Effects of Isolation on Dementia and What You Can Do to Help

As a health care provider, I’ve lost more patients than I care to think about, during this pandemic. Within the first year, many nursing homes and assisted living facilities lost 40-50% of their patient population. We were no exception.

April and May of 2020 served up our first taste of the devastation. COVID-19 ran through our facilities like wildfire. We got a bit of a reprieve during the summer. A calm be for the storm. Then wave 2 pummeled us in the last quarter of the year.

But what was more challenging, yet equally painful to watch was the fading away and loss of our dementia population, largely due to the effects of social isolation.

So, I wanted to take some time to take a look at dementia, the effects of social isolation on dementia, and what you can do to help, without compromising safety.

What is dementia?

Dementia is the umbrella term for more than 100 different diseases that affect brain function. Dementia mainly affects the mental faculties, the so-called cognitive abilities such as thinking, memory, orientation and language. Affected people are increasingly limited in their daily and work activities and need help progressively as dementia progresses.

Today there is no clear picture about the causes of dementia. According to scientific studies, dementia is the consequence of two events, the death of brain nerve cells and the malfunction of intercellular communications.

IS DEMENTIA TREATABLE?

Dementia can have many causes. Some forms are reversible: dementia can be partially or entirely treatable with appropriate treatment, as in dementia due to metabolic diseases such as hypothyroidism or vitamin B12 deficiency.

In irreversible forms, the brain is directly affected. The best known irreversible conditions are Alzheimer’s disease and vascular dementia. Lewy body dementia, frontotemporal dementia and Parkinson’s dementia are pretty rare.

To this day, these diseases cannot be cured or stopped. Adequate therapy, however, preserves the independence of affected people longer and relieves symptoms. This is why early diagnosis by a specialist is essential.

THE EFFECTS OF COVID-19 ON DEMENTIA

Over 80% of Covid-19 deaths occurred since the recent outbreak all over the world. And in almost 1 in 6 cases, the victims had dementia. The first studies agree that neurodegenerative disease negatively affects the symptoms and the course of the disease. In addition to this, according to experts, dementia hinders the timely detection of the first symptoms of the infection. Difficulty in reporting the signs of the disease has often led to late diagnosis. Furthermore, it should not be underestimated that cognitive problems make understanding the measures indicated for the prevention of contagion more complex. Concepts such as social distancing, frequent hand washing, and masks can create confusion in the patient’s mind.

THE EFFECTS OF DEMENTIA IN ISOLATION

It was verified that the isolation caused significant changes in lifestyles: over 1 in 3 people reduced their physical activity levels, and 70% reported an increase in a sedentary lifestyle. About 1 in 3 older adults mainly reported less healthy changes in their diet (more food, fewer fresh foods, and less variety), and 35% reported weight gain.

Almost a year after the first recognized case of Covid-19, it is now clear that the pandemic has hit the oldest part of our population the hardest. According to the estimates of January 2020, about 1 million and 100 thousand people had dementia. Of these, 20% are over 80 years old.

Elderly patients with cognitive impairment represent the most fragile population. They have a greater risk of adverse psychological impact due to a maladaptation to negative environmental stimuli and a greater need for multidimensional stimulation, that was greatly reduced or suspended during the lockdown.

NEGATIVE EFFECTS OF ISOLATION ON DEMENTIA PATIENTS

In the general population, the known effects of isolation on dementia patients are an increase in:

Depression:

Psychophysical exhaustion, trauma, anger, these emotions alternate, mix, and grow in intensity until they overwhelm the person and lead to clinically significant psychological disorders, such as “reactive depression”.

While the isolation crisis increases the risk of depression, depression impairs an individual’s ability to solve problems, set and achieve goals, and function effectively, at work or in relationships; making recovery from the crisis is even more difficult.

In fact, although it manifests itself in different ways, at the base of depression there is always a renounced attitude.

Anxiety:

Worry and stress are now quite common conditions to experience in this uncertain period. Cases of increased anxiety and agitation linked to the global pandemic and increasingly restrictive measures to prevent contagion are documented by various researches

Behavioral Aspect:

The reduction or loss of social contacts, outdoor activities, playful and properly rehabilitative activities, have largely contributed to worsening cognitive and behavioral aspects.

