de Gerontologia, São Paulo SP, Brazil
| | - Lais Aparecida Pereira Mota
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, Departamento de Gerontologia, São Paulo SP, Brazil
| | - Gabriela Dos Santos
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, Departamento de Gerontologia, São Paulo SP, Brazil
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, Grupo de Estudos de Treinamento Cognitivo, São Paulo SP, Brazil
| | - Ana Paula Bagli Moreira
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, Grupo de Estudos de Treinamento Cognitivo, São Paulo SP, Brazil
| | - Cássia Elisa Rossetto Verga
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, Departamento de Gerontologia, São Paulo SP, Brazil
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, Grupo de Estudos de Treinamento Cognitivo, São Paulo SP, Brazil
| | - Graciela Akina Ishibashi
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, Departamento de Gerontologia, São Paulo SP, Brazil
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, Grupo de Estudos de Treinamento Cognitivo, São Paulo SP, Brazil
| | - Guilherme Alves da Silva
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, Departamento de Gerontologia, São Paulo SP, Brazil
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, Grupo de Estudos de Treinamento Cognitivo, São Paulo SP, Brazil
| | - Luiz Carlos de Moraes
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, Grupo de Estudos de Treinamento Cognitivo, São Paulo SP, Brazil
- Instituto Supera de Educação, São José dos Campos SP, Brazil
| | - Patrícia Prata Lessa
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, Grupo de Estudos de Treinamento Cognitivo, São Paulo SP, Brazil
- Instituto Supera de Educação, São José dos Campos SP, Brazil
| | | | - Sonia Maria Dozzi Brucki
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, Grupo de Estudos de Treinamento Cognitivo, São Paulo SP, Brazil
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Grupo de Neurologia Cognitiva e Comportamental, São Paulo SP, Brazil
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, São Paulo SP, Brazil
| | - Thais Bento Lima da Silva
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, Departamento de Gerontologia, São Paulo SP, Brazil
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, Grupo de Estudos de Treinamento Cognitivo, São Paulo SP, Brazil
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Grupo de Neurologia Cognitiva e Comportamental, São Paulo SP, Brazil
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8
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Ainsworth NJ, Wright H, Tereshchenko K, Blumberger DM, Flint AJ, Lenze EJ, Perivolaris A, Mulsant BH. Recruiting for a Randomized Clinical Trial for Late-Life Depression During COVID-19: Outcomes of Provider Referrals Versus Facebook Self-Referrals. Am J Geriatr Psychiatry 2023; 31:366-371. [PMID: 36849329 PMCID: PMC9893767 DOI: 10.1016/j.jagp.2023.01.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/10/2023] [Accepted: 01/21/2023] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of online recruitment for a clinical trial of pharmacotherapy for late-life depression during COVID-19. METHODS The authors calculated the yield, defined as recruitment leading to randomization (enrollment), from provider referrals versus Facebook self-referrals; compared characteristics and drop-out rates of participants from each source; and analyzed correlations between stringency of public health restrictions and referrals from each source over time. RESULTS Provider referrals had a significantly higher yield (10 of 33 referrals; 30.3%) versus Facebook self-referrals (14 of 323; 4.3%) (p <0.00001). Participants self-referred from Facebook had significantly more education; otherwise, both groups had similar characteristics and drop-out rates. While public health stringency was negatively correlated with provider referrals (ρ = -0.32) and positively correlated with Facebook self-referrals (ρ = 0.39), neither association reached statistical significance. CONCLUSION Online recruitment may improve access to clinical research for older depressed adults. Future studies should evaluate cost-effectiveness and potential barriers such as computer literacy.
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Affiliation(s)
- Nicholas J Ainsworth
- Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto ON, Canada.
| | - Hailey Wright
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | | | - Daniel M Blumberger
- Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto ON, Canada
| | - Alastair J Flint
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto ON, Canada; Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada
| | - Eric J Lenze
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO
| | | | - Benoit H Mulsant
- Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto ON, Canada
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9
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Chebil D, Ben Hassine D, Melki S, Nouira S, Kammoun Rebai W, Hannachi H, Merzougui L, Ben Abdelaziz A. Place of distancing measures in containing epidemics: a scoping review. Libyan J Med 2022; 17:2140473. [DOI: 10.1080/19932820.2022.2140473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Dhekra Chebil
- Infection Prevention Control Department, Ibn Al Jazzar University Hospital, Kairouan, Tunisia
- Research Laboratory, LR19SP01, Sousse, Tunisia
- Faculty of medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Donia Ben Hassine
- Research Laboratory, LR19SP01, Sousse, Tunisia
- Information System Direction (DSI), Sahloul University Hospital, Sousse, Tunisia
| | - Sarra Melki
- Research Laboratory, LR19SP01, Sousse, Tunisia
- Information System Direction (DSI), Sahloul University Hospital, Sousse, Tunisia
| | - Sarra Nouira
- Research Laboratory, LR19SP01, Sousse, Tunisia
- Information System Direction (DSI), Sahloul University Hospital, Sousse, Tunisia
| | - Wafa Kammoun Rebai
- Regional Training Center supported by WHO-TDR for East Mediterranean Region (EMR), Pasteur Institute of Tunis, Tunisia
| | - Hajer Hannachi
- Infection Prevention Control Department, Ibn Al Jazzar University Hospital, Kairouan, Tunisia
- Faculty of medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Latifa Merzougui
- Infection Prevention Control Department, Ibn Al Jazzar University Hospital, Kairouan, Tunisia
- Faculty of medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Ahmed Ben Abdelaziz
- Research Laboratory, LR19SP01, Sousse, Tunisia
- Faculty of medicine of Sousse, University of Sousse, Sousse, Tunisia
- Information System Direction (DSI), Sahloul University Hospital, Sousse, Tunisia
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10
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Alexescu TG, Nechita MS, Maierean AD, Vulturar DM, Handru MI, Leucuța DC, Orășan OH, Negrean V, Ciumarnean L, Todea DA. Change in Neuroticism and Extraversion among Pre-University Education Employees during the COVID-19 Pandemic. Medicina (B Aires) 2022; 58:medicina58070895. [PMID: 35888616 PMCID: PMC9324659 DOI: 10.3390/medicina58070895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/28/2022] [Accepted: 06/28/2022] [Indexed: 11/16/2022] Open
Abstract
Background and objectives: Since the first reports of SARS-CoV-2 infection cases in China, the virus has rapidly spread to many countries, including Romania. In Romania, schools were closed in March 2020 to prevent the virus from spreading; since then, they have been sporadically opened, but only for a short time. Teachers had to adopt online education methods, experiencing real difficulties in their attempts to maintain high-quality teaching, as a result of social distancing from students and colleagues. The current study aimed to evaluate the burden on the neuroticism states of employees in the pre-university education system during the COVID-19 pandemic. Materials and Methods: A prospective study was conducted, in which personality trait data from 138 employees were collected via a questionnaire (EPI, Eysenck Personality Inventory), which measured extraversion–introversion and neuroticism scores before and during the COVID-19 pandemic. Initially, 150 subjects were invited to participate in the study, although 12 of them refused to participate. Based on the questionnaire not being fully filled in a further three subjects were excluded from the study, leaving a total of 135, of which 115 were woman and 20 were men. Results: The results demonstrate that the subjects included in the study expressed higher neuroticism during the COVID-19 pandemic than in the pre-pandemic period. This change could promote more stress and depression symptoms. Subjects with high school education had significantly lower neuroticism scores over time than those with university education (p = 0.006). Furthermore, we found extraversion scores to be statistically significant in our population (p = 0.022). Conclusion: The gender and living environment of the teachers were not significantly associated with the reduction in the extraversion score, but were more frequently found among older persons and in subjects without higher education. Subjects of Hungarian ethnicity had lower extraversion scores than those of Romanian ethnicity.
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Affiliation(s)
- Teodora-Gabriela Alexescu
- 5th Departament Internal Medicine, 4th Medical Clinic, University of Medicine and Pharmacy, 400015 Cluj-Napoca, Romania; (T.-G.A.); (O.H.O.); (V.N.); (L.C.)
| | | | - Anca-Diana Maierean
- Department of Pneumology, University of Medicine and Pharmacy, 400332 Cluj-Napoca, Romania; (A.-D.M.); (D.A.T.)
| | - Damiana-Maria Vulturar
- Department of Pneumology, University of Medicine and Pharmacy, 400332 Cluj-Napoca, Romania; (A.-D.M.); (D.A.T.)
- Correspondence:
| | | | - Daniel-Corneliu Leucuța
- Department of Informatics and Biostatistics, University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Olga Hilda Orășan
- 5th Departament Internal Medicine, 4th Medical Clinic, University of Medicine and Pharmacy, 400015 Cluj-Napoca, Romania; (T.-G.A.); (O.H.O.); (V.N.); (L.C.)
| | - Vasile Negrean
- 5th Departament Internal Medicine, 4th Medical Clinic, University of Medicine and Pharmacy, 400015 Cluj-Napoca, Romania; (T.-G.A.); (O.H.O.); (V.N.); (L.C.)
| | - Lorena Ciumarnean
- 5th Departament Internal Medicine, 4th Medical Clinic, University of Medicine and Pharmacy, 400015 Cluj-Napoca, Romania; (T.-G.A.); (O.H.O.); (V.N.); (L.C.)
| | - Doina Adina Todea
- Department of Pneumology, University of Medicine and Pharmacy, 400332 Cluj-Napoca, Romania; (A.-D.M.); (D.A.T.)
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11
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Rapidly adapting an effective health promoting intervention for older adults-choose to move-for virtual delivery during the COVID-19 pandemic. BMC Public Health 2022; 22:1172. [PMID: 35690744 PMCID: PMC9188419 DOI: 10.1186/s12889-022-13547-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 05/25/2022] [Indexed: 11/10/2022] Open
Abstract
Background The COVID-19 (COVID) pandemic shifted way of life for all Canadians. ‘Stay-at-home’ public health directives counter transmission of COVID but may cause, or exacerbate, older adults’ physical and social health challenges. To counter unintentional consequences of these directives, we rapidly adapted an effective health promoting intervention for older adults—Choose to Move (CTM)—to be delivered virtually throughout British Columbia (BC). Our specific objectives were to 1. describe factors that influence whether implementation of CTM virtually was acceptable, and feasible to deliver, and 2. assess whether virtual delivery retained fidelity to CTM’s core components. Methods We conducted a 3-month rapid adaptation feasibility study to evaluate the implementation of CTM, virtually. Our evaluation targeted two levels of implementation within a larger socioeconomic continuum: 1. the prevention delivery system, and 2. older adult participants. We implemented 33 programs via Zoom during BC’s 1st wave acute and transition stages of COVID (April–October 2020). We conducted semi-structured 30-45 min telephone focus groups with 9 activity coaches (who delivered CTM), and semi-structured 30-45 min telephone interviews with 30 older adult participants, at 0- and 3-months. We used deductive framework analysis for all qualitative data to identify themes. Results Activity coaches and older adults identified three key factors that influenced acceptability (a safe and supportive space to socially connect, the technological gateway, and the role of the central support unit) and two key factors that influenced feasibility (a virtual challenge worth taking on and CTM flexibility) of delivering CTM virtually. Activity coaches also reported adapting CTM during implementation; adaptations comprised two broad categories (time allocation and physical activity levels). Conclusion It was feasible and acceptable to deliver CTM virtually. Programs such as CTM have potential to mitigate the unintended consequences of public health orders during COVID associated with reduced physical activity, social isolation, and loneliness. Adaptation and implementation strategies must be informed by community delivery partners and older adults themselves. Pragmatic, virtual health promoting interventions that can be adapted as contexts rapidly shift may forevermore be an essential part of our changing world.
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12
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Pinyopornpanish K, Nantsupawat N, Buawangpong N, Pliannuom S, Vaniyapong T, Jiraporncharoen W. Concerns of Home Isolating COVID-19 Patients While Receiving Care via Telemedicine during the Pandemic in the Northern Thailand: A Qualitative Study on Text Messaging. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116591. [PMID: 35682177 PMCID: PMC9180485 DOI: 10.3390/ijerph19116591] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 05/16/2022] [Accepted: 05/26/2022] [Indexed: 01/02/2023]
Abstract
As there were strict limits on contact between health professionals and patients during the COVID-19 pandemic, telemedicine increased in importance with regard to improving the provision of health care and became the preferred method of care. This study aims to determine the topics of concern expressed by individuals with COVID-19 receiving care at home via teleconsultation. The qualitative study was conducted using secondary data of chat messages from 213 COVID-19 patients who had consented to online consultation with the health care team. The messages were sent during the home isolation period, which was between 29th October and 20th December 2021. Thematic analysis was used to analyze the data. All patients had consented to the use of their data. A small majority of the patients were female (58.69%). The average age was 32.26 ± 16.92 years. A total of 475 questions were generated by 150 patients during the isolation period. Nearly thirty percent (29.58%) never asked any questions. From the analysis, the questions could be divided into three themes including: (1) complex care system; (2) uncertainty about self-care and treatment plan with regard to lack of knowledges and skills; and (3) concern about recovery and returning to the community after COVID-19 infection. In conclusion, there were enquiries about many aspects of medical care during home isolation, detailed answers from professionals were useful for the self-care of patients and to provide guidance for their future health behavior. The importance of the service being user friendly and accessible to all became increasingly evident.
