Impact of COVID pandemic on neuropsychiatric symptoms and caregiver distress in cognitively impaired older adults
Bibliographic record
Abstract
Abstract Background Neuropsychiatric symptoms (NPS) are cardinal symptoms of dementia. They are often associated with functional decline, poor quality of life, and caregiver burden. Anecdotal reports have suggested increase in NPS during the COVID pandemic. However, decreased time demands on the caregivers could be hypothesized to have improved relationships and indirectly NPS. There has been limited literature on whether NPS improved or worsened during the current pandemic. The current study examines the prevalence of NPS and changes in NPS profile during the pandemic. Loneliness, cognition, function, and caregiver distress were also studied. Methods The COVID Dementia study is an ongoing cross‐sectional study of community dwelling cognitively impaired older adults (N=102). Loneliness was assessed with the 3‐item loneliness questionnaire, cognition with the Tele‐Montreal Cognitive Assessment (T‐MoCA), and functional status with the Functional Activities Questionnaire (FAQ). Neuropsychiatry symptoms including severity and distress were collected using the Neuropsychiatric Inventory (NPI) and change during COVID was also recorded for each symptom. Results Mean age was 73.0 (±8.0) years, 96.1% male, 42.2% rural, 75.2% Caucasian, and 24.8% non‐Caucasian. T‐MoCA and FAQ mean scores were 15.2 (±4.6) and 8.0 (±9.3), respectively. Loneliness was prevalent in majority of participants (53.5%). Mean loneliness score was 4.7 (±2.1). Mean NPI total severity and total distress were 7.5 (±6.5) and 10.9 (±8.8), respectively. Irritability and night‐time behavior were most frequently reported symptoms (45.7% each), followed by anxiety (45.3%), and agitation (41.1%). Majority of the participants reported worsening of neuropsychiatric symptoms during COVID (61.5%). Irritability, agitation, and anxiety was the cluster that was reported as most frequently worsened symptoms during the pandemic followed by depression and apathy cluster (Fig. 1). Among those that reported worsening of neuropsychiatric symptoms, 66.1% noted an increase in ≥ two symptoms. Conclusions Older adults with pre‐existent cognitive impairment may be at high risk for loneliness and worsening of neuropsychiatric symptoms during the COVID pandemic. Some NPS might worsen more frequently during the pandemic and need particular attention.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".