Furthermore, these effects can be exacerbated by a long duration of the lockdown and can also increase in the;

Fear of contagion
Economic worries
Insomnia

HOW TO DEAL WITH THE EFFECT OF ISOLATION

Recognizing depression immediately in one’s behavior is the best way to move in the opposite direction and break the vicious circle that leads to global renunciation and that characterizes the most severe forms of depression.

Sharing one’s emotions and concerns: not leaving one’s fears inside and connecting with others is useful to avoid conditions of isolation.

Maintain continuity with the routine of their habits.

Carve out a personal space where they can read, listen to music or indulge in a relaxing hobby. Incorporated puzzles and brain games to keep the mind active.

Choose a healthy diet and perform relaxation exercises , also paying attention to the correct sleep-wake cycle.

Use social tools to avoid feelings of loneliness and isolation, like Zoom and FaceTime.

THE IMPACT ON LIFE EXPECTANCY

How much is the pandemic affecting the longevity of the population of the US? For the moment, it is not possible to make precise predictions.

To have accurate data, we will have to wait until next year. Only then will we see what effects the pandemic has had on the life expectancy of individual in the US and round the globe. For now, a decline is expected from a minimum of 6 months to a maximum of 1 year and a half.

CAN I SLOW THE PROGRESSION DEMENTIA?

Although much of dementia is still a mystery, to keep the brain healthy, reduce the risk of diabetes mellitus, obesity, metabolic syndrome, hypertension, high cholesterol, sleep apnea, smoking, alcohol abuse, vascular coronary heart disease, and sedentary lifestyle.

No one can directly protect themselves from dementia or Alzheimer’s, however, these tips help keep the brain fit and healthy and slow disease progression:

Diet

A healthy diet for the heart and blood vessels is good for our brain: more fruits, vegetables, herbs and nuts. Also, fish, polyunsaturated fatty acids from vegetable oils such as grapeseed oil and olive oil, and carbohydrates from pasta, bread or rice.

Make the brain work

If we train it, our brains can form new connections even in old age. Anyone who reads daily, for example, newspapers or books, or solves puzzles is on the right track. Playing an instrument and dancing is also fitness for the brain.

Exercise

Exercise keeps the body in not only shape but also the brain. Daily tasks, such as window cleaning or gardening, that accelerate the pulse and breath are also valuable.

YouTube offers tons of free workout videos for older adults, even for those with reduced mobility. Give chair aerobics a try.

Check out SilverSneakers.com for FREE Online classes at not cost to adults 65 and older through select Medicare plans.

Maintain social relationships

A lively social life helps keep one mentally fit longer, whether with family and friends.

Taking part in social and recreational activities and engaging in relationships with other people regularly improves the quality of life and carries a lower risk of dementia.

Consider outdoor meetings with family and friends and utilized mask and safe social distancing practices.

STAYING HEALTHY

If it is not possible to go out safely, provide for indoor physical exercise (stretching, walking) and cognitively stimulating activities such as reading, card games, manual chores.

Organize virtual meetings with other caregivers or groups for exercises, recreational activities and chats, but also cognitive and physical telerehabilitation sessions with therapists.

Monitor parameters such as pressure, heart rate, temperature, oxygen saturation, blood sugar: keeping blood pressure under strict control can help against an aggravation of dementia.

Do simple assessments of cognitive function, possibly also using online tests indicated by the doctor.

Also identify with the help of health professionals which situations trigger the appearance of symptoms such as aggression, anxiety, irritability in order to avoid them.

Record episodes of difficult-to-manage behavior and discuss them with the healthcare professionals of reference, so as to receive personalized advice to be able to deal with them in the best possible way.

Have an easily reachable contact (nurse, family doctor, geriatrician) to be able to consult in case of psycho-behavioral problems.

Remember that delirium may be one of the earliest manifestations of Covid-19 in elderly patients with dementia.

Have the emergency number at hand to call in case of psycho-behavioral emergencies that you cannot manage on your own, such as violent or self-harming gestures.

SUMMARY

While safety should be your top priority during these uncertain times, do not allow social isolation to accelerate the negative effects of dementia.

Slow the progress of dementia by nourishing social relationships, staying active, and stimulating the brain and body regularly.

Comment below and tell me what you’re doing to combat social isolation.

Until next time, be blessed!