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Affiliation(s)
- Kanokporn Pinyopornpanish
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (K.P.); (N.B.); (S.P.); (W.J.)
| | - Nopakoon Nantsupawat
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (K.P.); (N.B.); (S.P.); (W.J.)
- Correspondence: ; Tel.: +66-53935462
| | - Nida Buawangpong
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (K.P.); (N.B.); (S.P.); (W.J.)
| | - Suphawita Pliannuom
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (K.P.); (N.B.); (S.P.); (W.J.)
| | - Tanat Vaniyapong
- Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand;
| | - Wichuda Jiraporncharoen
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (K.P.); (N.B.); (S.P.); (W.J.)
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13
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Tosoni S, Voruganti I, Lajkosz K, Mustafa S, Phillips A, Kim SJ, Wong RKS, Willison D, Virtanen C, Heesters A, Liu FF. Patient consent preferences on sharing personal health information during the COVID-19 pandemic: "the more informed we are, the more likely we are to help". BMC Med Ethics 2022; 23:53. [PMID: 35596210 PMCID: PMC9122733 DOI: 10.1186/s12910-022-00790-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 04/27/2022] [Indexed: 11/10/2022] Open
Abstract
Background Rapid ethical access to personal health information (PHI) to support research is extremely important during pandemics, yet little is known regarding patient preferences for consent during such crises. This follow-up study sought to ascertain whether there were differences in consent preferences between pre-pandemic times compared to during Wave 1 of the COVID-19 global pandemic, and to better understand the reasons behind these preferences.
Methods A total of 183 patients in the pandemic cohort completed the survey via email, and responses were compared to the distinct pre-pandemic cohort (n = 222); all were patients of a large Canadian cancer center. The survey covered (a) broad versus study-specific consent; (b) opt-in versus opt-out contact approach; (c) levels of comfort sharing with different recipients; (d) perceptions of commercialization; and (e) options to track use of information and be notified of results. Four focus groups (n = 12) were subsequently conducted to elucidate reasons motivating dominant preferences. Results Patients in the pandemic cohort were significantly more comfortable with sharing all information and biological samples (90% vs. 79%, p = 0.009), sharing information with the health care institution (97% vs. 83%, p < 0.001), sharing information with researchers at other hospitals (85% vs. 70%, p < 0.001), sharing PHI provincially (69% vs. 53%, p < 0.002), nationally (65% vs. 53%, p = 0.022) and internationally (48% vs. 39%, p = 0.024) compared to the pre-pandemic cohort. Discomfort with sharing information with commercial companies remained unchanged between the two cohorts (50% vs. 51% uncomfortable, p = 0.58). Significantly more pandemic cohort patients expressed a wish to track use of PHI (75% vs. 61%, p = 0.007), and to be notified of results (83% vs. 70%, p = 0.012). Thematic analysis uncovered that transparency was strongly desired on outside PHI use, particularly when commercialization was involved. Conclusions In pandemic times, patients were more comfortable sharing information with all parties, except with commercial entities, where levels of discomfort (~ 50%) remained unchanged. Focus groups identified that the ability to track and receive results of studies using one’s PHI is an important way to reduce discomfort and increase trust. These findings meaningfully inform wider discussions on the use of personal health information for research during global crises. Supplementary Information The online version contains supplementary material available at 10.1186/s12910-022-00790-z.
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Affiliation(s)
- Sarah Tosoni
- Radiation Medicine Program, Princess Margaret Cancer Centre, 700 University Avenue, Toronto, ON, M5G 2M9, Canada
| | - Indu Voruganti
- Radiation Medicine Program, Princess Margaret Cancer Centre, 700 University Avenue, Toronto, ON, M5G 2M9, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada
| | - Katherine Lajkosz
- Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Shahbano Mustafa
- Radiation Medicine Program, Princess Margaret Cancer Centre, 700 University Avenue, Toronto, ON, M5G 2M9, Canada
| | | | - S Joseph Kim
- Department of Medicine, University Health Network, Toronto, ON, Canada
| | - Rebecca K S Wong
- Radiation Medicine Program, Princess Margaret Cancer Centre, 700 University Avenue, Toronto, ON, M5G 2M9, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Donald Willison
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Carl Virtanen
- University Health Network Digital, Toronto, ON, Canada
| | - Ann Heesters
- Department of Bioethics, University Health Network, Toronto, ON, Canada.,Joint Centre for Bioethics, University of Toronto, Toronto, ON, Canada
| | - Fei-Fei Liu
- Radiation Medicine Program, Princess Margaret Cancer Centre, 700 University Avenue, Toronto, ON, M5G 2M9, Canada. .,Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada.
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14
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Borelli WV, Xavier LDL, Ornell F, Schuch JB, Von Diemen L. The hidden stigma of aging and COVID-19: aggravating factors and strategies to mitigate the impact of the pandemic in older adults, a text mining analysis. Aging Ment Health 2022; 26:881-889. [PMID: 33949899 DOI: 10.1080/13607863.2021.1910793] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To identify factors associated with mental health of older adults during the pandemic and to provide strategies to mitigate their psychosocial impact in the elderly. METHOD An integrative text mining analysis in Medline was performed to identify studies on the mental health of older adults during the pandemic. Subsequently, statistical topic modeling was performed to identify the most prevalent terms and topics discussed in included studies. RESULTS A total of 29 studies were retrieved until July 1st 2020, including a majority of letters (12 studies) and commentaries (8 studies). The most frequent terms overall were: loneliness (n = 137), support (n = 132), home (n = 102), suicide (n = 96) and help (n = 94). The most prevalent terms were then divided in five topics: home (33%), suicide (32%), apps (15%), loneliness (12%) and physical activity (9%). Additionally, a section focused on low- and middle-income countries was included. A summary of strategies to mitigate the effects of pandemic in mental health of older adults was also provided. CONCLUSION These factors demonstrate the importance of developing strategies for psychosocial support that take into consideration the particularities of the elderly. Different levels of care are immediately necessary to diminish the devastating impact of the pandemic in the mental health of older adults.
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Affiliation(s)
| | - Laura de Lima Xavier
- Department of Otolaryngology Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.,Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Felipe Ornell
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, RS, Brazil.,Programa de Pós-Graduação em Psiquiatria e Ciências Do Comportamento, Departamento de Psiquiatria e Medicina Legal, Faculdade de Medicina, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, RS, Brazil
| | - Jaqueline Bohrer Schuch
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, RS, Brazil
| | - Lisia Von Diemen
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, RS, Brazil
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15
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Delude C, Abi‐Elias IH, Quinn CC, Adams AS, Magaziner JS, Ito K, Jain P, Gurwitz JH, Mazor KM. Stakeholders’ Views on Priorities Essential for Establishing a Supportive Environment for Clinical Trials in Nursing Homes. J Am Geriatr Soc 2022; 70:950-959. [PMID: 35188222 PMCID: PMC8986625 DOI: 10.1111/jgs.17710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 02/02/2022] [Accepted: 02/03/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND The U.S. clinical research enterprise in nursing homes was unprepared to mount clinical trials in nursing homes to address urgent questions relevant to prevention and treatment during the COVID-19 pandemic. We identify priorities essential for establishing a supportive environment for future clinical trials in nursing homes. METHODS Two cross-sectional online questionnaires were administered between January and February 2021. One was administered to nursing home providers, researchers, and policymakers; respondents rated the importance of attributes of researchers, facilities, leaders and staff for conducting clinical trials in nursing homes. Because importance may depend on trial type, respondents rated each attribute for efficacy trials (testing an intervention in ideal circumstances) and effectiveness trials (testing an intervention in "real world" circumstances). We calculated the attribute rating means and standard deviations, and used content analysis to characterize open-ended responses. The second questionnaire for resident family members and advocates included open-ended questions about nursing home research, and factors influencing willingness to participate. RESULTS The attributes rated as most essential for conducting efficacy and effectiveness trials in nursing homes are research team attributes, that is, that researchers recognize regulatory constraints; understand and adapt to nursing home workflow; and work collaboratively with nursing home leaders to identify priorities. Resident and facility diversity emerged as essential for effectiveness trials; important dimensions included resident race, ethnicity and income, as well as nursing home urban/rural location, quality ratings, geography, staffing ratios, size, and profit status. Caregivers and resident advocates stressed the importance of communication among participants, researchers, and nursing home leadership and staff at all stages of a trial. CONCLUSION Developing a robust U.S. clinical research enterprise capable of efficiently mounting future clinical trials in nursing homes will require a reimagining of the relationships that exist between researchers, facilities, nursing home leaders, and residents, with a research infrastructure specifically focused on supporting and fostering these connections.
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Affiliation(s)
| | | | | | | | | | - Kouta Ito
- Meyers Health Care Institute
- UMass Chan Medical School
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16
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Hoffmann E, Specht K, Elkjær M, Kjær M, Primdahl J. Relatives’ experiences of the hospitalisation of older people with COVID‐19: A qualitative interview study. Int J Older People Nurs 2022; 17:e12451. [PMID: 35156293 PMCID: PMC9115343 DOI: 10.1111/opn.12451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 09/03/2021] [Accepted: 01/29/2022] [Indexed: 12/01/2022]
Abstract
Background During the COVID‐19 pandemic, visitors were restricted from hospitals, separating them from hospitalised friends and family to reduce the infection risk. Objectives The objective was to explore how relatives of older people acutely admitted to hospital with COVID‐19 experienced being a relative, and how they felt about their contact with health care professionals (HCPs) when visitor restrictions prevented their physical presence in the ward. Method This study employed a qualitative design. We used individual qualitative semi‐structured interviews and the participants were relatives of acutely admitted older people from three COVID‐19 wards in Denmark. A total of 18 relatives participated, 14 female and 4 male, aged between 45 and 83 years. The analysis was guided by Graneheim and Lundman’s qualitative content analysis. Results The analysis derived the following three themes: (1) the importance of trust in a period of uncertainty; (2) the meaning of contact with HCPs, and (3) active but at a distance—a balancing act. The participants' feelings of uncertainty were prominent. The unknown nature of the disease and the unusual situation challenged relatives' trust in HCPs and the health care system. Conclusions and relevance to practice The findings highlight relatives' stress when the possibilities for visiting are restricted and the importance of trust in, and the relationship with HCPs. This study can strengthen HCPs' understanding of relatives' situation when older people are hospitalised during and after the COVID‐19 pandemic.
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Affiliation(s)
- Eva Hoffmann
- University College South Denmark Aabenraa Denmark
- Hospital Sønderjylland University Hospital of Southern Denmark Aabenraa Denmark
- OPEN Odense Denmark
| | - Kirsten Specht
- Department of Regional Health Research University of Southern Denmark Odense Denmark
- Department of Orthopaedic Surgery Hospital Sønderjylland University Hospital of Southern Denmark Aabenraa Denmark
| | - Mette Elkjær
- Department of Emergency Medicine Hospital Sønderjylland University Hospital of Southern Denmark Aabenraa Denmark
| | - Maria Kjær
- University College South Denmark Aabenraa Denmark
| | - Jette Primdahl
- Hospital Sønderjylland University Hospital of Southern Denmark Aabenraa Denmark
- Department of Regional Health Research University of Southern Denmark Odense Denmark
- Danish Hospital for Rheumatic Diseases University Hospital of Southern Denmark Sønderborg Denmark
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17
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Brown C, Wilkins K, Craig-Neil A, Upshaw T, Pinto AD. Reducing Inequities During the COVID-19 Pandemic: A Rapid Review and Synthesis of Public Health Recommendations. Public Health Rev 2022; 42:1604031. [PMID: 35140994 PMCID: PMC8802804 DOI: 10.3389/phrs.2021.1604031] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 11/04/2021] [Indexed: 01/10/2023] Open
Abstract
Objectives: Efforts to contain the COVID-19 pandemic should take into account worsening health inequities. While many public health experts have commented on inequities, no analysis has yet synthesized recommendations into a guideline for practitioners. The objective of this rapid review was to identify the areas of greatest concern and synthesize recommendations. Methods: We conducted a rapid systematic review (PROSPERO: CRD42020178131). We searched Ovid MEDLINE, Embase, PsycINFO, CINAHL and Cochrane Central Register of Controlled Trials databases from December 1, 2019 to April 27, 2020. We included English language peer-reviewed commentaries, editorials, and opinion pieces that addressed the social determinants of health in the context of COVID-19. Results: 338 articles met our criteria. Authors represented 81 countries. Income, housing, mental health, age and occupation were the most discussed social determinants of health. We categorized recommendations into primordial, primary, secondary and tertiary prevention that spoke to the social determinants of COVID-19 and equity. Conclusion: These recommendations can assist efforts to contain COVID-19 and reduce health inequities during the pandemic. Using these recommendations, public health practitioners could support a more equitable pandemic response. Systematic Review Registration: PROSPERO, CRD42020178131.
