Steeper memory decline after COVID-19 lockdown measures
Abstract Background During COVID-19 lockdown measures, memory clinic patients reported worries for faster cognitive decline, due to loss of structure and feelings of loneliness and depression. We aimed to investigate the impact of the COVID-19 lockdown on rate of cognitive decline in a mixed memory...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-04-01
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| Series: | Alzheimer’s Research & Therapy |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13195-023-01226-5 |
| _version_ | 1827966385419976704 |
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| author | Els D. Bakker Stéphanie L. van der Pas Marissa D. Zwan Freek Gillissen Femke H. Bouwman Philip Scheltens Wiesje M. van der Flier Ingrid S. van Maurik |
| author_facet | Els D. Bakker Stéphanie L. van der Pas Marissa D. Zwan Freek Gillissen Femke H. Bouwman Philip Scheltens Wiesje M. van der Flier Ingrid S. van Maurik |
| author_sort | Els D. Bakker |
| collection | DOAJ |
| description | Abstract Background During COVID-19 lockdown measures, memory clinic patients reported worries for faster cognitive decline, due to loss of structure and feelings of loneliness and depression. We aimed to investigate the impact of the COVID-19 lockdown on rate of cognitive decline in a mixed memory clinic population, compared to matched historical controls. Methods We included patients who visited Alzheimer Center Amsterdam 6 months to 1 week before the first Dutch COVID-19 lockdown, and had a second visit 1 year later, after this lockdown period (n = 113; 66 ± 7 years old; 30% female; n = 55 dementia, n = 31 mild cognitive impairment (MCI), n = 18 subjective cognitive decline (SCD), n = 9 postponed diagnosis). Historical controls (visit in 2016/2017 and second visit 1 year later (n = 640)) were matched 1:1 to lockdown patients by optimal Mahalanobis distance matching (both groups n = 113). Groups were well matched. Differences between lockdown patients and historical controls over time in Mini-Mental State Examination, Trail Making Test part A and B, Rey-Auditory Verbal Learning Test (RAVLT) immediate and delayed recall, and category fluency scores were analyzed using linear mixed effect models with random intercepts. We examined differences in rate of cognitive decline between whole groups, and after stratification in SCD, MCI, and dementia separately. Results Lockdown patients had a faster rate of memory decline compared to controls on both RAVLT immediate [B(SE) = − 2.62 (1.07), p = 0.015] and delayed recall [B(SE) = − 1.07 (0.34), p = 0.002]. Stratification by syndrome diagnosis showed that this effect was largely attributable to non-demented participants, as we observed faster memory decline during lockdown in SCD and MCI (RAVLT immediate [SCD: B(SE) = − 6.85 (2.97), p = 0.027; MCI: B(SE) = − 6.14 (1.78), p = 0.001] and delayed recall [SCD: B(SE) = − 2.45 (1.11), p = 0.035; MCI: B(SE) = − 1.50 (0.51), p = 0.005]), but not in dementia. Conclusion Memory clinic patients, specifically in pre-dementia stages, showed faster memory decline during COVID-19 lockdown, providing evidence that lockdown regulations had a deleterious effect on brain health. In individuals that may have been able to deal with accumulating, subclinical neuropathology under normal and structured circumstances, the additional stress of lockdown regulations may have acted as a “second hit,” resulting in less beneficial disease trajectory. |
| first_indexed | 2024-04-09T17:49:13Z |
| format | Article |
| id | doaj.art-60892e7a3e9d4f15b0cb6dbfeb2c441c |
| institution | Directory Open Access Journal |
| issn | 1758-9193 |
| language | English |
| last_indexed | 2024-04-09T17:49:13Z |
| publishDate | 2023-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Alzheimer’s Research & Therapy |
