Impact of COVID-19 and imposed lockdown on presenting complaints of persons with dementia and challenges faced by caregivers in India

Abstract

BACKGROUND: A diagnosis of dementia increases the vulnerability of an already vulnerable older adult population. COVID-19 infection and the imposed lockdown have both had a huge impact on the lives of persons with dementia and their caregivers. The aim of this study is to evaluate presenting complaints provided by caregivers in the COVID-19-context in India. METHOD: We examined the case records of persons with dementia who presented at theDementia Care in SCARF (DEMCARES), an outpatient clinic in Chennai between May 2020 and April 2021 during the COVID-19 pandemic. We reviewed their presenting complaints to look for ones specific to the COVID-19 context and identified caregiver challenges. RESULT: COVID-19 infection was reported by caregivers to affect the cognition and functioning of their relatives with dementia. The impact of imposed lockdown was observed through reports of caregivers noticing initial signs of dementia following the increased social isolation experienced by their loved ones during the pandemic. Some of the challenges faced by caregivers included their relative with dementia's inability to understand the gravity of the COVID-19 situation, wanting to step out of the house and inability to do so contributing to restlessness, agitation and aggression. CONCLUSION: Caregivers are increasingly facing challenges posed by behavioral and psychological symptoms of dementia stemming from the imposed lockdown restrictions. Teleconsultation and virtual delivery of dementia-specific interventions could potentially help caregivers overcome some of these challenges. Older persons at risk for social isolation and those recovering from COVID-19 should be screened for dementia. General and primary care physicians should actively watch out for signs of cognitive impairment and make necessary referrals as early detection of dementia in elderly persons recovering from COVID-19 may improve outcomes.