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Affiliation(s)
- Chloe Brown
- Upstream Lab, MAP/Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON, Canada
- Undergraduate Medical Education, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Katie Wilkins
- Upstream Lab, MAP/Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON, Canada
- Undergraduate Medical Education, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Amy Craig-Neil
- Upstream Lab, MAP/Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON, Canada
| | - Tara Upshaw
- Upstream Lab, MAP/Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON, Canada
| | - Andrew David Pinto
- Upstream Lab, MAP/Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON, Canada
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Family and Community Medicine, St. Michael's Hospital, Toronto, ON, Canada
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18
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Qureshi I. Psychological and social implications of COVID-19. CORONAVIRUS DISEASE 2022. [DOI: 10.1016/b978-0-12-824409-8.00003-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
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19
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Veiga-Seijo R, Miranda-Duro MDC, Veiga-Seijo S. Strategies and actions to enable meaningful family connections in nursing homes during the COVID-19: A Scoping Review. Clin Gerontol 2022; 45:20-30. [PMID: 34170785 DOI: 10.1080/07317115.2021.1937424] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To better understand the impact of visitor restrictions on nursing home residents and their families as well as strategies and actions that were conducted in nursing homes during the COVID-19 pandemic. METHODS A scoping review was carried out in October 2020. Several electronic databases were used: Cochrane Plus, Scopus, Web of Sciences and PubMed. 725 results were identified. We included 10 articles. RESULTS Thematic analysis obtained the following categories: the impact of COVID-19 on nursing home residents' lives and their families, procedures and frameworks of nursing homes during and after lockdown, and solutions and resources implemented by health care professionals to improve the connection between older people and their families. CONCLUSIONS Visitor restrictions have a high impact on the health and well-being of older adults' and their families. The main strategies and solutions employed to reduce social isolation and facilitate the communication between older adults' and their families were the use of information and communication technologies, family support groups, and the assignment of reference staff to each family. CLINICAL IMPLICATIONS The strategies and solutions mentioned should be internationally considered by health care providers in nursing homes to improve connections between family and older adults.
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Affiliation(s)
- Raquel Veiga-Seijo
- Department of Health Sciences, Faculty of Nursery and Podiatry, Ferrol Campus, Universidade da Coruña (University of A Coruña),Ferrol,A Coruña, Spain.,Grupo de Investigación en Reumatología y Salud (GIR-S), Faculty of Phisiotherapy, Oza Campus, Universidade da Coruña (University of A Coruña), A Coruña, Spain
| | - María Del Carmen Miranda-Duro
- CITIC(Centre for Information and Communications Technology Research),TALIONIS Group,Elviña Campus, Universidade da Coruña (University of A Coruña), A Coruña, Spain.,Department of Physiotherapy, Medicine and Biomedical Sciences, Faculty of Health Sciences, Oza Campus, Universidade da Coruña (University of A Coruña), A Coruña, Spain
| | - Silvia Veiga-Seijo
- Department of Health Sciences, Faculty of Health Sciences, Oza Campus, Universidade da Coruña (University of A Coruña), A Coruña, Spain
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20
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Beauchamp MK, Vrkljan B, Kirkwood R, Vesnaver E, Macedo LG, Keller H, Astephen-Wilson J, Sohel N, Noble T, Dietrich N, Gardner P, Newbold KB, Scott D. Impact of COVID-19 on mobility and participation of older adults living in Hamilton, Ontario, Canada: a multimethod cohort design protocol. BMJ Open 2021; 11:e053758. [PMID: 34916322 PMCID: PMC8678540 DOI: 10.1136/bmjopen-2021-053758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION The novel COVID-19 required many countries to impose public health measures that likely impacted the participation and mobility of community-dwelling older adults. This protocol details a multimethod cohort design undertaken to describe short-term and medium-term changes to the mobility and participation of older Canadians living in the community rather than retirement facilities during the COVID-19 pandemic. METHODS AND ANALYSIS A longitudinal telephone (or online)-administered survey is being conducted with a random sample of older adults living within 20 km of McMaster University, Hamilton, Ontario, Canada, identified from census dissemination areas. Baseline data collection of community-dwelling older adults aged 65 years and over began in May 2020 with follow-ups at 3, 6, 9 and 12 months. The Late-Life Function and Disability Instrument and global rating of change anchors are the primary outcomes of interest. A subsample of respondents will participate in open-ended, semistructured interviews conducted over the telephone or through video-conference, to explore participants' lived experiences with respect to their mobility and participation during the pandemic. Descriptive statistics and quantitative approaches will be used to determine changes in mobility and social and personal participation, and associated personal and environmental factors. For the interviews, qualitative data will be analysed using descriptive phenomenology. ETHICS AND DISSEMINATION Approval was obtained from the Hamilton Integrated Research Ethics Board of McMaster University (2020-10814-GRA). This study may inform the design of programmes that can support community-dwelling older adults during and after the COVID-19 pandemic. Findings will be disseminated through peer-reviewed publications and conferences focused on ageing.
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Affiliation(s)
- Marla K Beauchamp
- School of Rehabilitation Science, McMaster University, Hamilton, California, Canada
| | - Brenda Vrkljan
- School of Rehabilitation Science, McMaster University, Hamilton, California, Canada
| | - Renata Kirkwood
- School of Rehabilitation Science, McMaster University, Hamilton, California, Canada
| | - Elisabeth Vesnaver
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Luciana G Macedo
- School of Rehabilitation Science, McMaster University, Hamilton, California, Canada
| | - Heather Keller
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
| | | | - Nazmul Sohel
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, California, Canada
| | - Tara Noble
- School of Rehabilitation Science, McMaster University, Hamilton, California, Canada
| | - Nicholas Dietrich
- School of Rehabilitation Science, McMaster University, Hamilton, California, Canada
| | - Paula Gardner
- Department of Communication Studies and Multimedia, McMaster University, Hamilton, California, Canada
| | - K Bruce Newbold
- School of Earth, Environment & Society, McMaster University, Hamilton, California, Canada
| | - Darren Scott
- School of Earth, Environment & Society, McMaster University, Hamilton, California, Canada
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21
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Dubey S, Sengupta S, Ghosh R, Dubey MJ, Chatterjee S, Das G, Roy D, Ray BK, Benito-León J. COVID-19 Pandemic, Personality and Geriatric Population: Proposed Pragmatism. J Patient Exp 2021; 8:23743735211059051. [PMID: 34869840 PMCID: PMC8633839 DOI: 10.1177/23743735211059051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The elderly population is a sensitive and delicate cohort of society who is being compelled to bear the significant smoulders of disruptive social behavior of humankind amidst the COVID-19 pandemic. Our aim for this review was (1) to find out the root of disruption of societal integrity and self-centeredness by analyzing the spokes of HEXACO; (2) to delineate their possible relationships with the formation of Neuroticism and eventually Psychopathy, which have endangered human civilization the most in this pandemic; and (3) to search for the potential ways to get rid of these dark times. The constellation of different negative human behaviors probably originate from the negative deflection of components of the HEXACO model of personality towards the genesis of the dark triad. COVID-19 pandemic and upsurge of the dark triad in the form of Neuroticism, Narcissism and Machiavellianism potentially portend major mental health threats. Cultivation and practice of positive emotions and triumph of honesty, humility and humanity are imperative to save the mankind from the savagery of this pandemic.
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Affiliation(s)
- Souvik Dubey
- Department of Neuromedicine, Bangur Institute of Neurosciences, Kolkata, India
| | - Samya Sengupta
- Department of General Medicine, Apollo Gleneagles Hospitals, Kolkata, India
| | - Ritwik Ghosh
- Department of General Medicine, Burdwan Medical College & Hospital, Burdwan, India
| | - Mahua Jana Dubey
- Department of Psychiatry, Berhampore Mental Hospital, Murshidabad, India
| | - Subham Chatterjee
- Department of Psychiatry, Institute of Psychiatry, Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - Gautam Das
- Department of Neuromedicine, Bangur Institute of Neurosciences, Kolkata, India
| | - Dipayan Roy
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Jodhpur, India
| | - Biman Kanti Ray
- Department of Neuromedicine, Bangur Institute of Neurosciences, Kolkata, India
| | - Julián Benito-León
- Department of Neurology, University Hospital "12 de Octubre", Madrid, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.,Department of Medicine, Complutense University, Madrid, Spain
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22
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Johnson C, Dupuis JB, Goguen P, Grenier G. Changes to telehealth practices in primary care in New Brunswick (Canada): A comparative study pre and during the COVID-19 pandemic. PLoS One 2021; 16:e0258839. [PMID: 34813618 PMCID: PMC8610241 DOI: 10.1371/journal.pone.0258839] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 10/07/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND During the COVID-19 pandemic, telehealth technologies were used in the primary health care setting in New Brunswick as a means to continue providing care to patients while following public health guidelines. This study aimed to measure these changes and examine if they improved timely access to primary care. A secondary goal was to identify which telehealth technologies were deemed sustainable by primary care providers. METHODS This was a comparative study on the use of telehealth technology before and during the COVID-19 pandemic. Between April 2020 and November 2020, 114 active primary care providers (family physicians or nurse practitioners) responded to the online survey. RESULTS The findings illustrated an increase in the use of telehealth technologies. The use of phone consultations increased by 122%, from 43.9% pre-pandemic to 97.6% during the pandemic (p < 0.001). The use of virtual consultation (19.3% pre-pandemic vs. 41.2% during the pandemic, p < 0.001), emails and texts also increased during the pandemic. Whereas the more structural organizational tools (electronic medical charts and reservation systems) remained stable. However, those changes did not coincide with a significant improvement to timely access to care during the pandemic. Many participants (40.1%) wanted to keep phone consultations, and 21.9% of participants wanted to keep virtual consultations as part of their long-term practice. INTERPRETATION The observed increase in the use of telehealth technologies may be sustainable, but it has not significantly improved timely access to primary care in New Brunswick.
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Affiliation(s)
- Claire Johnson
- School of Public Policy Studies, Université de Moncton, Moncton, New Brunswick, Canada
- * E-mail:
| | - Jérémie B. Dupuis
- Faculty of Education, Université de Moncton, Moncton, New Brunswick, Canada
| | - Pierre Goguen
- Champlain Library, Université de Moncton, Moncton, New Brunswick, Canada
| | - Gabrielle Grenier
- School of Public Policy Studies, Université de Moncton, Moncton, New Brunswick, Canada
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23
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Mahapatra P, Sahoo KC, Desaraju S, Pati S. Coping with COVID-19 pandemic: reflections of older couples living alone in urban Odisha, India. Prim Health Care Res Dev 2021; 22:e64. [PMID: 34728006 PMCID: PMC8569829 DOI: 10.1017/s1463423621000207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 02/16/2021] [Accepted: 03/05/2021] [Indexed: 11/25/2022] Open
Abstract
AIM We explored the 'coping reflections' of elderly couples living alone (without any other family members) during the COVID-19 pandemic in urban Odisha, India. BACKGROUND Evidence worldwide suggests that older people are at increased risk from COVID-19 adverse outcomes and experience greater stress. In our previous community-based study urban dwelling, particularly elderly participants, and living alone reported higher pandemic-associated health care challenges than their rural and residing-with-family counterparts. We intended to explore how the elderly couples living alone coped through this challenging yet stressful situation during the COVID-19 pandemic and what were their key strategies adopted toward this. METHODS We conducted telephonic in-depth interviews (IDIs) with 11 urban elderly couples living alone in Bhubaneswar city of Odisha, India using a semi-structured interview guide. All IDIs were digitally recorded, transcribed into the original language, and translated to English. We used a thematic approach for analysis. FINDINGS Four themes emerged: (1) Risk appraisal and feeling vulnerable; (2) Safeguarding against COVID-19; (3) Managing routine health care and emergency; and (4) Pursuing mental and psychological well-being. Although fear, anxiety, and loneliness were continuing stressors, many of them learnt to adapt and emerge resilient with the evolving situation. Various elements at the individual, family, community, and organizational levels were conducive to better coping. The companionship and complementary support of spouse, self-health literacy, and digital efficacy, virtual connectedness with family and friends, availability of community pharmacy and diagnostic services in the vicinity, support of neighbors, reengaging with creative leisure time activity, and assurance of a responsive administration at the time of emergency helped them to cruise through the pandemic. Furthermore, watching the re-telecast of prime time serials made these elderly fondly remember their own youth time memories. Self-health monitoring, indoor physical exercise, spiritual practices, continuation of previous prescription, telephonic advice of physicians were add-on strategies that facilitated their physical and psychological well-being during the pandemic.
