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Cognitive, Psychological, and Psychiatric Consequences of the Coronavirus (COVID-19) Pandemic in the Population of Older Persons with Cognitive Impairment, Dementia, and/or Neuropsychiatric Disorders

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The worldwide population is exposed to many different problems during the present coronavirus (COVID-19) pandemic. However, elderly people are the often severely affected by the consequence of natural disasters and crises from many different points of view: increased morbidity and mortality, difficulties ...

The worldwide population is exposed to many different problems during the present coronavirus (COVID-19) pandemic. However, elderly people are the often severely affected by the consequence of natural disasters and crises from many different points of view: increased morbidity and mortality, difficulties accessing regular outpatient visits and medication management, social isolation and loneliness, psychiatric-psychological phenomenology and cognitive deterioration. Indeed, these last two aspects are particularly dramatic because people with dementia or mild cognitive impairment and people with mental disorders are extremely vulnerable. They often suffer from polypathologies and frailty and need continuous monitoring of their physical and mental state to maintain sufficient physical and psychological integrity or, at least, delay deterioration and reduce acute events. People with dementia (even those with mild cognitive deterioration) may have restricted and inadequate access to information and difficulties in management of protection and infection-control procedures, fundamental for their healthcare and also for public health. This also applies to people with mental disorders, who may have pseudodementia.

It is well established that prevention is the most useful action against cognitive deterioration, of both a primary or secondary nature. Thus, physical activity, appropriate nutrition, social support and social interactions, and cognitive stimulation are important measures for reducing cognitive decline. During the current COVID-19 crisis, where many countries have initiated isolation and lockdown procedures, it is likely that these protective factors are compromised, particularly in frail elderly, with or without mental disorders, at risk of developing dementia and those with and low cognitive/brain reserve, which may cause a cascade of events leading to cognitive impairment. Thus, in this Research Topic we launch a call related to all the below-mentioned issues to clarify risk factors and possible solutions:

1. Physical and social environments related to loneliness and mental health factors in persons over 50, with social cohesion and social participation playing an important role.
2. Quarantine measures leading to reduced social contact and increased loneliness in older individuals, especially those who live alone. About 1 out of 7 of households in the EU are composed of a single person aged 65 or over.
3. Reduced social network, isolation, and loneliness increasing generalized anxiety and major depression disorders in older persons.
4. Reduced caregiver support/psychological support of caregivers.
5. Impact of COVID-19 pandemic on caregivers and family stress.
6. Issues related to communicating information during the COVID-19 outbreak to persons with cognitive impairment; (e.g., educational and public health messages, social distancing laws etc).
7. Reduction in diagnosing new onset cases of cognitive impairment and other psychiatric disorders, which may delay the initiation of early treatment, leading to negative consequences for long-term clinical outcomes.
8. Reduction in physical activity and its effect on psychiatric symptoms and emergence of metabolic diseases (diabetes, obesity, hypertension).
9. People with existing mental health disorders might be more influenced by the emotional responses related to the pandemic that could lead to relapse or worsening of mental health symptoms.
10. New onset of anxiety, depression related to COVID-19 in terms of fear of infection.
11. People with existing mental health disorders may suffer during quarantine periods due difficulties accessing regular outpatient visits for evaluations and prescriptions; effects on medication management, dosage adjustment, side effects, drug adherence in geriatric psychiatry.
12. Worsening of symptoms in unmonitored patients (including patients with dementia syndromes, MCI, geriatric depression and anxiety).
13. Development of scales to measure neuropsychiatric, cognitive and other neuropsychiatric problems in relation to the COVID-19 pandemic and related infection-control measures (e.g., lockdowns, social distancing).
14. Practical solutions to support the elderly with neuropsychiatric diseases during quarantine and social distancing periods.
15. Web-platforms and telemedicine to help managing neuropsychiatric issues during periods of social isolation and movement restrictions.

 ***Due to the exceptional nature of the COVID-19 situation, Frontiers is waiving all article publishing charges for COVID-19 related research.***

Keywords: COVID-19, coronavirus, pandemic, elderly, mental health, dementia, cognitive impairment

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