Image of older man with cane, sitting alone

Reduced activity participation during the pandemic had a particularly deleterious effect on the mental health of older adults with dementia, a new comparative study has found.

The study is the first to show that having dementia and a reduced level of activity independently affected the risk of depression and anxiety during the pandemic, according to the researchers. 

Investigators analyzed data of more than 4,500 community-dwelling older adults who participated in the U.S. National Health and Aging Trends Study from between 2018 and 2021. The goal was to examine links between pandemic-era activity participation and mental health in people living with and without dementia. 

Results showed a higher relative risk of depressive symptoms and anxiety among older adults with dementia overall both before and during the COVID-19 pandemic. Reduced participation in activities also was associated with worse mental health outcomes.

Notably, the overall level of depressive symptoms increased between 2019 and 2020, likely due to the onset of the pandemic and lifestyle changes that followed restrictions, the researchers surmised. These symptoms then decreased between 2020 and 2021, with the trajectory of social activity coinciding with this rise and fall. For example, social activities decreased between 2019 and 2020 as depression levels rose, and increased between 2020 and 2021 as depression levels fell. 

Supports needed for vulnerable group

People with dementia may already be more vulnerable to reduced contact than those without dementia, since loneliness and social isolation are linked to an increased risk of cognitive decline, wrote Miharu Nakanishi, PhD, of Tohoku University in Japan, and colleagues. The study results highlight the additional emotional and social burden experienced by people with dementia during a public health crisis, he and his colleagues said. 

The authors urge stakeholders to be ready with dementia-friendly initiatives using accessible means during times of long-term social activity restriction. 

“Participation in meaningful activities benefits older adults’ emotional and physical well-being, including those with dementia, providing a sense of continuity, quality of life and self-identity,” they wrote.

“[D]ementia care and support should be developed to enable people with dementia to engage in meaningful activities and experience feelings of connectedness,” they concluded.

Full findings were published in the Journal of Alzheimer’s Disease Reports.

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