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Affiliation(s)
- Pranab Mahapatra
- Department of Psychiatry, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Krushna Chandra Sahoo
- Regional Medical Research Centre, Indian Council of Medical Research, Bhubaneswar, Odisha, India
| | - Shyama Desaraju
- Regional Medical Research Centre, Indian Council of Medical Research, Bhubaneswar, Odisha, India
| | - Sanghamitra Pati
- Regional Medical Research Centre, Indian Council of Medical Research, Bhubaneswar, Odisha, India
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24
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Importancia del método Pilates como alternativa de ejercicio físico para ancianos en aislamiento social debido a COVID-19. FISIOTERAPIA 2021. [PMCID: PMC8064837 DOI: 10.1016/j.ft.2021.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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25
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Brooks H, Oughli HA, Kamel L, Subramanian S, Morgan G, Blumberger DM, Kloeckner J, Kumar S, Mulsant BH, Lenze EJ, Rajji TK. Enhancing Cognition in Older Persons with Depression or Anxiety with a Combination of Mindfulness-Based Stress Reduction (MBSR) and Transcranial Direct Current Stimulation (tDCS): Results of a Pilot Randomized Clinical Trial. Mindfulness (N Y) 2021; 12:3047-3059. [PMID: 34630733 PMCID: PMC8491443 DOI: 10.1007/s12671-021-01764-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/18/2021] [Indexed: 11/30/2022]
Abstract
Objectives Individuals with subjective memory complaints and symptoms of depression and/or anxiety are at high risk for further cognitive decline, and possible progression to dementia. Low-burden interventions to help slow or prevent cognitive decline in this high-risk group are needed. The objective of this study is to assess the feasibility of combining Mindfulness-Based Stress Reduction (MBSR) with transcranial direct current stimulation (tDCS) to increase putative benefits of MBSR for cognitive function and everyday mindfulness in depressed or anxious older adults with subjective cognitive decline. Methods We conducted a two-site pilot double-blind randomized sham-controlled trial, combining active MBSR with either active or sham tDCS. The intervention included weekly in-class group sessions at the local university hospital and daily at-home practice. Anodal tDCS was applied for 30 min during MBSR meditative practice, both in-class and at-home. Results Twenty-six individuals with subjective cognitive complaints and symptoms of depression and/or anxiety were randomized to active (n = 12) or sham tDCS (n = 14). The combination of MBSR and tDCS was safe and well tolerated, though at-home adherence and in-class attendance were variable. While they were not statistically significant, the largest effect sizes for active vs. sham tDCS were for everyday mindfulness (d = 0.6) and social functioning (d = 0.9) (F(1,21) = 3.68, p = 0.07 and F(1,21) = 3.9, p = 0.06, respectively). Conclusions Our findings suggest that it is feasible and safe to combine tDCS with MBSR in older depressed and anxious adults, including during remote, at-home use. Furthermore, tDCS may enhance MBSR via transferring its meditative learning and practice into increases in everyday mindfulness. Future studies need to improve adherence to MBSR with tDCS. Trial Registration ClinicalTrials.gov (NCT03653351 and NCT03680664). Supplementary Information The online version contains supplementary material available at 10.1007/s12671-021-01764-9.
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Affiliation(s)
- Heather Brooks
- Centre for Addiction and Mental Health and Department of Psychiatry, University of Toronto, Toronto, ON Canada
| | | | - Lojine Kamel
- Washington University School of Medicine, St. Louis, MO USA
| | | | - Gwen Morgan
- Centre for Mindfulness Studies, Toronto, Canada
| | - Daniel M Blumberger
- Centre for Addiction and Mental Health and Department of Psychiatry, University of Toronto, Toronto, ON Canada
| | | | - Sanjeev Kumar
- Centre for Addiction and Mental Health and Department of Psychiatry, University of Toronto, Toronto, ON Canada
| | - Benoit H Mulsant
- Centre for Addiction and Mental Health and Department of Psychiatry, University of Toronto, Toronto, ON Canada
| | - Eric J Lenze
- Washington University School of Medicine, St. Louis, MO USA
| | - Tarek K Rajji
- Centre for Addiction and Mental Health and Department of Psychiatry, University of Toronto, Toronto, ON Canada.,Toronto Dementia Research Alliance, University of Toronto, Toronto, Canada
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Kalaivanan RC, Rahul P, Manjunatha N, Kumar CN, Sivakumar PT, Math SB. Telemedicine in Geriatric Psychiatry: Relevance in India. Indian J Psychol Med 2021; 43:S121-S127. [PMID: 34732964 PMCID: PMC8543607 DOI: 10.1177/02537176211033007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Telemedicine has evolved as a novel tool in delivering health care in the modern world. With the advancement in video conferencing technology at an affordable price and innovative digital medical instruments, it has grown from guiding paramedics in managing patients to aiding physicians in providing direct consultation. Delivering care for older adults has always been challenging due to comorbidities that may warrant a multidisciplinary approach leading to frequent visits across specialties. As per the preliminary reports of the Longitudinal Aging Study in India, 55% of this population suffers from any chronic illness, of which 40% have some form of disability and 20% deal with mental health issues. Over the years, telepsychiatry care for older adults has received increasing acceptability. Videoconferencing with improved connectivity and transmission rates has aided in evaluating, assessing, and providing mental health interventions at ease. The recent regulation of telemedicine practice in the country by rolling out the Telemedicine Practice Guidelines 2020 and Telepsychiatry Operational Guidelines 2020 has fast-tracked its utility during the COVID-19 pandemic. Concerns of physical examination, psychological satisfaction of consulting physician in person, confidentiality, and security of information shared are points that need better addressing in the future. However, Telemedicine is recommended to be used judiciously, taking the risk and benefit of older adults on a case basis as it can significantly bring down the financial and emotional burden.
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Affiliation(s)
- Rakesh Chander Kalaivanan
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Patley Rahul
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Narayana Manjunatha
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | | | | | - Suresh Bada Math
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
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27
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Bavare AC, Goldman JR, Musick MA, Sembera KA, Sardual AA, Lam AK, Tume SC, Thammasitboon SX, Williams EA. Virtual Communication Embedded Bedside ICU Rounds: A Hybrid Rounds Practice Adapted to the Coronavirus Pandemic. Pediatr Crit Care Med 2021; 22:e427-e436. [PMID: 33653995 DOI: 10.1097/pcc.0000000000002704] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Coronavirus disease 2019 containment strategies created challenges with patient-centered ICU rounds. We examined how hybrid rounds with virtual communication added to in-person rounds could facilitate social distancing while maintaining patient-centered care. DESIGN Continuous quality improvement. SETTING Quaternary care referral pediatric hospital. PATIENTS Daytime rounds conducted on PICU patients. INTERVENTIONS Following a needs assessment survey and pilot trials, multiple technological solutions were implemented in a series of plan-do-study-act cycles. Hybrid rounds model was deployed where a videoconference platform was used to establish communication between the bedside personnel (nurse, patient/family, and partial ICU team) with remotely located remaining ICU team, ancillary, and consultant providers. Floor labels marking 6-feet distance were placed for rounders. MEASUREMENTS AND MAIN RESULTS Outcome metrics included compliance with social distancing, mixed methods analysis of surveys, direct interviews of providers and families, and reports of safety concerns. The clinicians adopted hybrid rounds readily. Compliance with social distancing and use of floor labels needed reminders. One-hundred fourteen providers completed the feedback survey. Twenty-five providers and 11 families were interviewed. Feedback about hybrid rounds included inability to teach effectively, suboptimal audio-video quality, loss of situational awareness of patient/unit acuity, alarm interference, and inability to socially distance during other ICU interactions. Benefits noted were improved ancillary input, fewer interruptions, improved efficiency, opportunity to integrate with data platforms, and engage remote consultants and families. Nurses and families appreciated the efforts to ensure safety but wanted the ICU attending/fellow supervising the team to participate at bedside, during rounds. Clinicians appreciated the multidisciplinary input but felt that teaching was difficult. CONCLUSIONS Hybrid rounds employed during pandemic facilitated social distancing while retaining patient-centered multidisciplinary ICU rounds but compromised teaching during rounds. A change to ingrained rounding habits needs team commitment and ongoing optimization. The hybrid rounds model has potential for generalizability to other settings.
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Affiliation(s)
- Aarti C Bavare
- Section of Critical Care, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Jordana R Goldman
- Section of Critical Care, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Matthew A Musick
- Section of Critical Care, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Kerry A Sembera
- Pediatric Critical Care Unit, Texas Children's Hospital, Houston, TX
| | - Alex A Sardual
- Pediatric Critical Care Unit, Texas Children's Hospital, Houston, TX
| | - Anne K Lam
- Pediatric Critical Care Unit, Texas Children's Hospital, Houston, TX
| | - Sebastian C Tume
- Section of Critical Care, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Satid X Thammasitboon
- Section of Critical Care, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Eric A Williams
- Section of Critical Care, Department of Pediatrics, Baylor College of Medicine, Houston, TX
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Macaulay TR, Pa J, Kutch JJ, Lane CJ, Duncan D, Yan L, Schroeder ET. 12 weeks of strength training improves fluid cognition in older adults: A nonrandomized pilot trial. PLoS One 2021; 16:e0255018. [PMID: 34293060 PMCID: PMC8297768 DOI: 10.1371/journal.pone.0255018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 07/05/2021] [Indexed: 11/18/2022] Open
Abstract
Objectives Resistance training (RT) is a promising strategy to slow or prevent fluid cognitive decline during aging. However, the effects of strength-specific RT programs have received little attention. The purpose of this single-group proof of concept clinical trial was to determine whether a 12-week strength training (ST) program could improve fluid cognition in healthy older adults 60 to 80 years of age, and to explore concomitant physiological and psychological changes. Methods Twenty participants (69.1 ± 5.8 years, 14 women) completed this study with no drop-outs or severe adverse events. Baseline assessments were completed before an initial 12-week control period, then participants were re-tested at pre-intervention and after the 12-week ST intervention. The NIH Toolbox Cognition Battery and standard physical and psychological measures were administered at all three time points. During the 36 sessions of periodized ST (3 sessions per week), participants were supervised by an exercise specialist and challenged via autoregulatory load progression. Results Test-retest reliability over the control period was good for fluid cognition and excellent for crystallized cognition. Fluid composite scores significantly increased from pre- to post-intervention (8.2 ± 6.1%, p < 0.01, d = 1.27), while crystallized composite scores did not (-0.5 ± 2.8%, p = 0.46, d = -0.34). Performance on individual fluid instruments, including executive function, attention, working memory, and processing speed, also significantly improved. Surprisingly, changes in fluid composite scores had small negative correlations with changes in muscular strength and sleep quality, but a small positive correlation with changes in muscular power. Conclusions Thus, improvements in fluid cognition can be safely achieved in older adults using a 12-week high-intensity ST program, but further controlled studies are needed to confirm these findings. Furthermore, the relationship with other widespread physiological and psychological benefits remains unclear.
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Affiliation(s)
- Timothy R Macaulay
- Division of Biokinesiology and Physical Therapy, Ostrow School of Dentistry, University of Southern California, Los Angeles, California, United States of America
| | - Judy Pa
- Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Jason J Kutch
- Division of Biokinesiology and Physical Therapy, Ostrow School of Dentistry, University of Southern California, Los Angeles, California, United States of America
| | - Christianne J Lane
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Dominique Duncan
- Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Lirong Yan
- Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - E Todd Schroeder
- Division of Biokinesiology and Physical Therapy, Ostrow School of Dentistry, University of Southern California, Los Angeles, California, United States of America
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Abstract
PURPOSE OF REVIEW We review recent evidence on suicide among older adults, examine risk factors contributing to vulnerability to late-life suicide, and summarize possible interventions. RECENT FINDINGS We found a steadily increasing rate of late-life suicide in the USA in the past decade. Evidence supporting the integration of depression care managers into primary care for risk reduction is among the strongest to date. Pharmacologic and neuromodulation studies should be considered in geriatric depression complicated by suicidality. Broad societal campaigns about suicide education, as well as active outreach to psychiatric patients after discharge or a suicidal crisis, prevent suicidal behavior. Growing research supports an integrative multidisciplinary approach. Suicide is a complex and multifaceted behavior with numerous casual points for intervention. Access to deadly means, presence of depression, disease, disability, and social disconnection are factors that increase vulnerability. Quality geriatric care, regular screening in primary and emergency care settings, and a multidisciplinary approach are necessary to mitigate risk factors. The COVID-19 pandemic amplifies need for a more aggressive approach.
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Affiliation(s)
- Olivia J Ding
- Department of Psychiatry and Behavioral Science, Bronx, NY, USA
| | - Gary J Kennedy
- Department of Psychiatry and Behavioral Science, Bronx, NY, USA.
