P18: Frailty and Long -COVID in a elderly population living with dementia:a observational study in a cohort of people with dementia in charge of Memory Clinic in Modena

Abstract

Background:

A significant number of patients with COVID-19 experience prolonged symptoms well known as Long-COVID that can occurred between 3 to 24 weeks after acute phase. Most frequent symptoms expressed are fatigue, and cognitive dysfunction, but few studies have investigated the effect in outpatients ‘elderly population. A recent Study followed hospitalized seniors for COVID-19; 22% complain “Brain Fog” one year later correlated with cognitive impairment. It is a challenge to recognized symptoms as “Brain Fog” or fatigue in a frail population affected by dementia (pwd) that yet experience cognitive impairment and disability.

This observational study wants to evaluate the effect of COVID on clinical, cognitive, functional and frailty indices before infection and after in a sample of older pwd matching with control group in outpatients setting.

Methods:

We collected 67 pwd and COVID infection between March 2020 and 2022 followed by Memory Clinic with pre and post geriatric assessment compared with 41 older people with dementia in control group without COVID-19. The geriatric assessment describes comorbility (CIRS), cognitive performance (MMSE), functional assessment (IADL. ADL), psychological and behavioral symptoms (NPI) and frailty evaluation (CFS) at baseline T0 (within 6 moths before COVID infections), at T1 (4-6 moths after ) and T2 (12 months after). Death is recorder for both groups

Results:

Both groups are similar for demographic and clinical characteristics at the baseline. We calculated Delta value T0-T1 and T1-T2 for clinical variables and compared case and control group. As compared to control group, COVID group showed significantly worsening in comorbility in T1 and in disability (ADL) in T1 and T2, meanwhile challenging behavior improve during the time. Both in T1 and T2 COVID group develops in worst frailty compared to control group. None difference in mortality between groups. A possible information bias is that it is not possible to exclude presence of asymptomatic covid case in control group.

Conclusion:

COVID infection in older pwd seems to chance and speed up the natural frailty curve in people with dementia. Is it an effect of a hidden Long COVID? The study open new hypothesis in neurodegenerative implication of prolonged neuroinflammation caused by COVID brain infection.