Intergroup 'Skype' Quiz Sessions in Care Homes to Reduce Loneliness and Social Isolation in Older People

Bridging gaps in the design and implementation of socially assistive technologies for dementia care: the role of occupational therapy

Dementia is a global health challenge, and people living with dementia (PLWD) are especially susceptible to reduced engagement in meaningful occupations, including social participation. In the past few decades, socially assistive technologies continue to be developed amidst a rapidly evolving technological landscape to support the social health of PLWD and their caregivers. Examples include social robots, virtual reality, smart home technology, and various digital technologies, such as mobile applications for tablets and smartphones. Despite an increasing body of research and interest in this field, several gaps relating to the design and implementation process of socially assistive technologies continue to undermine their relevance for PLWD in daily life. In this paper, some of these gaps are highlighted and the role of occupational therapy in the design and implementation of socially assistive technology is presented. In the design process, occupational therapists are uniquely skilled to advise and advocate for the tailoring and personalisation of technology to address the occupational needs of PLWD. In the implementation of socially assistive technologies, occupational therapists are skilled to educate, train, and conduct ongoing evaluations with PLWD and their caregivers, to incorporate socially assistive technologies into their routine and daily lives. We recommend that occupational therapists should continue to be acquainted with such technologies through continuous professional development and educational curricula. Moreover, we highlight the necessary collaboration between occupational therapists, technology developers, and researchers to enhance the process of designing and implementing socially assistive technology, so that their relevance for PLWD and their caregivers can be maximised.Implications for rehabilitationDevelopers and designers of socially assistive technology should consider the disease trajectory of different types of dementia, as well as the different needs, abilities, preferences, occupations and routines of people living with dementia (PLWD) and/or their caregivers.Collaborations between technology developers, researchers, and occupational therapists should take place iteratively throughout the process of designing and implementing socially assistive technology to maximise their relevance and applicability for people living with dementia and their caregivers.To continue enhancing the current role of occupational therapy in socially assistive technology provision, occupational therapists should keep up to date with socially assistive technology that are being developed to support the social health of PLWD.

Exploring the Access and Use of Social Technologies by Older Adults in Support of Their Mental Health During the COVID-19 Pandemic: A Rapid Review

Coronavirus disease (COVID-19) lockdowns disproportionately affect older people where most suffer from social isolation and loneliness, which translate into higher rates of depression and anxiety. This study aimed to explore the accessibility, outcomes, and challenges of social technology use among community-dwelling older adults, older adults in long-term care, older adults with neurocognitive disorder, and older adults with pre-frailty and frailty, to help guide future research in this area. A rapid review was conducted, and articles were retrieved from four online databases, including Medline, AgeLine, EconLit and CINAHL, and grey literature from Google Scholar. Of the 131 articles retrieved, 24 were included in this review. The positive outcomes of social technology use include improved mental and physical health, reduced health disparities, and increased autonomy. Adverse outcomes include furthering the digital divide. More research surrounding the economic impacts of social technologies is warranted.

Strengthening Social Capital to Address Isolation and Loneliness in Long-Term Care Facilities During the COVID-19 Pandemic: Systematic Review of Research on Information and Communication Technologies

BACKGROUND

The COVID-19 pandemic has disproportionately and severely affected older adults, namely those living in long-term care facilities (LTCFs). Aside from experiencing high mortality rates, survivors were critically concerned by social isolation and loneliness (SIL). To address this serious public health concern and stay connected with LTCF residents, information and communication technology (ICT) platforms (eg, video calls) were used as an alternative to maintaining social interactions amid the visiting restriction policy.

OBJECTIVE

This paper aimed to synthesize the effects of ICT-related communication interventions using SMS text messaging or chat, video, voice mail, or photo to address SIL in LTCF residents during the COVID-19 pandemic.

METHODS

In total, 2793 references published in English and French in 2019 and onward were obtained from 10 relevant databases: PsycINFO-Ovid, Ovid-MEDLINE, CINAHL-EBSCO, Cochrane Library, Web of Science, Scopus, DirectScience, Communication & Mass Media Complete, IEEE Xplore, and ACM Digital Library. A 2-person screening approach was used, and the studies were screened independently and blindly. A narrative synthesis was performed to interpret the results of the included studies, and their quality was appraised.