- Division of Geriatric Psychiatry, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
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30
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Hayajneh AA, Rababa M, Al-Nusour EA, Alsatari ES. Predictors of depression amongst older adults with acute coronary syndrome seeking emergency care. Int J Clin Pract 2021; 75:e14203. [PMID: 33811440 DOI: 10.1111/ijcp.14203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 03/22/2021] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES Psychological and traumatic events may cause disruption to daily life for patients, in particular, older adult patients with acute coronary syndrome (ACS). The present study aimed to identify the prevalence of depression and explore its predictors amongst older adults with ACS seeking emergency care. METHODS Secondary data analysis of cross-sectional data, using a convenience sample of 300 older adult patients with ACS seeking emergency care, was used in this study. Bivariate and multivariate analyses, including linear regression models, were conducted. RESULTS The prevalence of depression amongst older adult patients with ACS seeking emergency care was 65.7%. The predictors of depression amongst this cohort of patients were age (t = 3.06, P = .003), frailty (t = 5.77, P < .001), troponin (t = 2.98, P = .003), and hemoglobin alpha 1C (HBA1C) (t = 3.18, P = .002). The model of these predictors explained 56.6% of the variation in the outcome (depression) (Adjusted R2 = 0.566, P = .017). Depression had a significant positive correlation with each intensive care unit (ICU) length of stay (LOS) (rho = 0.31, P < .001), hospital LOS (rho = 0.36, P < .001), and frailty (rho = 0.69). CONCLUSION Depression rate is high amongst those patients, so healthcare providers (HCPs) should assess those patients for depression and be prepared to intervene accordingly. Depression amongst older adult patients with ACS seeking emergency care necessitates emergency management protocol by HCPs to manage depression amongst this cohort of at-risk patients.
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Affiliation(s)
- Audai A Hayajneh
- Adult Health-Nursing Department, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohammad Rababa
- Adult Health-Nursing Department, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Esraa A Al-Nusour
- Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Eman S Alsatari
- Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
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Machado MMT, Rocha HAL, Castro MC, Sampaio EGM, Oliveira FA, Silva JPFD, Aquino CMD, Sousa LDARD, Carvalho FHC, Altafim ERP, Correia LL. COVID-19 and mental health of pregnant women in Ceará, Brazil. Rev Saude Publica 2021; 55:37. [PMID: 34105605 PMCID: PMC8139842 DOI: 10.11606/s1518-8787.2021055003225] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 02/02/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To assess the perceptions of pregnant women about COVID-19 and the prevalence of common mental disorders during the implemented social distancing period. METHODS This was an observational, cross-sectional study using digital media, of pregnant women exposed to social distancing due to the COVID-19 pandemic, in Fortaleza, Ceará, Northeastern Brazil. Common mental disorders were estimated using the modified Self-Report Questionnaire-20 (SRQ-20) scale, and the feelings towards COVID-19 were assessed using the Fear of COVID-19 scale through telephone calls made in May 2020. COX multivariate regression models were used to verify the associations. RESULTS Of the 1,041 pregnant women, 45.7% (95%CI: 42.7–48.8) had common mental disorders (CMD). All items of the Fear of COVID-19 Scale showed a significant association with the prevalence of CMD (p < 0.001). A CMD risk gradient was observed, going from a prevalence ratio of 1.52 (95%CI: 1.13–2.04) in pregnant women with two positive items to 2.70 (95%CI: 2.08–3.51) for those with four positive items. Early gestational age and the lack of prenatal care were also associated with CMD. CONCLUSIONS The prevalence of common mental disorders in pregnant women was high during the period of social distancing and was aggravated by negative feelings towards COVID-19.
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Affiliation(s)
| | - Hermano Alexandre Lima Rocha
- Universidade Federal do Ceará. Faculdade de Medicina. Departamento de Saúde Coletiva. Fortaleza, CE, Brasil.,Harvard TH Chan School of Public Health. Department of Global Health and Population. Boston, MA, USA
| | - Marcia C Castro
- Harvard TH Chan School of Public Health. Department of Global Health and Population. Boston, MA, USA
| | | | | | | | - Camila Machado de Aquino
- Universidade Federal do Ceará. Faculdade de Medicina. Departamento de Saúde Materno-Infantil. Fortaleza, CE, Brasil
| | | | | | | | - Luciano Lima Correia
- Universidade Federal do Ceará. Faculdade de Medicina. Departamento de Saúde Coletiva. Fortaleza, CE, Brasil
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Gedde MH, Husebo BS, Erdal A, Puaschitz NG, Vislapuu M, Angeles RC, Berge LI. Access to and interest in assistive technology for home-dwelling people with dementia during the COVID-19 pandemic (PAN.DEM). Int Rev Psychiatry 2021; 33:404-411. [PMID: 33416012 DOI: 10.1080/09540261.2020.1845620] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The COVID-19 restrictions affect daily living in Norway, including home-dwelling people with dementia, and researchers conducting clinical trials in dementia care. In this paper, we 1) describe the development of a pandemic cohort (PAN.DEM) incorporated in the LIVE@Home.Path, an ongoing clinical intervention trial on resource utilisation including home-dwelling people with dementia and their caregivers (N = 438 dyads), 2) describe pre-pandemic use of assistive technology and 3) explore the extent to which COVID-19 restrictions increase caregivers interest in innovation in the PAN.DEM cohort (N = 126). Our main finding is that assistive technology is available to 71% pre-pandemic; the vast majority utilise traditional stove guards and safety alarms, only a few operate sensor technology, including GPS, fall detectors or communication aids. In response to COVID-19, 17% show increased interest in technology; being less familiar with operating a telephone and having higher cognitive functioning are both associated with increased interest. We conclude that wearable and sensor technology has not yet been fully implemented among people with dementia in Norway, and few caregivers show increased interest under the restrictions. Clinicaltrials.gov (NCT0404336).
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Affiliation(s)
- Marie H Gedde
- Centre for Elderly and Nursing Home Medicine, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Haraldsplass Deaconess Hospital, Bergen, Norway
| | - Bettina S Husebo
- Centre for Elderly and Nursing Home Medicine, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Municipality of Bergen, Bergen, Norway
| | - Ane Erdal
- Centre for Elderly and Nursing Home Medicine, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Nathalie G Puaschitz
- Centre for Care Research, Western Norway University of Applied Sciences, Bergen, Norway
| | - Maarja Vislapuu
- Centre for Elderly and Nursing Home Medicine, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | | | - Line I Berge
- Centre for Elderly and Nursing Home Medicine, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,NKS Olaviken Gerontopsychiatric Hospital, Askoy, Norway
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Utley LM, Manchala GS, Phillips MJ, Doshi CP, Szatalowicz VL, Boozer JR. Bridging the Telemedicine Gap Among Seniors During the COVID-19 Pandemic. J Patient Exp 2021; 8:23743735211014036. [PMID: 34179442 PMCID: PMC8205366 DOI: 10.1177/23743735211014036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
At the onset of the COVID-19 pandemic, many senior patients in the USC-Keck Family Medicine clinics were limited or lacking in telemedicine participation. Three factors contributed: lack of video-enabled devices, technological literacy, and/or absence of Wi-Fi connectivity. We addressed the first 2 of these factors. Via phone contact, 9 patients agreed to receive donated Android or Apple devices and to trial instruction manuals for use. Donated equipment and instructions were prepared and delivered in accordance with pandemic guidelines. Follow-up calls indicated that 4 participants were able to set up their devices and 3 of whom had connected with their providers. The remaining 5 participants had not set up their devices by the end of the follow-up period, had difficulty with device setup, accessing applications necessary for telemedicine, or had limited access to Wi-Fi. This project highlights some telemedicine barriers that senior patients may overcome with the additional support of care providers.
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Affiliation(s)
- Lynn M Utley
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Grace S Manchala
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Mark J Phillips
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Chirag P Doshi
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Jennifer R Boozer
- Department of Family Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Regmi K, Lwin CM. Factors Associated with the Implementation of Non-Pharmaceutical Interventions for Reducing Coronavirus Disease 2019 (COVID-19): A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4274. [PMID: 33920613 PMCID: PMC8072790 DOI: 10.3390/ijerph18084274] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/10/2021] [Accepted: 04/15/2021] [Indexed: 01/01/2023]
Abstract
There has been much discussion recently about the importance of implementing non-pharmaceutical interventions (NPIs) to protect the public from coronavirus disease 2019 (COVID-19) infection. Different governments across the world have adopted NPIs (e.g., social distancing, quarantine, isolation, lockdowns, curfews, travel restrictions, closures of schools and colleges). Two fundamental strategies, namely a strict containment strategy-also called suppression strategy-and a mitigation strategy have been adopted in different countries, mainly to reduce the reproduction number (R0) to below one and hence to reduce case numbers to low levels or eliminate human-to-human transmission, as well as to use NPIs to interrupt transmission completely and to reduce the health impact of epidemics, respectively. However, the adoption of these NPI strategies is varied and the factors impacting NPI are inconsistent and unclear. This study, therefore, aimed to review the factors associated with the implementation of NPIs (social distancing, social isolation and quarantine) for reducing COVID-19. Following PRISMA guidelines, we searched for published and unpublished studies, undertaking a systematic search of: MEDLINE, EMBASE, Allied and Complementary Medicine, COVID-19 Research, WHO database on COVID-19, and Google Scholar. Thirty-three studies were included in the study. Seven descriptive themes emerged on enablers and barriers to NPIs: the positive impact of NPIs, effective public health interventions, positive change in people's behaviour and concerns about COVID-19, the role of mass media, physical and psychological impacts, and ethnicity/age associated with COVID-19. This study has highlighted that the effectiveness of NPIs in isolation is likely to be limited, therefore, a combination of multiple measures e.g., SD, isolation and quarantine, and workplace distancing appeared more effective in reducing COVID-19. Studies suggest that targeted approaches alongside social distancing might be the way forward, and more acceptable. Further research to promote country- and context-specific adoption of NPIs to deliver public health measures is needed. Studies comparing the effectiveness of interventions and strategies will help provide more evidence for future pandemics.
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Affiliation(s)
- Krishna Regmi
- Institute for Health Research, University of Bedfordshire, Luton LU1 3JU, UK
- Centre for Medical Education, School of Medicine, University of Dundee, Dundee DD2 4BF, UK
| | - Cho Mar Lwin
- Department of Rheumatology, University of Medicine Mandalay, Mandalay 05024, Myanmar;
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Simkovich SM, Thompson LM, Clark ML, Balakrishnan K, Bussalleu A, Checkley W, Clasen T, Davila-Roman VG, Diaz-Artiga A, Dusabimana E, Fuentes LDL, Harvey S, Kirby MA, Lovvorn A, McCollum ED, Mollinedo EE, Peel JL, Quinn A, Rosa G, Underhill LJ, Williams KN, Young BN, Rosenthal J. A risk assessment tool for resumption of research activities during the COVID-19 pandemic for field trials in low resource settings. BMC Med Res Methodol 2021; 21:68. [PMID: 33845785 PMCID: PMC8040756 DOI: 10.1186/s12874-021-01232-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 02/17/2021] [Indexed: 12/14/2022] Open
Abstract
RATIONALE The spread of severe acute respiratory syndrome coronavirus-2 has suspended many non-COVID-19 related research activities. Where restarting research activities is permitted, investigators need to evaluate the risks and benefits of resuming data collection and adapt procedures to minimize risk. OBJECTIVES In the context of the multicountry Household Air Pollution Intervention (HAPIN) trial conducted in rural, low-resource settings, we developed a framework to assess the risk of each trial activity and to guide protective measures. Our goal is to maximize the integrity of reseach aims while minimizing infection risk based on the latest scientific understanding of the virus. METHODS We drew on a combination of expert consultations, risk assessment frameworks, institutional guidance and literature to develop our framework. We then systematically graded clinical, behavioral, laboratory and field environmental health research activities in four countries for both adult and child subjects using this framework. National and local government recommendations provided the minimum safety guidelines for our work. RESULTS Our framework assesses risk based on staff proximity to the participant, exposure time between staff and participants, and potential viral aerosolization while performing the activity. For each activity, one of four risk levels, from minimal to unacceptable, is assigned and guidance on protective measures is provided. Those activities that can potentially aerosolize the virus are deemed the highest risk. CONCLUSIONS By applying a systematic, procedure-specific approach to risk assessment for each trial activity, we were able to protect our participants and research team and to uphold our ability to deliver on the research commitments we have made to our staff, participants, local communities, and funders. This framework can be tailored to other research studies conducted in similar settings during the current pandemic, as well as potential future outbreaks with similar transmission dynamics. The trial is registered with clinicaltrials.gov NCT02944682 on October 26. 2016 .
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Affiliation(s)
- Suzanne M Simkovich
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, USA.
- Center for Global Non-Communicable Disease Research and Training, School of Medicine, Johns Hopkins University, Baltimore, USA.
