COVID-19 Pandemic Impact on the Trajectories of Cognitive Decline and Depression Symptoms in Long-Term Care Facility Residents.
J Am Med Dir Assoc
; 25(2): 328-334.e6, 2024 Feb.
Article
in En
| MEDLINE
| ID: mdl-38195079
ABSTRACT
OBJECTIVES:
To compare the longitudinal rates of change in cognition and depressive symptoms between 2019 (pre-COVID-19 pandemic) and 2020 (COVID-19 pandemic) among long-term care facility (LTCF) residents in Iowa, which ranked among the top 10 US states that suffered from extreme nursing staff shortages during this crisis.DESIGN:
A longitudinal cohort study analyzing the Long-Term Care Minimum Data Set (MDS) version 3.0 between January 1, 2019, and December 31, 2020. SETTING ANDPARTICIPANTS:
LTCF residents from the state of Iowa, with a first assessment before March 10 for each year (2019 and 2020), LTCF stay period >60 days, and at least 2 documented assessments with a minimum of 45 days in between. LTCF residents with a Brief Interview for Mental Status score (BIMS) <3 were excluded.METHODS:
We computed doubly robust estimators by combining regression and propensity score models for BIMS (cognitive decline) and Nine-item Patient Health Questionnaire (PHQ-9; depression symptoms) monthly scores for 2020 vs 2019.RESULTS:
A total of 24,025 residents from 436 LTCFs were included. Our research revealed a marginally accelerated monthly decline in BIMS scores during 2020 as opposed to 2019, with a rate of -0.012 per month (95% CI -0.022, -0.002; P = .016). Simultaneously, we observed a monthly increment of 0.016 in the PHQ-9 scores among LTCF residents in 2020 (95% CI 0.006, 0.028; P = .003). CONCLUSIONS AND IMPLICATIONS Our study identified a notable yet modest increase in cognitive decline and depressive symptoms among NH residents in Iowa during the COVID-19 pandemic. Although statistically significant, the changes were small and may not have clinical relevance over 1 year. Further research is needed to examine risk factors for cognitive decline during pandemic scenarios such as social isolation, loneliness, inappropriate patient-centered care, and the relationship with staff shortage and facility resources.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Cognitive Dysfunction
/
COVID-19
Type of study:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Humans
Language:
En
Journal:
J Am Med Dir Assoc
Journal subject:
HISTORIA DA MEDICINA
/
MEDICINA
Year:
2024
Document type:
Article
Affiliation country:
United States
Country of publication:
United States