RESULTS

In total, 4 studies were included in the review. ICT-related applications were used to ensure connectedness to address SIL. ICT interventions consisted mainly of videoconferencing, intergroup video call sessions between residents, and chatting (SMS text messages and phone calls). Roughly 3 classes of mediating ICT tools were used: video calls using software applications (eg, Skype); robot systems embedding video telephones; and ordinary telecommunication such as telephone, internet, social media platforms, and videoconferencing. This review has included the role of humanoid robots in LTCFs as an innovation avenue because of their multipurpose use (eg, communication tools and remotely operable).

CONCLUSIONS

Remote social capitalization through ICT applications has become an avenue to reduce SIL among LTCF residents. This review examined a social connection approach that will remain relevant and even be fostered after the COVID-19 pandemic. As families remain the main stakeholders of LTCFs, this study's findings could inform policy makers and frontline managers to better shape programs and initiatives to prevent or reduce SIL in LTCFs.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.2196/36269.

Use of Digital Technologies to Maintain Older Adults' Social Ties During Visitation Restrictions in Long-Term Care Facilities: Scoping Review

BACKGROUND

Digital technologies were implemented to address the disruption of long-term care facility residents' socialization needs during the COVID-19 pandemic. A literature review regarding this topic is needed to inform public policy, facility managers, family caregivers, and nurses and allied health professionals involved in mediating the use of digital devices for residents' social ties.

OBJECTIVE

Our study outlines key concepts, methodologies, results, issues, and gaps in articles published during pandemic-related visitation restrictions.

METHODS

Following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) protocol, a scoping review was conducted by searching 3 database aggregator platforms (EBSCO, ProQuest, and PubMed) for studies published in peer-reviewed journals from early 2020 to the end of June 2021, when the most stringent restrictions were in place. We included qualitative and quantitative studies, reviews, commentaries, viewpoints, and letters to the editors in French or English focusing on digital technologies aiming to support the social contact of residents in long-term care facilities during pandemic-related visitation restrictions.

RESULTS

Among 763 screened articles, 29 met our selection criteria. For each study, we characterized the (1) authors, title, and date of the publication; (2) country of the first author; (3) research fields; (4) article type; and (5) type of technology mentioned. The analysis distinguished 3 main themes emerging from the literature: (1) impact and expectations of remote social contact on the physical and mental health and well-being of the residents (n=12), (2) with whom or what the social contact took place (n=17), and (3) limitations and barriers to significant social contact related to digital technologies (n=14). The results first underlined the highly positive impact expected by the authors of the digital technologies on health and quality of life of residents of long-term care facilities. Second, they highlighted the plurality of ties to consider, since social contact takes place not only with family caregivers to maintain contact but also for other purposes (end-of-life videoconferences) and with other types of contact (eg, with staff and robots). Third, they exposed the limitations and barriers to significant contact using digital technologies and outlined the required conditions to enable them.

CONCLUSIONS

The review demonstrated the opportunities and risks outlined by the literature about the implementation of digital technologies to support remote social contact. It showed the plurality of ties to consider and revealed the need to evaluate the positive impact of remote contact from the residents' perspectives. Therefore, to go beyond the risk of digital solutionism, there is a need for studies considering the holistic impact on health regarding the implementation of digital technologies, including the meaning residents give to interpersonal exchanges and the organizational constraints.

TRIAL REGISTRATION

OSF Registries osf.io/yhpx3; https://osf.io/yhpx3.

Barriers and Enablers for the Use of Digital Interactive Television in Nursing Home Settings: An Interview Case Study with Older Adults and Professionals

Increasingly, public health programs are recommending the use of information and communication technologies to address the psychosocial needs of Older Adults (OAs). Recently, several applications that allow access to communication and stimulation functionalities using digital interactive television (DiTV) have been developed. The use of the television interface to access digital services seems to help meet several accessibility and usability needs of OAs. However, its use entails other challenges related to different dimensions (organizational, technological, ethical, etc.). This study aims to identify the factors that enable or hinder the use of DiTV by OAs living in geriatric institutions. A qualitative interview case study was conducted in three French geriatric facilities. A total of 25 semi-structured interviews were carried out with residents and care professionals, between February and April 2022, to identify enablers and barriers to DiTV use. Data were processed using a thematic deductive analysis inspired by a multidimensional Health Technology Assessment model. The analysis showed that DiTV use may be limited by organizational (e.g., workload), technological (e.g., ergonomic issues), human (e.g., health issues), ethical (e.g., privacy), and safety factors (e.g., frustration due to technical problems). A summary of these factors and five recommendations for DiTV implementation in geriatric settings are presented in this paper.