- MedStar Health Research Institute, Hyattsville, USA.
| | - Lisa M Thompson
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, USA
| | - Maggie L Clark
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, USA
| | - Kalpana Balakrishnan
- Department of Environmental Health Engineering, ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra Institute for Higher Education and Research (Deemed University), Chennai, India
| | - Alejandra Bussalleu
- A.B. PRISMA, San Miguel, Peru
- CLIMA - Latin American Center of Excellence in Climate Change and Health; and Intercultural Citizenship and Indigenous Health Unit, Faculty of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - William Checkley
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, USA
- Center for Global Non-Communicable Disease Research and Training, School of Medicine, Johns Hopkins University, Baltimore, USA
| | - Thomas Clasen
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, USA
| | - Victor G Davila-Roman
- Cardiovascular Division, Department of Medicine, Washington University School of Medicine, St. Louis, USA
| | - Anaite Diaz-Artiga
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | | | - Lisa de Las Fuentes
- Cardiovascular Division, Department of Medicine, Washington University School of Medicine, St. Louis, USA
| | - Steven Harvey
- Center for Global Non-Communicable Disease Research and Training, School of Medicine, Johns Hopkins University, Baltimore, USA
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
| | - Miles A Kirby
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Amy Lovvorn
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, USA
| | - Eric D McCollum
- Global Program for Respiratory Sciences, Eudowood Division of Pediatric Respiratory Sciences, Department of Pediatrics, School of Medicine, Johns Hopkins University, Baltimore, USA
| | - Erick E Mollinedo
- Department of Environmental Health Science, College of Public Health, University of Georgia, Athens, USA
| | - Jennifer L Peel
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, USA
| | - Ashlinn Quinn
- Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, USA
| | - Ghislaine Rosa
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Lindsay J Underhill
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, USA
- Center for Global Non-Communicable Disease Research and Training, School of Medicine, Johns Hopkins University, Baltimore, USA
| | - Kendra N Williams
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, USA
- Center for Global Non-Communicable Disease Research and Training, School of Medicine, Johns Hopkins University, Baltimore, USA
| | - Bonnie N Young
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, USA
| | - Joshua Rosenthal
- Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, USA
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Eslami P, Niakan Kalhori SR, Taheriyan M. eHealth solutions to fight against COVID-19: A scoping review of applications. Med J Islam Repub Iran 2021; 35:43. [PMID: 34268231 PMCID: PMC8271222 DOI: 10.47176/mjiri.35.43] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Indexed: 12/23/2022] Open
Abstract
Background: eHealth has a notable potential to help in prevention, diagnosis, treatment, screening, management, and control of the COVID-19 pandemic. Since ehealth is considered here broadly, as an umbrella term, it also covers subsets like telehealth and mhealth. This study aimed to review the literature to identify and classify subdomains of eHealth solutions that have been utilized, developed, or suggested for the COVID-19 pandemic.
Methods: A comprehensive literature search was performed using the PubMed, Scopus, Embase, and Cochrane library databases in April 2020, with no time limitation. The search strategy was built based on 2 concept domains of eHealth solutions and covid-19. For each concept domain, the search query comprised a combination of free text keywords identified from reference papers and controlled vocabulary terms. Obtained results were classified, graphically presented, and discussed.
Results: Of the 423 studies identified initially, 35 were included in this study. From related papers, general characteristics, study objective, eHealth-related outcomes, target populations, eHealth interventions, health service category, eHealth solution, and eHealth domain were extracted, classified, and tabulated. Most publication types were ideas, editorials, or opinions (46%). The most targeted populations were people of the community and medical staff (80%). The most implemented or suggested eHealth solution was telehealth (63%), followed by mhealth, health information technology, and health data analytics. Most of the COVID-19 ehealth interventions designed or suggested for improving prevention (48%) and diagnosis (48%). Most of the studies applied or proposed eHealth solutions for general practice or epidemiological purposes (48%).
Conclusion: eHealth solutions have the potential to provide useful services to help in COVID-19 pandemics in terms of prevention, diagnosis, treatment, screening, surveillance, resource allocation, education, management, and control. The obtained results from this review might be used for a better understanding of current ehealth solutions provided or recommended in response to the COVID-19 pandemic.
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Affiliation(s)
- Parisa Eslami
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Sharareh R Niakan Kalhori
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Moloud Taheriyan
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
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Loizos M, Neugroschl J, Zhu CW, Li C, Sewell M, Kinsella MT, Aloysi A, Grossman H, Schimming C, Martin J, Sano M. Adapting Alzheimer Disease and Related Dementias Clinical Research Evaluations in the Age of COVID-19. Alzheimer Dis Assoc Disord 2021; 35:172-177. [PMID: 33901048 PMCID: PMC8137642 DOI: 10.1097/wad.0000000000000455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 03/29/2021] [Indexed: 11/25/2022]
Abstract
In March 2020, the novel coronavirus (COVID-19) became a global pandemic that would cause most in-person visits for clinical studies to be put on pause. Coupled with protective stay at home guidelines, clinical research at the Icahn School of Medicine at Mount Sinai Alzheimer's Disease Research Center (ISMMS ADRC) needed to quickly adapt to remain operational and maintain our cohort of research participants. Data collected by the ISMMS ADRC as well as from other National Institute on Aging (NIA) Alzheimer Disease centers, follows the guidance of the National Alzheimer Coordinating Center (NACC). However, at the start of this pandemic, NACC had no alternative data collection mechanisms that could accommodate these safety guidelines. To stay in touch with our cohort and to ensure continued data collection under different stages of quarantine, the ISMMS ADRC redeployed their work force to continue their observational study via telehealth assessment. On the basis of this experience and that of other centers, NACC was able to create a data collection process to accommodate remote assessment in mid-August. Here we review our experience in filling the gap during this period of isolation and describe the adaptations for clinical research, which informed the national dialog for conducting dementia research in the age of COVID-19 and beyond.
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Affiliation(s)
- Maria Loizos
- Icahn School of Medicine at Mount Sinai, New York, NY USA
| | | | - Carolyn W. Zhu
- Icahn School of Medicine at Mount Sinai, New York, NY USA
- James J. Peters VA Medical Center, Bronx, NY, USA
| | - Clara Li
- Icahn School of Medicine at Mount Sinai, New York, NY USA
| | | | | | - Amy Aloysi
- Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Hillel Grossman
- Icahn School of Medicine at Mount Sinai, New York, NY USA
- James J. Peters VA Medical Center, Bronx, NY, USA
| | | | - Jane Martin
- Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Mary Sano
- Icahn School of Medicine at Mount Sinai, New York, NY USA
- James J. Peters VA Medical Center, Bronx, NY, USA
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Gaertner B, Fuchs J, Möhler R, Meyer G, Scheidt-Nave C. Older people at the beginning of the COVID-19 pandemic: A scoping review. JOURNAL OF HEALTH MONITORING 2021; 6:2-37. [PMID: 35586562 PMCID: PMC8832372 DOI: 10.25646/7857] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 02/12/2021] [Indexed: 12/23/2022]
Abstract
This scoping review focuses on evidence gaps regarding the effects on health, social participation and life contexts of older people at the beginning of the COVID-19 pandemic. It is based on a systematic search strategy of the international literature covering a period between December 2019 and June 2020. The review is supplemented by a search of the websites of selected organisations in Germany (cut-off date: 29 June 2020). Search hits were differentiated by types of publication (empirical study, review, discussion paper). The contents were summarised in tabular form according to topic. The publications mainly discussed the high risks of suffering severe courses of COVID-19 faced by older people, specifically those belonging to certain subgroups. In addition, further main topics were the pandemic’s indirect impacts on physical and mental health, physical and cognitive functions and participation in society. Social isolation, loneliness, reduced levels of physical activity and difficulties in maintaining care were discussed as major health risks. Ageism was an issue that was addressed across all of the identified topics. The publications highlighted the need, but also the opportunity, for raising public awareness of the needs of older people in various life contexts. Publications pointed to the urgent need for research into the biological and social causes of older peoples’ high infection risk and how measures could be adapted in a differentiated manner (infection prevention and control measures, social support, medical and nursing care).
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Affiliation(s)
- Beate Gaertner
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Judith Fuchs
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Ralph Möhler
- Heinrich Heine University Düsseldorf, Institute for Health Services Research and Health Economics.,Bielefeld University, School of Public Health, Department of Health Services Research and Nursing Science
| | - Gabriele Meyer
- Martin Luther University Halle-Wittenberg, Institute for Health and Nursing Science
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Xiang XM, Bernard J. Telehealth in Multiple Sclerosis Clinical Care and Research. Curr Neurol Neurosci Rep 2021; 21:14. [PMID: 33646409 PMCID: PMC7917521 DOI: 10.1007/s11910-021-01103-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2021] [Indexed: 12/21/2022]
Abstract
Purpose of Review The COVID-19 pandemic has provided us with a unique opportunity to experiment with telehealth and evaluate its benefits and limitations. This review discusses the impact of telehealth on multiple sclerosis (MS) care and research in adults and children. Recent Findings Telehealth visits for MS patients have been shown to reduce missed workdays and costs for patients. Brief telephone-based counseling may be associated with better adherence to disease-modifying therapy, although results of multiple home-based tele-rehabilitation for people with MS have been equivocal. Overall, patients and providers have reported high levels of satisfactions with telehealth. Several remote disability measures and numerous other technological tools have emerged for use in remote MS research and care. Major challenges of telehealth include limitations to performing a complete neurologic exam and disparities in access to telehealth amongst vulnerable populations with limited access to virtual platforms. Summary Following the rapid expansion of telehealth during the pandemic, it is highly likely that we will continue to embrace the benefits of this valuable tool. Future directions for improving telehealth should include more evidence-based research on the diagnostic accuracy in neuroimmunology and reducing disparities in the access to telehealth.
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Affiliation(s)
- Xinran Maria Xiang
- Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, L226, Portland, OR, 97239, USA.
| | - Jacqueline Bernard
- Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, L226, Portland, OR, 97239, USA
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40
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Volkers N, Wiebe S, Asadi-Pooya AA, Balagura G, Gómez-Iglesias P, Guekht A, Hall J, Ikeda A, Jetté N, Kishk NA, Murphy P, Perucca E, Pérez-Poveda JC, Sanya EO, Trinka E, Zhou D, Cross JH. The initial impact of the SARS-CoV-2 pandemic on epilepsy research. Epilepsia Open 2021; 6:255-265. [PMID: 34033250 PMCID: PMC8013398 DOI: 10.1002/epi4.12471] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 01/08/2021] [Accepted: 01/26/2021] [Indexed: 02/05/2023] Open
Abstract
The COVID-19 pandemic has changed the face of many practices throughout the world. Through necessity to minimize spread and provide clinical care to those with severe disease, focus has been on limiting face-to-face contact. Research in many areas has been put on hold. We sought to determine the impact of the COVID-19 pandemic on epilepsy research from international basic science and clinical researchers. Responses to five questions were solicited through a convenience sample by direct email and through postings on the ILAE social media accounts and an ILAE online platform (utilizing Slack). Information was collected from 15 respondents in 11 countries by email or via Zoom interviews between May 19, 2020, and June 4, 2020. Several themes emerged including a move to virtual working, project delays with laboratory work halted and clinical work reduced, funding concerns, a worry about false data with regard to COVID research and concern about research time lost. However, a number of positive outcomes were highlighted, not least the efficiency of online working and other adaptations that could be sustained in the future.
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Affiliation(s)
- Nancy Volkers
- International League Against Epilepsy, Flower Mound, TX, USA
| | - Samuel Wiebe
- Departments of Clinical Neurosciences and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Ali Akbar Asadi-Pooya
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Neurology, Jefferson Comprehensive Epilepsy Center, Thomas Jefferson University, Philadelphia, PA, USA
| | - Ganna Balagura
- Pediatric Neurology and Muscular Diseases Unit, IRCCS "G. Gaslini" Institute, Genova, Italy.,Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Patricia Gómez-Iglesias
- Epilepsy Unit, Department of Neurology, Hospital Clínico San Carlos, Health Research Institute "San Carlos" (IdISCC), Universidad Complutense de Madrid, Madrid, Spain
| | - Alla Guekht
- Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russia.,Department of Neurology, Neurosurgery and Medical Genetics, Russian National Research Medical University, Moscow, Russia
| | - Julie Hall
- International League Against Epilepsy, Flower Mound, TX, USA
| | - Akio Ikeda
- Department of Epilepsy, Movement Disorders and Physiology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Nathalie Jetté
- Division of Health Outcomes and Knowledge Translation Research, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nirmeen A Kishk
- Neurology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | - Emilio Perucca
- Division of Clinical and Experimental Pharmacology, Department of Internal Medicine and Therapeutics, University of Pavia, Pavia and IRCCS Mondino Foundation, Pavia, Italy.,ERN EpiCARE
| | - Juan Carlos Pérez-Poveda
- Neuroscience Department, Faculty of Medicine, Xavierian University, and Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Emmanuel O Sanya
- Neurology Division, Medicine Department, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Eugen Trinka
- ERN EpiCARE.,Department of Neurology, Centre for Cognitive Neuroscience, Christian-Doppler University Hospital, Paracelsus Medical University, Salzburg, Austria.,Institute of Public Health, Medical Decision-Making and HTA, UMIT, Private University for Health Sciences, Medical Informatics and Technology, Hall in Tyrol, Austria
| | - Dong Zhou
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - J Helen Cross
- ERN EpiCARE.,Programme of Developmental Neurosciences, UCL NIHR BRC Great Ormond Street Institute of Child Health, London, UK.,Young Epilepsy Lingfield, London, UK.,Great Ormond Street Hospital for Children, London, UK
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41
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Bansod S, Ahirwar AK, Sakarde A, Asia P, Gopal N, Alam S, Kaim K, Ahirwar P, Sorte SR. COVID-19 and geriatric population: from pathophysiology to clinical perspectives. Horm Mol Biol Clin Investig 2021; 42:87-98. [PMID: 33544506 DOI: 10.1515/hmbci-2020-0053] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 01/19/2021] [Indexed: 12/27/2022]
Abstract
The COVID-19 pandemic has not only led to a worldwide socio-economic depression, but has also had the highest health impact on the geriatric population. Elderly population, due to various reasons such as low immunity, pre-existing co-morbidities such as hypertension, cardiovascular diseases or diabetes, are obviously predisposed to develop severe infections and exhibit a high mortality rate. This is because of many reasons which include the atypical presentation in the geriatric population which might have led to diagnostic delay. As per the WHO guidelines to perform RT-PCR only on the symptomatic individuals, a very small portion of individuals were tested, leaving a fraction of population undiagnosed. Therefore, there remained a chance that many asymptomatic individuals such caregivers, healthcare professionals, family members were undiagnosed and might have carried this virus to the geriatric patients. Also, many countries were not prepared to handle the burden on their healthcare system which included sudden increased demand of ICU beds, mechanical ventilation etc. As a result, they had to make decision on who to be admitted. Atypical presentation in geriatric population may include afebrile or low-grade fever, absence of cough, malaise, muscle pains, dyspnoea etc. Geriatric population shows a more severe type of pneumonia, significantly higher number of neutrophils and C-reactive protein, less lymphocytes and a higher proportion of multiple lobe involvement. Extreme social suppression during COVID-19 pandemic has increased the risk of mental and physical adverse effects that has made older adults more vulnerable to depression and anxiety.
