Cognitive Impairment, Dementia, Depression, Anxiety, Loneliness
Conditions
Keywords
Dementia, Pandemic, Health care services, Population study, Older adults, Depression
Brief summary
This study will examine which impact lockdown strategies intending to prevent the spread of COVID-19 had on people with cognitive impairment and dementia. Comprehensive data from two large health studies in Norway, conducted before and after the COVID-19 outbreak, will be linked with health register data on the use of health care services and medication. Further, it will be conducted a survey addressing questions on social isolation and use of communicative technology, from March 2020 to January 2021. The knowledge gained from this study can improve the health care system's ability to respond more adequately to pandemics and other unforeseen events, so that the negative consequences for older adults with dementia and cognitive impairment can be reduced.
Detailed description
Introduction: To prevent the spread of COVID-19 societies around the world have implemented various levels of lockdown strategies. Norway locked down major parts of the society from March 2020. Specifically, this meant that public services were closed (e.g. most in-home healthcare services, day care centres, group exercise/gyms and services that offer physiotherapy, medical and psychological consultation). For people with cognitive impairment and dementia, social distancing and self-isolation may have limited the use of normal strategies (e.g., distraction, stimulation, and social interaction) that are routinely adopted to manage some of the dementia symptoms, such as neuropsychiatric symptoms. A lack of daily routines may change the clinical conditions of patients with dementia. Worsening of preexisting and/or the onset of new neuropsychiatric symptoms may occur, in addition to a possible decline of cognitive and functional capacities Aim: The overarching aim of this project is to provide decision makers with vital information to improve the healthcare of people with dementia and cognitive impairment in the context of an epidemic. Method: We will use four data sources:1) The fourth wave of the Trøndelag Health study (HUNT, HUNT4 70+), 2) Three national health registries (The Norwegian Patient Registry (NPR), the Norwegian Registry for Primary Health Care (NRPHC) and the Norwegian Prescription Database (NorPD)), 3) A postal questionnaire concerning social isolation during the COVID-19 epidemic, and 4) The Ageing in Trøndelag study (AiT), which is a follow-up of the HUNT4 70+ study. With this linkage of cohort data and national health registry data, we can identify factors that may make people with cognitive impairment and dementia vulnerable to loss of healthcare services because of COVID-19 and subsequently to negative health consequences.
Interventions
None listed
Sponsors
Norwegian Centre for Ageing and Health
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
70 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Inhabitants living in the designated areas
Exclusion criteria
* None
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Use of Health care services | The participants' use of health care services from the period 2017-2019 | Information from the Norwegian Patient Registry (NPR) and the Norwegian Registry for Primary Health Care (NRPHC) |
| Use of psychotropic medications | The participants' use of psychotropic medication from the period 2017-2019 | Information from the Norwegian Prescription Database (NorPD) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Montreal Cognitive Assessment scale | The participants were assessed when attending the HUNT4 70+-study, and will be assessed with the same measures in the followup study in 2021/2022 | Tests cognitive function in the domain's memory, visuospatial and executive functions, attention, concentration, language and orientation. Scores from 0 - 30 where 30 indicates best function. impairment or dementia, and questions on subjective memory decline |
| CERAD Ten-words test | The participants were assessed when attending the HUNT4 70+-study, and will be assessed with the same measures in the followup study in 2021/2022 | Tests immediate and delayed memory. Scores from 0 - 30 in immediate memory and 0-10 in delayed recall, higher scores indicates better function. |
| Incidence of dementia diagnosis | The participants were assessed when attending the HUNT4 70+-study, and will be assessed with the same measures in the followup study in 2021/2022 | Two clinical and scientific experts will independently set at diagnosis of cognitive impairment or dementia based on all available information applying standard diagnostic criteria DSM-5 |
| Incidence of mild cognitive impairment | The participants were assessed when attending the HUNT4 70+-study, and will be assessed with the same measures in the followup study in 2021/2022 | Two clinical and scientific experts will independently set at diagnosis of cognitive impairment or dementia based on all available information applying standard diagnostic criteria DSM-5 |
Other
| Measure | Time frame | Description |
|---|---|---|
| Alcohol consumption | The participants were assessed when attending the HUNT4 70+-study, and will be assessed with the same measures in the followup study in 2021/2022 | Innhouse made questionnaire about average alcohol units per week and/or month |
| Physical Self-Maintenance scale | The participants were assessed when attending the HUNT4 70+-study, and will be assessed with the same measures in the followup study in 2021/2022 | Assess problems with personal activities of daily living. Assessed in proxy interview and by health personnel for participants in institutions, scores function in 6 personal activities, lower scores indicates better function |
| Instrumental Activities of daily function | The participants were assessed when attending the HUNT4 70+-study, and will be assessed with the same measures in the followup study in 2021/2022 | Assess problems with instrumental activities of daily living, scores function in 8 instrumental activities, lower scores indicates better function |
| Short Physical Performance Battery | The participants were assessed when attending the HUNT4 70+-study, and will be assessed with the same measures in the followup study in 2021/2022. | The test combines the results of the gait speed, chair stand and balance test |
| Fear of Covid-19 | The participants receive a postal questionnaire in Januar 2021, regarding the period from March 2020-January 20201 | A seven-item scale on fear of covid-19, rated on a 5-point scale from 1 (strongly disagree) to 5 (strongly agree) with scores ranging from 7 to 35. The higher the score, the greater the fear of COVID-19 |
| The use of information and communicative technology (ICT) | The participants receive a postal questionnaire in Januar 2021, regarding the period from March 2020-January 20201 | Questions on the use of ICT, including questions on keeping contact with familly, friend and health care personnel |
| Social isolation | The participants receive a postal questionnaire in Januar 2021, regarding the period from March 2020-January 20201 | Questions on the experience of social isolation as a result of containment measures due to covid-19, including information on the level of isolation; accepting visits from friends, family or health care services, and restrictions about outdoor activities |
| Grip strength | The participants were assessed when attending the HUNT4 70+-study, and will be assessed with the same measures in the followup study in 2021/2022. | Measured in both hands with a Jamar and digital dynamometer |
| Blood Pressure | The participants were assessed when attending the HUNT4 70+-study, and will be assessed with the same measures in the followup study in 2021/2022 | Systolic blood pressure |
| Body mass index | The participants were assessed when attending the HUNT4 70+-study, and will be assessed with the same measures in the followup study in 2021/2022 | Weight and height will be combined to report BMI in kg/m\^2 |
| Upper arm circumference | The participants were assessed when attending the HUNT4 70+-study, and will be assessed with the same measures in the followup study in 2021/2022 | The circumference Is measured in centimeters |
| The Hospital Anxiety and Depression scale | The participants were assessed when attending the HUNT4 70+-study, and will be assessed with the same measures in the followup study in 2021/2022 | Gathers information on anxiety and depression, scores from 0 - 42 where 0 indicates best function |
Countries
Norway
Contacts
Primary ContactTanja Louise Ibsen
Outcome results
None listed