Analyzing the use of videoconference by and for older adults in nursing homes: an interdisciplinary approach to learn from the pandemic

Introduction

During the Covid-19 pandemic and the resulting visitation restrictions, digital tools were used in many nursing homes in France to allow the older adults and their relatives to maintain social contact via videoconferencing. This article adopts an interdisciplinary approach to analyze the processes that affect the use of digital technologies.

Methods

Drawing on the concept of "mediation," it seeks to shed light on how individuals embrace these tools in a relational situation. The interviews and observations undertaken among residents, their relatives, professionals, and the management head of seven nursing homes in 2021, make it possible to outline the different forms of practices and uses and to identify the factors leading to the variations observed.

Results

While the key objective of these technical and technological tools is to compensate - on a functional level - for the communication problems and the isolation of individuals in order to promote residents' "quality of life" by maintaining "social contact," our study reveals that these tools' uses and practices largely differ. It also shows considerable inequalities in terms of residents' acquisition of subjective feelings of ownership of the tools. These are never attributed to isolated physical, cognitive, psychic, and social difficulties, but are influenced by specific organizational, interactional, and psychic configurations. Some of the structures analyzed revealed situations in which mediation failed, occasionally exposing the risk associated with seeking "ties at all costs," or revealing a disturbing strangeness when residents were placed in front of screens. Some configurations, however, showed that it was possible to set up an intermediate space for the experience to unfold, which in turn opened up a space where individuals, groups, and institutions could experiment, allowing them to develop subjective feelings of ownership of this experience.

Discussion

This article discusses how the configurations that failed to promote the mediation process reveal the need to assess the representations of care and assistance in the relationships between older adults, their loved ones, and nursing home professionals. Indeed, in certain situations, the use of videoconferencing, while seeking to produce a positive effect, risks displacing and increasing the effects of the "negative" associated with dependency, which may worsen individuals' difficulties within nursing homes. The risks associated with the failure to take into account residents' requests and consent explain why it is important to discuss how certain uses of digital tools may renew the dilemma between concerns for protection, on the one hand, and respect for autonomy on the other.

A social practice theory approach to exploring the ubiquity of quizzes in dementia care settings

Quizzes are a ubiquitous part of the dementia social care landscape. This article explores why. Using an ethnographic approach which draws on close analysis of communication, we examine dementia quizzes as a ‘social practice’, and what such a lens can tell us about their popularity in social care settings. Vignettes of real interactions drawn from ten different quizzes recorded in four different group settings attended by 28 people living with dementia and 15 staff members are presented to highlight particular issues. We show that the conditions of post-diagnosis dementia social care are uniquely well suited to an activity such as quizzes which are malleable, requiring little preparation or materials, and impose a communication framework which can help to organise the interactional space. Quizzes also draw on previously forged interactional competences, such as turn-taking and question–answer sequences, a skill that has been shown to persist even as dementia progresses. Finally, we argue that the meaning of quizzes with people with dementia feeds into wider societal values and associations attached to memory, dementia and personhood. The extent to which quizzes are akin to a ‘test’ or a fun and enjoyable social activity rests in how they are enacted. We suggest that practice can be adapted, developed and made more inclusive through input from people living with dementia themselves.

Digital Technologies to Prevent Social Isolation and Loneliness in Dementia: A Systematic Review

Background: Dementia poses significant and sustained challenges to global society. Diagnosis can lead to increased feelings of loneliness and social isolation. People with dementia living alone are particularly at risk. Considering the growing number of technologies proposed to aid people with dementia address social isolation and loneliness, we reviewed the existing literature. Objective: To collate and summarize current evidence for digital technologies to prevent social isolation and loneliness for people with dementia. Methods: Following the PRISMA guidelines, we systematically searched five databases to identify studies of digital technologies designed to support or prevent social isolation or loneliness for people with dementia. Pre-specified outcomes included social isolation, loneliness, and quality of life. We used deductive thematic analysis to synthesize the major themes emerging from the studies. Results: Ten studies met our inclusion criteria where all studies reported improvements in quality of life and seven reported benefits regarding social inclusion or a reduction in loneliness. Technologies were varied across purpose, delivery format, theoretical models, and levels of personalization. Two studies clearly described the involvement of people with dementia in the study design and five technologies were available outside the research context. Conclusion: There is limited— but increasing— evidence that technologies hold potential to improve quality of life and reduce isolation/loneliness for people with dementia. Results presented are largely based in small-scale research studies. Involvement of people with dementia was limited and few research concepts are reaching implementation. Closer collaboration with people with dementia to provide affordable, inclusive, and person-centered solutions is urgently required.