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Affiliation(s)
- Swanjal Bansod
- All India Institute of Medical Sciences, Nagpur, Maharashtra, India
| | - Ashok Kumar Ahirwar
- Department of Biochemistry, All India Institute of Medical Sciences, Nagpur, Maharashtra, India
| | - Apurva Sakarde
- Department of Biochemistry, All India Institute of Medical Sciences, Nagpur, Maharashtra, India
| | - Priyanka Asia
- Department of Biochemistry, All India Institute of Medical Sciences, Nagpur, Maharashtra, India
| | - Niranjan Gopal
- Department of Biochemistry, All India Institute of Medical Sciences, Nagpur, Maharashtra, India
| | - Sana Alam
- Department of Biochemistry, Hamdard Institute of Medical Sciences and Research, New Delhi, India
| | - Kirti Kaim
- Department of Ophthalmology, Indira Gandhi ESI Hospital, New Delhi, India
| | | | - Smita R Sorte
- Department of Physiology, All India Institute of Medical Sciences, Nagpur, Maharashtra, India
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July J, Pranata R. Prevalence of dementia and its impact on mortality in patients with coronavirus disease 2019: A systematic review and meta-analysis. Geriatr Gerontol Int 2021; 21:172-177. [PMID: 33340212 DOI: 10.1111/ggi.14107] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 10/24/2020] [Accepted: 10/30/2020] [Indexed: 12/23/2022]
Abstract
AIM In this systematic review and meta-analysis, we aimed to evaluate the prevalence of dementia in patients with COVID-19 and its association with mortality. We also aimed to discover whether age, sex and other comorbidities might affect the association between dementia and mortality. METHODS We carried out a systematic literature search using PubMed, SCOPUS, EuropePMC and the Cochrane Central Database. The outcome of interest was mortality, defined as clinically validated mortality/death/non-survivor in the studies. The pooled effect estimates were presented as odds ratio and adjusted odds ratio. RESULTS A total of 56 577 patients from 10 studies were included. The prevalence of dementia in this pooled analysis was 10% (7-13%). Dementia was associated with increased mortality in both pooled unadjusted (odds ratio 2.80, 95% CI 1.85-4.24, P < 0.001; I2 = 93.7%) and adjusted effect estimates (adjusted odds ratio 1.80, 95% CI 1.45-2.24, P < 0.001; I2 = 72.9%). The association between dementia and mortality was influenced by age (coefficient -0.047, P < 0.001) and hypertension (coefficient -0.009, P = 0.020). CONCLUSIONS This study showed that dementia was associated with increased mortality in COVID-19 patients. The association was affected by age and comorbidities. Geriatr Gerontol Int 2021; 21: 172-177.
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Affiliation(s)
- Julius July
- Department of Neurosurgery, Medical Faculty of Pelita Harapan University, Lippo Village Tangerang, Neuroscience Center Siloam Hospital, Tangerang, Indonesia
| | - Raymond Pranata
- Faculty of Medicine, Pelita Harapan University, Tangerang, Indonesia
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Rodie DJ, Fitzgibbon K, Perivolaris A, Crawford A, Geist R, Levinson A, Mitchell B, Oslin D, Sunderji N, Mulsant BH. The primary care assessment and research of a telephone intervention for neuropsychiatric conditions with education and resources study: Design, rationale, and sample of the PARTNERs randomized controlled trial. Contemp Clin Trials 2021; 103:106284. [PMID: 33476774 DOI: 10.1016/j.cct.2021.106284] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 01/06/2021] [Accepted: 01/11/2021] [Indexed: 11/25/2022]
Abstract
While most patients with depression, anxiety, or at-risk drinking receive care exclusively in primary care settings, primary care providers experience challenges in diagnosing and treating these common problems. Over the past two decades, the collaborative care model has addressed these challenges. However, this model has been adopted very slowly due to the high costs of care managers; inability to sustain their role in small practices; and the perceived lack of relevance of interventions focused on a specific psychiatric diagnosis. Thus, we designed an innovative randomized clinical trial (RCT), the Primary Care Assessment and Research of a Telephone Intervention for Neuropsychiatric Conditions with Education and Resources study (PARTNERs). This RCT compared the outcomes of enhanced usual care and a novel model of collaborative care in primary care patients with depressive disorders, generalized anxiety, social phobia, panic disorder, at-risk drinking, or alcohol use disorders. These conditions were selected because they are present in almost a third of patients seen in primary care settings. Innovations included assigning the care manager role to trained lay providers supported by computer-based tools; providing all care management centrally by phone - i.e., the intervention was delivered without any face-to-face contact between the patient and the care team; and basing patient eligibility and treatment selection on a transdiagnostic approach using the same eligibility criteria and the same treatment algorithms regardless of the participants' specific psychiatric diagnosis. This paper describes the design of this RCT and discusses the rationale for its main design features.
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Affiliation(s)
- David J Rodie
- Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | | | | | - Allison Crawford
- Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Rose Geist
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Hospital for Sick Children, Toronto, ON, Canada
| | - Andrea Levinson
- Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | | | - David Oslin
- University of Pennsylvania and the Department of Veteran Affairs, Philadelphia, PA, United States of America
| | - Nadiya Sunderji
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Waypoint Centre for Mental Health Care, Penetanguishene, ON, Canada
| | - Benoit H Mulsant
- Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
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Being a Gambler during the COVID-19 Pandemic: A Study with Italian Patients and the Effects of Reduced Exposition. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020424. [PMID: 33430353 PMCID: PMC7825745 DOI: 10.3390/ijerph18020424] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 01/03/2021] [Accepted: 01/04/2021] [Indexed: 02/06/2023]
Abstract
The COVID-19 pandemic, with the consequent lockdown of about 3 months, can be viewed as an experimental model to observe the impact of the depletion of environmental factors that stimulate gambling, particularly electronic gambling machines (EGMs) that were set to zero. The effects of some structural characteristics of gambling activities that increase gambling behavior were studied among disordered gamblers in treatment in this unique scenario. In fact, studies investigating the effects of the lockdown on problem gamblers (PGs) under treatment are missing. The aims of this study were to analyze patients’ gambling behavior and craving during the lockdown and to conduct a comparison between gambling disorder (GD) symptoms at the beginning of the treatment and during lockdown. The study was conducted in Italy, the European country with the largest gambling market and the first to be affected by the virus. Data were collected through a semi-structured telephone interview conducted by healthcare professionals. Participants were 135 PGs under treatment (109 males, mean age = 50.07). Results showed that most PGs achieved a significant improvement in their quality of life, with less gambling behavior, GD symptoms, and lower craving. No shift toward online gambling and very limited shift towards other potential addictive and excessive behaviors occurred. The longer the treatment, the more monitoring is present and the better the results in terms of symptoms reduction. Individual and environmental characteristics during the lockdown favored the reduction in symptoms. Consideration for prevention and treatment are discussed.
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Ullah SMA, Islam MM, Mahmud S, Nooruddin S, Raju SMTU, Haque MR. Scalable Telehealth Services to Combat Novel Coronavirus (COVID-19) Pandemic. ACTA ACUST UNITED AC 2021; 2:18. [PMID: 33426530 PMCID: PMC7786340 DOI: 10.1007/s42979-020-00401-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 11/18/2020] [Indexed: 01/14/2023]
Abstract
An ongoing pandemic, the novel coronavirus disease 2019 (COVID-19) is threatening the nations of the world regardless of health infrastructure conditions. In the age of digital electronic information and telecommunication technology, scalable telehealth services are gaining immense importance by helping to maintain social distances while providing necessary healthcare services. This paper aims to review the various types of scalable telehealth services used to support patients infected by COVID-19 and other diseases during this pandemic. Recently published research papers collected from various sources such as Google Scholar, ResearchGate, PubMed, Scopus, and IEEE Xplore databases using the terms "Telehealth", "Coronavirus", "Scalable" and "COVID-19" are reviewed. The input data and relevant reports for the analysis and assessment of the various aspects of telehealth technology in the COVID-19 pandemic are taken from official websites. We described the available telehealth systems based on their communication media such as mobile networks, social media, and software based models throughout the review. A comparative analysis among the reviewed systems along with necessary challenges and possible future directions are also drawn for the proper selection of affordable technologies. The usage of scalable telehealth systems improves the quality of the healthcare system and also reduces the infection rate while keeping both patients and doctors safe during the pandemic.
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Affiliation(s)
- Shah Muhammad Azmat Ullah
- Department of Electronics and Communication Engineering, Khulna University of Engineering & Technology, Khulna, 9203 Bangladesh
| | - Md Milon Islam
- Department of Computer Science and Engineering, Khulna University of Engineering & Technology, Khulna, 9203 Bangladesh
| | - Saifuddin Mahmud
- Advanced Telerobotics Research Lab, Department of Computer Science, Kent State University, Kent, Ohio USA
| | - Sheikh Nooruddin
- Department of Computer Science and Engineering, Khulna University of Engineering & Technology, Khulna, 9203 Bangladesh
| | - S M Taslim Uddin Raju
- Department of Computer Science and Engineering, Khulna University of Engineering & Technology, Khulna, 9203 Bangladesh
| | - Md Rezwanul Haque
- Department of Computer Science and Engineering, Khulna University of Engineering & Technology, Khulna, 9203 Bangladesh
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Zubatsky M. Editorial: Virtual Groups to Address the Health of Homebound Adults During COVID-19: A Biopsychosocial Framework. J Nutr Health Aging 2021; 25:281-283. [PMID: 33575716 PMCID: PMC7794637 DOI: 10.1007/s12603-021-1584-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 12/22/2020] [Indexed: 12/18/2022]
Affiliation(s)
- M Zubatsky
- Max Zubatsky, PhD, LMFT, Associate Professor, Program Director, Medical Family Therapy Program, School of Medicine, Saint Louis University, 3700 Lindell Boulevard, St. Louis, MO 63108, USA,
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Thyrian JR, Kracht F, Nikelski A, Boekholt M, Schumacher-Schönert F, Rädke A, Michalowsky B, Vollmar HC, Hoffmann W, Rodriguez FS, Kreisel SH. The situation of elderly with cognitive impairment living at home during lockdown in the Corona-pandemic in Germany. BMC Geriatr 2020; 20:540. [PMID: 33375944 PMCID: PMC7770747 DOI: 10.1186/s12877-020-01957-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 12/10/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The outbreak of the Corona virus is a challenge for health care systems worldwide. The aim of this study is to analyze a) knowledge about, and feelings related to the Corona-pandemic. Describe b) loneliness, depression and anxiety and, c) the perceived, immediate impact of the lockdown on frequency of social contacts and quality of health care provision of people with cognitive impairment during social distancing and lockdown in the primary care system and living at home in Germany. METHODS This analysis is based on data of a telephone-based assessment in a convenience sample of n = 141 people with known cognitive impairment in the primary care setting. Data on e.g. cognitive and psychological status prior to the pandemic was available. Attitudes, knowledge about and perceived personal impact of the pandemic, social support, loneliness, anxiety, depression, change in the frequency of social activities due to the pandemic and perceived impact of the pandemic on health care related services were assessed during the time of lockdown. RESULTS The vast majority of participants are sufficiently informed about Corona (85%) and most think that the measures taken are appropriate (64%). A total of 11% shows one main symptom of a depression according to DSM-5. The frequency of depressive symptoms has not increased between the time before pandemic and lockdown in almost all participants. The sample shows minimal (65.0%) or low symptoms of anxiety (25%). The prevalence of loneliness is 10%. On average seven activities have decreased in frequency due to the pandemic. Social activities related to meeting people, dancing or visiting birthdays have decreased significantly. Talking with friends by phone and activities like gardening have increased. Utilization of health care services like day clinics, relief services and prescribed therapies have been reported to have worsened due to the pandemic. Visits to general practitioners decreased. CONCLUSIONS The study shows a small impact of the pandemic on psychological variables like depression, anxiety and loneliness in the short-term in Germany. There is a decrease in social activities as expected. The impact on health care provision is prominent. There is a need for qualitative, in-depth studies to further interpret the results.
