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The Effects of the 2020 COVID-19 Lockdown on Mood, Behavior, and Social and Cognitive Functioning in Older Long-Term Care Residents
OBJECTIVES: We aimed to explore the effects of the Dutch COVID-19 lockdown (March 20–May 25, 2020) on mood, behavior, and social and cognitive functioning of older residents of long-term care facilities (LTCFs) prospectively. DESIGN: Mixed methods: historically controlled longitudinal cohort study a...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Authors. Published by Elsevier Inc. on behalf of AMDA - The Society for Post-Acute and Long-Term Care Medicine.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9276644/ https://www.ncbi.nlm.nih.gov/pubmed/35964663 http://dx.doi.org/10.1016/j.jamda.2022.07.003 |
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author | Angevaare, Milou J. Joling, Karlijn J. Smalbrugge, Martin Hertogh, Cees M.P.M. Twisk, Jos W.R. van Hout, Hein P.J. |
author_facet | Angevaare, Milou J. Joling, Karlijn J. Smalbrugge, Martin Hertogh, Cees M.P.M. Twisk, Jos W.R. van Hout, Hein P.J. |
author_sort | Angevaare, Milou J. |
collection | PubMed |
description | OBJECTIVES: We aimed to explore the effects of the Dutch COVID-19 lockdown (March 20–May 25, 2020) on mood, behavior, and social and cognitive functioning of older residents of long-term care facilities (LTCFs) prospectively. DESIGN: Mixed methods: historically controlled longitudinal cohort study and focus groups. SETTING AND PARTICIPANTS: Residents of Dutch LTCFs. METHODS: Residents who were assessed during and prior to the lockdown were compared to residents of the same wards with 2 assessments prior to the lockdown. We used mixed models and generalized estimating equation analyses to explore differences in changes in mood, withdrawal and aggressive behavior, loneliness and conflict, and cognition and delirium. We also explored whether the effect of the lockdown differed for different subgroups. In 2 online focus groups, LTCF care professionals, ranging from care staff to physicians, reflected on their experiences of the effect of the lockdown and the cohort study results. RESULTS: The lockdown group of 298 residents was compared to the control group of 625 residents. Self-reported mood symptoms showed a slightly greater increase during the lockdown. During the first half of the lockdown, the level of conflict with other residents decreased whereas it increased in the control group. The subgroup with moderate-severe cognitive impairment showed a decrease in withdrawal during the lockdown, whereas the group with no-mild cognitive impairment showed a statistically nonsignificant relative increase. Professionals described great individual variation in the effects of the lockdown on residents. Facilities attempted to preserve the experienced positive effects, for example, by promoting tranquility in shared rooms and continuing to organize individualized ward-based activities. CONCLUSIONS AND IMPLICATIONS: We did not find clinically relevant negative effects of the lockdown on mood, behavior, and social and cognitive functioning in older residents of LTCFs at the group level. Possibly, staff mitigated the negative effects at the group level. Meanwhile, they learned lessons that they continue to apply to enhance resident well-being. |
format | Online Article Text |
id | pubmed-9276644 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | The Authors. Published by Elsevier Inc. on behalf of AMDA - The Society for Post-Acute and Long-Term Care Medicine. |
record_format | MEDLINE/PubMed |
spelling | pubmed-92766442022-07-14 The Effects of the 2020 COVID-19 Lockdown on Mood, Behavior, and Social and Cognitive Functioning in Older Long-Term Care Residents Angevaare, Milou J. Joling, Karlijn J. Smalbrugge, Martin Hertogh, Cees M.P.M. Twisk, Jos W.R. van Hout, Hein P.J. J Am Med Dir Assoc Original Study OBJECTIVES: We aimed to explore the effects of the Dutch COVID-19 lockdown (March 20–May 25, 2020) on mood, behavior, and social and cognitive functioning of older residents of long-term care facilities (LTCFs) prospectively. DESIGN: Mixed methods: historically controlled longitudinal cohort study and focus groups. SETTING AND PARTICIPANTS: Residents of Dutch LTCFs. METHODS: Residents who were assessed during and prior to the lockdown were compared to residents of the same wards with 2 assessments prior to the lockdown. We used mixed models and generalized estimating equation analyses to explore differences in changes in mood, withdrawal and aggressive behavior, loneliness and conflict, and cognition and delirium. We also explored whether the effect of the lockdown differed for different subgroups. In 2 online focus groups, LTCF care professionals, ranging from care staff to physicians, reflected on their experiences of the effect of the lockdown and the cohort study results. RESULTS: The lockdown group of 298 residents was compared to the control group of 625 residents. Self-reported mood symptoms showed a slightly greater increase during the lockdown. During the first half of the lockdown, the level of conflict with other residents decreased whereas it increased in the control group. The subgroup with moderate-severe cognitive impairment showed a decrease in withdrawal during the lockdown, whereas the group with no-mild cognitive impairment showed a statistically nonsignificant relative increase. Professionals described great individual variation in the effects of the lockdown on residents. Facilities attempted to preserve the experienced positive effects, for example, by promoting tranquility in shared rooms and continuing to organize individualized ward-based activities. CONCLUSIONS AND IMPLICATIONS: We did not find clinically relevant negative effects of the lockdown on mood, behavior, and social and cognitive functioning in older residents of LTCFs at the group level. Possibly, staff mitigated the negative effects at the group level. Meanwhile, they learned lessons that they continue to apply to enhance resident well-being. The Authors. Published by Elsevier Inc. on behalf of AMDA - The Society for Post-Acute and Long-Term Care Medicine. 2022-09 2022-07-13 /pmc/articles/PMC9276644/ /pubmed/35964663 http://dx.doi.org/10.1016/j.jamda.2022.07.003 Text en © 2022 The Authors Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Original Study Angevaare, Milou J. Joling, Karlijn J. Smalbrugge, Martin Hertogh, Cees M.P.M. Twisk, Jos W.R. van Hout, Hein P.J. The Effects of the 2020 COVID-19 Lockdown on Mood, Behavior, and Social and Cognitive Functioning in Older Long-Term Care Residents |
title | The Effects of the 2020 COVID-19 Lockdown on Mood, Behavior, and Social and Cognitive Functioning in Older Long-Term Care Residents |
title_full | The Effects of the 2020 COVID-19 Lockdown on Mood, Behavior, and Social and Cognitive Functioning in Older Long-Term Care Residents |
title_fullStr | The Effects of the 2020 COVID-19 Lockdown on Mood, Behavior, and Social and Cognitive Functioning in Older Long-Term Care Residents |
title_full_unstemmed | The Effects of the 2020 COVID-19 Lockdown on Mood, Behavior, and Social and Cognitive Functioning in Older Long-Term Care Residents |
title_short | The Effects of the 2020 COVID-19 Lockdown on Mood, Behavior, and Social and Cognitive Functioning in Older Long-Term Care Residents |
title_sort | effects of the 2020 covid-19 lockdown on mood, behavior, and social and cognitive functioning in older long-term care residents |
topic | Original Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9276644/ https://www.ncbi.nlm.nih.gov/pubmed/35964663 http://dx.doi.org/10.1016/j.jamda.2022.07.003 |
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