Strengthening Social Capital to Address Isolation and Loneliness in Long-term Care Facilities During the COVID-19 Pandemic: Protocol for a Systematic Review of Research on Information and Communication Technologies

BACKGROUND

The COVID-19 pandemic has had the greatest impact in long-term care facilities (LTCFs) by disproportionately harming older adults and heightening social isolation and loneliness (SIL). Living in close quarters with others and in need of around-the-clock assistance, interactions with older adults, which were previously in person, have been replaced by virtual chatting using information and communication technologies (ICTs). ICT applications such as FaceTime, Zoom, and Microsoft Teams video chatting have been overwhelmingly used by families to maintain residents' social capital and subsequently reduce their SIL.

OBJECTIVE

Because of the lack of substantive knowledge on this ever-increasing form of social communication, this systematic review intends to synthesize the effects of ICT interventions to address SIL among residents in LTCFs during the COVID-19 period.

METHODS

We will include studies published in Chinese, English, and French from December 2019 onwards. Beyond the traditional search strategy approach, 4 of the 12 electronic databases to be queried will be in Chinese. We will include quantitative and intervention studies as well as qualitative and mixed methods designs. Using a 2-person approach, the principal investigator and one author will blindly screen eligible articles, extract data, and assess risk of bias. In order to improve the first round of screening, a pilot-tested algorithm will be used. Disagreements will be resolved through discussion with a third author. Results will be presented as structured summaries of the included studies. We plan to conduct a meta-analysis if sufficient data are available.

RESULTS

A total of 1803 articles have been retrieved to date. Queries of the Chinese databases are ongoing. The systematic review and subsequent manuscript will be completed by the fall of 2022.

CONCLUSIONS

ICT applications have become a promising avenue to reduce SIL by providing a way to maintain communication between LTCF residents and their families and will certainly remain in the post-COVID-19 period. This review will investigate and describe context-pertinent and high-quality programs and initiatives to inform, at the macro level, policy makers and researchers, frontline managers, and families. These methods will remain relevant in the post-COVID-19 era.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/36269.

Direct and Indirect Effects of COVID-19 on Long-Term Care Residents and Their Family Members

INTRODUCTION

The first cases of COVID-19 in Israel were reported in February 2020. Family visits were prohibited from March 10, 2020, and then allowed on a limited basis on April 20, 2020. This article examines how COVID-19 impacted long-term care residents and their family members from the perspective of long-term care facility (LTCF) administrative staff.

METHODS

An online survey was sent to Israeli LTCF administrators between mid-July and mid-October 2020, resulting in 52 completed questionnaires. Quantitative analysis involved descriptive statistics using SPSS, with differences compared via t tests, ANOVA, and χ2 tests. Qualitative analysis involved thematic analysis of responses to open-ended questions.

RESULTS

COVID-19 was reported to have multiple types of negative impact on residents, including direct effects on morbidity and mortality as well as indirect effects manifested as negative reactions to measures aimed at limiting infection, including isolation from relatives, decreased activities for residents, and COVID-19 testing. The impact of isolation on LTCF residents was reported as negative or very negative by over three-quarters of the respondents. Behavioral problems among residents increased in 32% of the facilities. The qualitative results suggested that adverse effects on residents and family members were partially mitigated by the use of communication technologies.

DISCUSSION/CONCLUSION

The interplay of multiple factors affected LTCF residents against the backdrop of COVID-19 restrictions. The emergence of mitigating factors which provide solutions to some of the challenges has the potential of improving quality of care for LTCF residents as the pandemic continues and thereafter.

Care for dementia patients and caregivers amid COVID-19 pandemic

BACKGROUND

Multiple efforts have been taken across the world to bridge gaps in evidence and provide recommendations for dementia care and caregiver support during the COVID-19 pandemic. We aimed to review the available literature on measures used to alleviate the negative impacts of the pandemic on dementia care.

METHODS

We searched three databases: PubMed, CINAHL and PsycINFO to identify studies that described strategies that were recommended or taken to provide care and support to persons with dementia and their caregivers during the COVID-19 pandemic.

