The Global Impact of COVID-19 Control Measures on People With Dementia Living at Home and Their Carers: A Systematic Review of Quantitative and Qualitative Research Across 27 Countries

Brain Behav. 2025 Nov;15(11):e71100. doi: 10.1002/brb3.71100.

ABSTRACT

BACKGROUND: COVID-19 control measures have had a unique impact on people with dementia (PWD) and their carers living at home. Yet, uncertainty exists regarding the global impact of such measures and whether differences exist between countries and global regions. We aimed to synthesize evidence on this topic.

METHODS: We searched Medline, PsycINFO, EMBASE, Web of Science, CINAHL, Latin American and Caribbean Health Literature (LILACS), Scientific Electronic Library Online (SciELO), and EM Premium from the start of the pandemic to July 2022. At least two researchers independently screened citations and performed quality assessment following recommended criteria for critical appraisal according to study methodology. We analyzed data by country and region and synthesized results descriptively.

RESULTS: Sixty-nine studies met inclusion criteria (74% quantitative and 26% qualitative; 22% included PWD, 44% carers of PWD, and 4% dyads), with a total of 209,738 participants. Most studies were conducted in Europe (59%), followed by Asia and North America (15% each), South America (7%), and Oceania (1%). Two studies presented data from multiple regions (3%). The quality of the studies varied, with the majority (62%) being of moderate quality. Across the study populations and global regions, COVID-19 control measures had implications for PWD and carers' access to health services, physical and mental health and daily routine, cognition, behavior, with accompanying social and economic costs. The impact on mental health for PWD and on loneliness and well-being for carers were the two most frequently studied outcomes.

CONCLUSION: People with dementia and their carers represent a heterogeneous group of people across countries and communities; despite that, the impacts of COVID-19 control measures on PWD and their carers were broadly consistent across regions. Our evidence synthesis highlights the critical need for decision-makers to account for the needs of PWD and their carers when designing and implementing public health measures.

OTHER: This work was funded by the JPND Call for Expert Working Groups: The Impact of COVID-19 on Neurodegenerative Diseases in partnership with the CIHR-Institute of Aging and the Public Health Agency (CIHR #02342-000). PROSPERO CRD42024554701.

PMID:41277681 | DOI:10.1002/brb3.71100