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Affiliation(s)
- Jochen René Thyrian
- German Center for Neurodegenerative Diseases (DZNE), site Rostock/ Greifswald, Ellernholzstr. 1-2, 17489, Greifswald, Germany.
- Institute for Community Medicine, Department of Epidemiology and Community Health, University Medicine Greifswald, Greifswald, Germany.
| | - Friederike Kracht
- German Center for Neurodegenerative Diseases (DZNE), site Rostock/ Greifswald, Ellernholzstr. 1-2, 17489, Greifswald, Germany
| | - Angela Nikelski
- Division of Geriatric Psychiatry, Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, University Hospital OWL - Campus Bielefeld-Bethel, Bielefeld, Germany
| | - Melanie Boekholt
- German Center for Neurodegenerative Diseases (DZNE), site Rostock/ Greifswald, Ellernholzstr. 1-2, 17489, Greifswald, Germany
| | - Fanny Schumacher-Schönert
- German Center for Neurodegenerative Diseases (DZNE), site Rostock/ Greifswald, Ellernholzstr. 1-2, 17489, Greifswald, Germany
| | - Anika Rädke
- German Center for Neurodegenerative Diseases (DZNE), site Rostock/ Greifswald, Ellernholzstr. 1-2, 17489, Greifswald, Germany
| | - Bernhard Michalowsky
- German Center for Neurodegenerative Diseases (DZNE), site Rostock/ Greifswald, Ellernholzstr. 1-2, 17489, Greifswald, Germany
| | - Horst Christian Vollmar
- Institute of General Practice and Family Medicine, Faculty of Medicine, Ruhr-University Bochum (RUB), Bochum, Germany
| | - Wolfgang Hoffmann
- German Center for Neurodegenerative Diseases (DZNE), site Rostock/ Greifswald, Ellernholzstr. 1-2, 17489, Greifswald, Germany
- Institute for Community Medicine, Department of Epidemiology and Community Health, University Medicine Greifswald, Greifswald, Germany
| | - Francisca S Rodriguez
- German Center for Neurodegenerative Diseases (DZNE), site Rostock/ Greifswald, Ellernholzstr. 1-2, 17489, Greifswald, Germany
| | - Stefan H Kreisel
- Division of Geriatric Psychiatry, Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, University Hospital OWL - Campus Bielefeld-Bethel, Bielefeld, Germany
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Prendki V, Tau N, Avni T, Falcone M, Huttner A, Kaiser L, Paul M, Leibovici-Weissmann Y, Yahav D. A systematic review assessing the under-representation of elderly adults in COVID-19 trials. BMC Geriatr 2020; 20:538. [PMID: 33342426 PMCID: PMC7749979 DOI: 10.1186/s12877-020-01954-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 12/09/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Coronavirus disease (COVID-19) has caused a pandemic threatening millions of people worldwide. Yet studies specifically assessing the geriatric population are scarce. We aimed to examine the participation of elderly patients in therapeutic or prophylactic trials on COVID-19. METHODS In this review, randomized controlled trials (RCTs; n = 12) comparing therapeutic or prophylactic interventions registered on preprint repositories and/or published since December 2019 were analyzed. We searched in PubMed, leading journals websites, and preprint repositories for RCTs and large observational studies. We aimed to describe the age of included patients, the presence of an upper age limit and of adjusted analyses on age, any exclusion criteria that could limit participation of elderly adults such as comorbidities, cognitive impairment, limitation of life expectancy; and the assessment of long-term outcomes such as the need of rehabilitation or institutionalization. Mean participant ages were reported and compared with observational studies. RESULTS Twelve RCTs assessing drug therapy for COVID-19 were included. Mean age of patients included in RCTs was 56.3 years. An upper age limit was applied in three published trials (25%) and in 200/650 (31%) trials registered at clinicaltrials.gov . One trial reported a subgroup analysis in patients ≥65. Patients were excluded for liver-function abnormalities in eight trials, renal disease in six, cardiac disease or risk of torsade de pointes in five, and four for cognitive or mental criteria, which are frequent comorbidities in the oldest patients. Only three trials allowed a family member to provide consent. Patients enrolled in RCTs were on average 20 years younger than those included in large (n ≥ 1000) observational studies. Seven studies had as their primary outcome a clinical endpoint, but none reported cognitive, functional or quality of life outcomes or need for rehabilitation or long-term care facility placement. CONCLUSIONS Elderly patients are clearly underrepresented in RCTs, although they comprise the population hardest hit by the COVID-19 pandemic. Long-term outcomes such as the need of rehabilitation or institutionalization were not reported. Future investigations should target specifically this vulnerable population.
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Affiliation(s)
- Virginie Prendki
- Division of Internal Medicine for the Aged, Geneva University Hospitals, and University of Geneva, Hôpital des Trois-Chêne, Chemin du Pont-Bochet 3, 1226, Genève, Thônex, Switzerland.
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.
- Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland.
| | - Noam Tau
- Department of Diagnostic Imaging, Chaim Sheba Medical Center, Ramat Gan, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Tel Aviv, Israel
| | - Tomer Avni
- Sackler Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Tel Aviv, Israel
- Medicine A, Rabin Medical Center, Beilinson Hospital, Petah-Tikva, Israel
| | - Marco Falcone
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Angela Huttner
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland
| | - Laurent Kaiser
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland
| | - Mical Paul
- Division of Infectious Diseases, Rambam Health Care Campus, Haifa, Israel
| | - Yaara Leibovici-Weissmann
- Sackler Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Tel Aviv, Israel
- Department of Acute Geriatrics, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel
| | - Dafna Yahav
- Sackler Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Tel Aviv, Israel
- Infectious Diseases Unit, Rabin Medical Center, Beilinson Hospital, Petah-Tikva, Israel
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Lenze EJ, Mattar C, Zorumski CF, Stevens A, Schweiger J, Nicol GE, Miller JP, Yang L, Yingling M, Avidan MS, Reiersen AM. Fluvoxamine vs Placebo and Clinical Deterioration in Outpatients With Symptomatic COVID-19: A Randomized Clinical Trial. JAMA 2020; 324:2292-2300. [PMID: 33180097 PMCID: PMC7662481 DOI: 10.1001/jama.2020.22760] [Citation(s) in RCA: 372] [Impact Index Per Article: 93.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
IMPORTANCE Coronavirus disease 2019 (COVID-19) may lead to serious illness as a result of an excessive immune response. Fluvoxamine may prevent clinical deterioration by stimulating the σ-1 receptor, which regulates cytokine production. OBJECTIVE To determine whether fluvoxamine, given during mild COVID-19 illness, prevents clinical deterioration and decreases the severity of disease. DESIGN, SETTING, AND PARTICIPANTS Double-blind, randomized, fully remote (contactless) clinical trial of fluvoxamine vs placebo. Participants were community-living, nonhospitalized adults with confirmed severe acute respiratory syndrome coronavirus 2 infection, with COVID-19 symptom onset within 7 days and oxygen saturation of 92% or greater. One hundred fifty-two participants were enrolled from the St Louis metropolitan area (Missouri and Illinois) from April 10, 2020, to August 5, 2020. The final date of follow-up was September 19, 2020. INTERVENTIONS Participants were randomly assigned to receive 100 mg of fluvoxamine (n = 80) or placebo (n = 72) 3 times daily for 15 days. MAIN OUTCOMES AND MEASURES The primary outcome was clinical deterioration within 15 days of randomization defined by meeting both criteria of (1) shortness of breath or hospitalization for shortness of breath or pneumonia and (2) oxygen saturation less than 92% on room air or need for supplemental oxygen to achieve oxygen saturation of 92% or greater. RESULTS Of 152 patients who were randomized (mean [SD] age, 46 [13] years; 109 [72%] women), 115 (76%) completed the trial. Clinical deterioration occurred in 0 of 80 patients in the fluvoxamine group and in 6 of 72 patients in the placebo group (absolute difference, 8.7% [95% CI, 1.8%-16.4%] from survival analysis; log-rank P = .009). The fluvoxamine group had 1 serious adverse event and 11 other adverse events, whereas the placebo group had 6 serious adverse events and 12 other adverse events. CONCLUSIONS AND RELEVANCE In this preliminary study of adult outpatients with symptomatic COVID-19, patients treated with fluvoxamine, compared with placebo, had a lower likelihood of clinical deterioration over 15 days. However, the study is limited by a small sample size and short follow-up duration, and determination of clinical efficacy would require larger randomized trials with more definitive outcome measures. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04342663.
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Affiliation(s)
- Eric J. Lenze
- Department of Psychiatry, School of Medicine, Washington University in St Louis, St Louis, Missouri
| | - Caline Mattar
- Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, Washington University in St Louis, St Louis, Missouri
| | - Charles F. Zorumski
- Department of Psychiatry, School of Medicine, Washington University in St Louis, St Louis, Missouri
| | - Angela Stevens
- Department of Psychiatry, School of Medicine, Washington University in St Louis, St Louis, Missouri
| | - Julie Schweiger
- Department of Psychiatry, School of Medicine, Washington University in St Louis, St Louis, Missouri
| | - Ginger E. Nicol
- Department of Psychiatry, School of Medicine, Washington University in St Louis, St Louis, Missouri
| | - J. Philip Miller
- Division of Biostatistics, Informatics Institute, School of Medicine, Washington University in St Louis, St Louis, Missouri
| | - Lei Yang
- Department of Psychiatry, School of Medicine, Washington University in St Louis, St Louis, Missouri
| | - Michael Yingling
- Department of Psychiatry, School of Medicine, Washington University in St Louis, St Louis, Missouri
| | - Michael S. Avidan
- Department of Anesthesiology, School of Medicine, Washington University in St Louis, St Louis, Missouri
| | - Angela M. Reiersen
- Department of Psychiatry, School of Medicine, Washington University in St Louis, St Louis, Missouri
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Dourado MCN, Belfort T, Monteiro A, de Lucena AT, Lacerda IB, Gaigher J, Baptista MAT, Brandt M, Kimura NR, de Souza N, Gasparini P, Rangel R, Marinho V. COVID-19: challenges for dementia care and research. Dement Neuropsychol 2020; 14:340-344. [PMID: 33354285 PMCID: PMC7735054 DOI: 10.1590/1980-57642020dn14-040002] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
The COVID-19 pandemic has raised significant concerns about the management and care for people with dementia and their caregivers. In this context, this work will discuss how social isolation or social distancing caused by the pandemic may impact the clinical management of people with dementia, caregivers’ health, and dementia research. The pandemic disrupts all forms of social interaction and may increase the behavioral impairment of people with dementia. Regarding pharmacological treatment, telemedicine is an option, but the context of social isolation raises questions about how to manage people with dementia with lack of cognitive stimulation and non-pharmacological treatment. In addition, the impact of the pandemic on caregivers should be considered. There is some evidence that telephone counseling can reduce depressive symptoms of caregivers of people with dementia. In dementia research, social isolation imposes researchers to modify their study protocols in order to continue collecting data by developing remote tools to assess the participants such as electronic informed consent and online questionnaires and tests. Thus, there is an urgent need for the evaluation and refinement of interventions to address several cognitive, behavioral, and clinical aspects of the long-term impact of the pandemic in dementia.
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Affiliation(s)
| | - Tatiana Belfort
- Center for Alzheimer's Disease, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Alexandre Monteiro
- Center for Alzheimer's Disease, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Aline Tavares de Lucena
- Center for Alzheimer's Disease, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Isabel Barbeito Lacerda
- Center for Alzheimer's Disease, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Julia Gaigher
- Center for Alzheimer's Disease, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Maria Alice Tourinho Baptista
- Center for Alzheimer's Disease, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Michelle Brandt
- Center for Alzheimer's Disease, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Nathália Ramos Kimura
- Center for Alzheimer's Disease, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Natalie de Souza
- Center for Alzheimer's Disease, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Paula Gasparini
- Center for Alzheimer's Disease, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Rogéria Rangel
- Center for Alzheimer's Disease, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Valeska Marinho
- Center for Alzheimer's Disease, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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