RESULTS

We included a total of 37 papers, originating from high, middle and low-income countries. We also included 6 papers exploring safety of COVID-19 vaccinations. Infection prevention recommendations predominantly involved providing consistent reminders to persons with dementia to engage in infection prevention measures and included measures to restrict wandering in long-term care settings to reduce spread of infection. Medical care included tele and video consultations to maintain and monitor clinical stability. Guidance for continuing rehabilitation activities for persons with dementia through remotely conducted cognitive stimulating activities, physical exercises and environmental modifications were further highlighted by multiple studies/articles. In addition, strategies to support caregivers were also advised and included teleconsultations and psycho-educational programs.

CONCLUSION

The COVID-19 pandemic has exposed gaps in health and social care systems across the world, but has also revealed the enduring dedication of clinicians, expert groups and dementia support organizations to modify and adapt existing dementia care services to meet the needs of persons with dementia and their caregivers during periods of emergency.

Video Calls for Older Adults: A Narrative Review of Experiments Involving Older Adults in Elderly Care Institutions

Social isolation in geriatric institutions is a real threat to older adults' (OAs) well-being. Visits from family members, when they are not impacted by geographical distance or illness, sometimes fail to provide sufficient opportunities for social connectedness and interaction to prevent and/or combat OAs' loneliness and social isolation. Information and Communication Technologies (ICTs) offer promising solutions to this problem. Video calls provide a quick and convenient way for remote communication between OAs and their families, and a complement to face-to-face visits in geriatric settings. Over the last months, during the several confinements imposed to stop the transmission of COVID-19 over the world, several care homes and long-care facilities have equipped themselves with laptops, tablets and video call applications to help OAs remain in contact with their relatives. However, numerous technical and human-related factors may hinder the use of video calls in these settings. The complexity of technological devices, as well as OAs limited digital skills, low confidence and experience in the use of technology are some examples. Furthermore, the specific context of use and the required implication of multiple actors (care professionals, family members) should also be considered when examining the use and implementation of video calls in geriatric institutions. We conducted a narrative review of literature describing the use of video calls in geriatric institutions between 2000 and 2021, especially because of the little information related to OAs' use of video calls in geriatric settings. One thousand one hundred ninety-seven references were screened and 15 studies focusing on the usability, acceptability and effectiveness of video calls were included. A qualitative, deductive thematic analysis inspired by a Health Technology Assessment (HTA) multidimensional model was used to identify barriers, enablers and solutions to video calls implementation in geriatric institutions. The results from the HTA-based analysis provide encouraging evidence for the feasibility of video call use in geriatric settings, and its efficacy on reducing social isolation among residents. However, numerous technical, human-related, ethical and organizational barriers persist and should be addressed in future works. The present analysis has also allowed the identification of potential solutions to overcome these barriers, which are discussed in this publication.

A Systematic Review of Telemedicine for Older Adults With Dementia During COVID-19: An Alternative to In-person Health Services?

Introduction: Older adults with dementia have been significantly at more risk for not receiving the care needed and for developing further mental health problems during COVID-19. Although the rise in telemedicine adoption in the healthcare system has made it possible for patients to connect with their healthcare providers virtually, little is known about its use and effects among older adults with dementia and their mental health.

Objective: This systematic review aimed to explore the use, accessibility, and feasibility of telemedicine in older adults with dementia, as well as examine the potential mental health impacts of these technologies, through reviewing evidence from studies conducted during COVID-19.

Methods: PubMed, Scopus, and Web of Science databases were searched with the following keywords: (COVID^* OR SARS-CoV-2 OR Coronavirus) AND (“mental health” OR Depression OR Stress) AND (Dementia OR Multi-Infarct Dementia OR Vascular Dementia OR Frontotemporal Dementia) AND (elder OR Aging OR Aging OR Aged) AND (Telemedicine OR “Remote Consultation” OR telehealth OR technology).

Results: A total of 7 articles from Asia, Europe, and the United States were included in this review. Throughout the studies cognitive and mental health assessments (e.g., MoCA, FAST, etc.) were performed. Despite the barriers, telemedicine was noted as a feasible approach to assist individuals with dementia in connecting with their service providers and family while reducing complications related to travel (e.g., difficulty moving, traffic, distance).

Conclusions: Due to the COVID-19 pandemic, finding alternative ways to provide services to older adults with dementia through technology may continue to become more necessary as time goes on.

