Impact of COVID-19 pandemic in an early-onset dementia clinic in Barcelona

Alzheimer's & dementia : the journal of the Alzheimer's Association

Alzheimers Dement. 2021 Dec;17 Suppl 7:e052114. doi: 10.1002/alz.052114.

ABSTRACT

BACKGROUND: The ongoing COVID-19 pandemic and related care policies have affected dementia patients. The characteristics of early-onset dementia (EOD, <65 years) patients in 2020 may provide insights on how to rearrange the provision of care.

METHOD: We retrospectively reviewed, from 2016 to 2020, the demographic and clinical data of the new referrals at our EOD clinic (Hospital Clínic Barcelona). We used Fisher's Exact test and Mann-Whitney U test in R4.0.2 (http://www.R-project.org/) to analyze differences between 2020 and the period 2016-2019.

RESULT: In 2020, we did not visit any new referral from 15th march to 31th may. We evaluated 104 patients in 2020 and 392 patients in 2016-2019 (mean=98(SD=11.8) patients/year). No differences were found in age at onset (AAO), sex, diagnostic delay and MMSE score (Table1). Significant differences were found in the diagnoses obtained in each period (p<0.000005, Figure1A). In 2020, 19.2% of the patients were diagnosed with neurodegenerative diseases (ND), 48.1% with non-neurodegenerative diseases (NND) and 32.7% with subjective cognitive decline (SCD). On contrast, in 2016-2019, 26% of the patients were diagnosed with ND, 22.2% with NND and 51.8% with SCD. Compared to 2016-2019, ND, but not SCD or NND, presented longer diagnostic delay in 2020 (p<0.0005, Figure1B). ND, NND and SCD did not show differences between periods in AAO, sex or MMSE. We did not find differences in the type of ND in each period (Figure1A). Compared to 2016-2019, Frontotemporal Lobar Degeneration (FTLD) presented longer diagnostic delay in 2020 (p<0.005, Figure1B) while ND subgroups did not show differences in AAO, sex or MMSE. Cognitive disturbances in recovered COVID-19 patients accounted for 16% of NND in 2020 [N=8, AAO 50.63(12), 63% female, MMSE 26.8(2.3)].

CONCLUSION: In 2020, albeit we were forced to stop our normal activity during 2.5 months, we visited a similar number of patients among which we observed an increase in NND, including cognitive disturbances in patients with recovered COVID-19. On contrast, we found a reduction in SCD and, to a lesser extent, ND. ND showed a longer diagnostic delay in 2020 that mainly affected FTLD. Whether COVID-19 pandemic entails a diagnostic delay in dementia patients must be confirmed in 2021.

PMID:35109636 | DOI:10.1002/alz.052114

Authors

José Contador
Nuria Guillén
Adrià Tort-Merino
Mircea Balasa
Neus Falgàs Martínez
Jaume Olives
Magdalena Castellví
Jordi Juncà-Parella
Sergi Borrego-Écija
Beatriz Bosch-Capdevila
Guadalupe Fernández-Villullas
Oscar Ramos-Campoy
Anna Antonell
Raquel Sanchez-Valle
Albert Lladó