Association Between Dementia, Change in Home-Care Use, and Depressive Symptoms During the COVID-19 Pandemic: A Longitudinal Study Using Data from Three Cohort Studies

Article type: Research Article

Authors: Nakanishi, Miharu^{a; b; c; *} | Yamasaki, Syudo^c | Nakashima, Taeko^d | Miyamoto, Yuki^e | Cooper, Claudia^f | Richards, Marcus^g | Stanyon, Daniel^c | Sakai, Mai^b | Yoshii, Hatsumi^b | Nishida, Atsushi^c

Affiliations: [a] Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands | [b] Department of Psychiatric Nursing, Tohoku University Graduate School of Medicine, Aoba-ku, Sendai-shi, Miyagi, Japan | [c] Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Tokyo, Japan | [d] Department of Social Healthcare and Business, Faculty of Healthcare Management, Nihon Fukushi University, Mihama-cho, Aichi, Japan | [e] Department of Psychiatric Nursing, School of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan | [f] Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London, UK | [g] MRC Unit for Lifelong Health & Ageing at UCL, University College London, London, UK

Correspondence: [*] Correspondence to: Miharu Nakanishi PhD, Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, 2333 ZD Leiden, The Netherlands. Tel.:+31 71 526 84 81; E-mail: mnakanishi-tky@umin.ac.jp.

Abstract: Background: The emotional impact of the coronavirus disease 2019 (COVID-19) pandemic on people with dementia has been quantified. However, little is known about the impact of change in home-care use owing to the pandemic. Objective: To determine the longitudinal association between dementia, change in home-care use, and depressive symptoms during the pandemic. Methods: We included data of 43,782 home-dwelling older adults from the English Longitudinal Study of Ageing (ELSA), Study of Health, Ageing and Retirement in Europe (SHARE), and National Health and Aging Trends Study (NHATS). This study considered the latest main wave survey prior to the pandemic as the baseline, and the COVID-19 survey as follow-up. In a series of coordinated analyses, multilevel binomial logistic regression model was used to examine the association between baseline dementia, change in home-care use at follow-up, and presence of depressive symptoms. Results: Dementia, using the ELSA, SHARE, and NHATS datasets, was identified in 2.9%, 2.3%, and 6.5% of older adults, and home-care use reduced in 1.7%, 2.8%, and 1.1% of individuals with dementia, respectively. Dementia was significantly associated with the increased risk of depressive symptoms in all three cohorts. However, the interaction between dementia and period (follow-up) was non-significant in SHARE and NHATS. Across all three cohorts, home-care use during the pandemic, regardless of change in amount, was significantly associated with increased depressive symptoms, compared to the non-use of home care. Conclusions: These results highlight the need for tailoring dementia care at home to promote independence and provide sustainable emotional support.

Keywords: Alzheimer’s disease, cohort studies, dementia, depression, home care services, SARS-CoV 2, social interaction

DOI: 10.3233/JAD-240097

Journal: Journal of Alzheimer's Disease, vol. 99, no. 1, pp. 403-415, 2024