COVID-19's Influence on Information and Communication Technologies in Long-Term Care: Results From an Online Survey with Long-Term Care Administrators

Background

The prevalence of COVID-19 in the United States led to mandated lockdowns for long-term care (LTC) facilities, resulting in loss of in-person contact with social ties for LTC residents. Though information and communication technologies (ICTs) can be used by LTC residents to support their socioemotional needs, residents must have access to ICTs to use them.

Objective

This study explored ICT access and use in LTC facilities and how LTC facilities adapted to try to enhance social connections for their residents during the COVID-19 pandemic.

Methods

LTC administrators in South Carolina (United States) were invited to complete a web-based survey exploring ICT access and use in LTC facilities and whether access and use changed as a result of the COVID-19 pandemic.

Results

LTC administrators (N=70, 12 nursing homes [NHs], and 58 assisted living facilities [ALFs]) completed the web-based survey. Since March 2020, a total of 53% (37/70) of the LTC facilities have purchased ICTs for residents’ use. ICTs have mainly been used for videoconferencing with family members (31/36, 86%), friends (25/36, 69%), and health care providers (26/36, 72%). NHs were 10.23 times more likely to purchase ICTs for residents’ use during the COVID-19 pandemic than ALFs (odds ratio 11.23, 95% CI 1.12-113.02; P=.04). Benefits of ICT use included residents feeling connected to their family members, friends, and other residents. Barriers to ICT use included staff not having time to assist residents with using the technology, nonfunctional technology, and residents who do not want to share technology.

Conclusions

Our results suggest that over half of the LTC facilities in this study were able to acquire ICTs for their residents to use during the COVID-19 pandemic. Additional research is needed to explore how residents adapted to using the ICTs and whether LTC facilities developed and adopted technology integration plans, which could help them be prepared for future situations that may affect LTC residents’ engagement and communication opportunities, such as another pandemic.

Depresssion, anxiety and other cognitive consequences of social isolation: Drug and non-drug treatments

OBJECTIVE

During the COVID-19 pandemic, quarantine and staying at home is advised. The social relationship between people has become deficient, and human social isolation (SI) has become the consequence of this situation. It was shown that SI has made changes in hippocampal neuroplasticity, which will lead to poor cognitive function and behavioural abnormalities. There is a connection between SI, learning, and memory impairments. In addition, anxiety-like behaviour and increased aggressive mood in long-term isolation have been revealed during the COVID-19 outbreak.

METHODS

Term searches was done in Google Scholar, Scopus, ScienceDirect, Web of Science and PubMed databases as well as hand searching in key resource journals from 1979 to 2020.

RESULTS

Studies have shown that some drug administrations may positively affect or even prevent social isolation consequences in animal models. These drug treatments have included opioid drugs, anti-depressants, Antioxidants, and herbal medications. In addition to drug interventions, there are non-drug treatments that include an enriched environment, regular exercise, and music.

CONCLUSION

This manuscript aims to review improved cognitive impairments induced by SI during COVID-19.

Dementia wellbeing and COVID-19: Review and expert consensus on current research and knowledge gaps

OBJECTIVES

In response to a commissioned research update on dementia during the COVID-19 pandemic, a UK-based working group, comprising dementia researchers from a range of fields and disciplines, aimed to describe the impact of the pandemic on dementia wellbeing and identify priorities for future research.

METHODS

We supplemented a rapid literature search (including unpublished, non-peer reviewed and ongoing studies/reports) on dementia wellbeing in the context of COVID-19 with expert group members' consensus about future research needs. From this we generated potential research questions the group judged to be relevant that were not covered by the existing literature.

RESULTS

Themes emerged from 141 studies within the six domains of the NHS England COVID-19 Dementia Wellbeing Pathway: Preventing Well, Diagnosing Well, Treating Well, Supporting Well, Living Well and Dying Well. We describe current research findings and knowledge gaps relating to the impact on people affected by dementia (individuals with a diagnosis, their carers and social contacts, health and social care practitioners and volunteers), services, research activities and organisations. Broad themes included the potential benefits and risks of new models of working including remote healthcare, the need for population-representative longitudinal studies to monitor longer-term impacts, and the importance of reporting dementia-related findings within broader health and care studies.

CONCLUSIONS

The COVID-19 pandemic has had a disproportionately negative impact on people affected by dementia. Researchers and funding organisations have responded rapidly to try to understand the impacts. Future research should highlight and resolve outstanding questions to develop evidence-based measures to improve the quality of life of people affected by dementia.