| spelling | doaj.art-60892e7a3e9d4f15b0cb6dbfeb2c441c2023-04-16T11:08:43ZengBMCAlzheimer’s Research & Therapy1758-91932023-04-011511910.1186/s13195-023-01226-5Steeper memory decline after COVID-19 lockdown measuresEls D. Bakker0Stéphanie L. van der Pas1Marissa D. Zwan2Freek Gillissen3Femke H. Bouwman4Philip Scheltens5Wiesje M. van der Flier6Ingrid S. van Maurik7Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmcAmsterdam UMC Location Vrije Universiteit Amsterdam, Epidemiology and Data ScienceAlzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmcAlzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmcAlzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmcAlzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmcAlzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmcAlzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmcAbstract Background During COVID-19 lockdown measures, memory clinic patients reported worries for faster cognitive decline, due to loss of structure and feelings of loneliness and depression. We aimed to investigate the impact of the COVID-19 lockdown on rate of cognitive decline in a mixed memory clinic population, compared to matched historical controls. Methods We included patients who visited Alzheimer Center Amsterdam 6 months to 1 week before the first Dutch COVID-19 lockdown, and had a second visit 1 year later, after this lockdown period (n = 113; 66 ± 7 years old; 30% female; n = 55 dementia, n = 31 mild cognitive impairment (MCI), n = 18 subjective cognitive decline (SCD), n = 9 postponed diagnosis). Historical controls (visit in 2016/2017 and second visit 1 year later (n = 640)) were matched 1:1 to lockdown patients by optimal Mahalanobis distance matching (both groups n = 113). Groups were well matched. Differences between lockdown patients and historical controls over time in Mini-Mental State Examination, Trail Making Test part A and B, Rey-Auditory Verbal Learning Test (RAVLT) immediate and delayed recall, and category fluency scores were analyzed using linear mixed effect models with random intercepts. We examined differences in rate of cognitive decline between whole groups, and after stratification in SCD, MCI, and dementia separately. Results Lockdown patients had a faster rate of memory decline compared to controls on both RAVLT immediate [B(SE) = − 2.62 (1.07), p = 0.015] and delayed recall [B(SE) = − 1.07 (0.34), p = 0.002]. Stratification by syndrome diagnosis showed that this effect was largely attributable to non-demented participants, as we observed faster memory decline during lockdown in SCD and MCI (RAVLT immediate [SCD: B(SE) = − 6.85 (2.97), p = 0.027; MCI: B(SE) = − 6.14 (1.78), p = 0.001] and delayed recall [SCD: B(SE) = − 2.45 (1.11), p = 0.035; MCI: B(SE) = − 1.50 (0.51), p = 0.005]), but not in dementia. Conclusion Memory clinic patients, specifically in pre-dementia stages, showed faster memory decline during COVID-19 lockdown, providing evidence that lockdown regulations had a deleterious effect on brain health. In individuals that may have been able to deal with accumulating, subclinical neuropathology under normal and structured circumstances, the additional stress of lockdown regulations may have acted as a “second hit,” resulting in less beneficial disease trajectory.https://doi.org/10.1186/s13195-023-01226-5COVID-19LockdownCognitive declineDementiaMCISubjective cognitive decline |
| spellingShingle | Els D. Bakker Stéphanie L. van der Pas Marissa D. Zwan Freek Gillissen Femke H. Bouwman Philip Scheltens Wiesje M. van der Flier Ingrid S. van Maurik Steeper memory decline after COVID-19 lockdown measures Alzheimer’s Research & Therapy COVID-19 Lockdown Cognitive decline Dementia MCI Subjective cognitive decline |
| title | Steeper memory decline after COVID-19 lockdown measures |
| title_full | Steeper memory decline after COVID-19 lockdown measures |
| title_fullStr | Steeper memory decline after COVID-19 lockdown measures |
| title_full_unstemmed | Steeper memory decline after COVID-19 lockdown measures |
| title_short | Steeper memory decline after COVID-19 lockdown measures |
| title_sort | steeper memory decline after covid 19 lockdown measures |
| topic | COVID-19 Lockdown Cognitive decline Dementia MCI Subjective cognitive decline |
| url | https://doi.org/10.1186/s13195-023-01226-5 |
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