EYE ON THE ELDERLY
Research suggests many could be at risk of dementia from COVID-19 complicationsMonday, September 27, 2021
BY KIMBERLEY HIBBERT
MEDICAL officials in Jamaica are keeping a close eye on the elderly who have contracted COVID-19 as global research suggests millions could face increased or accelerated risk of dementia as a result of long-term complications.
Dementia is described by the Oxford Dictionary as a chronic or persistent disorder of the mental processes caused by brain disease or injury and marked by memory disorders, personality changes, and impaired reasoning
Data from the 2021 World Alzheimer's Report says the current pandemic has major implications for dementia rates, including Alzheimer's disease, and several factors are likely to change the dynamics of dementia incidence now and for years to come, with specific impact on long-term care.
The report stated that older people with cognitive impairment or dementia are more susceptible to viral infection because of their age, co-existing morbidities, ageing of the immune system, and reduced ability to adhere to preventive measures.
While it may vary from country to country depending on economic status and social structure type, the report said up to 70 per cent of the retired older people with Alzheimer's disease or another form of dementia may reside in long-term care facilities, indicating that, in instances throughout 2020, as many as three-quarters of COVID-19-related deaths reported occurred in care residences.
In addition, the report said COVID-19 protective measures that included confinement and isolation, restrictions on social interaction, limits on physical tasks or daily activities of living, as well as a lack of emotional support normally provided by visiting staff and/or family members, all likely commingled to further deteriorate cognitive, behavioural, and physical conditions in residents of care facilities and made them more vulnerable. Incidences of family dynamics stress, under these same conditions, were also a contributing factor to weakened resilience.
Further, the report said while the virus may hasten death or dementia, it might also cause neurological injury or accelerate brain ageing mechanisms to cause new dementia variants within the spectrum of long-term complications of COVID-19.
Public health and ageing specialist Professor Denise Eldemire Shearer, however, told the Jamaica Observer that while she is aware of the international reports, and it is something Jamaica needs to be aware of, she has not seen the suggested acceleration of dementia in the island's population.
“If we are going to see it, we are not going to see it right now as it is not yet long COVID for us. I am equally concerned, and we will have some variables to look at if we see it. From what I have read, it depends on the severity of the COVID, it depends on whether they require ventilation or not. It is something we need to be aware of, but we have not started looking at it yet,” said Professor Eldemire Shearer, who is also director of the Mona Ageing and Wellness Centre .
Professor Eldemire Shearer added that another variable to consider is if Jamaicans do in fact see memory issues, how much of it is COVID-19-related and how much of it is linked to social isolation and mood stimulation for those who have been on lockdown for months.
“It's over a year now. That has impacted people, not so much in memory issues, but what I am seeing is tremendous increase in frailty and muscle loss. Because they are sitting around at home and not doing the normal going to church, going out, I am seeing a lot of weakness,” she said.
The public health and ageing professor also pointed out that a big misconception is that dementia and frailty are a part of ageing, when that is not the case.
“Frailty can be due to illness, it can be due to diabetes, it can be due to hypertension and such. But in the absence of a known chronic disease, if you are not using your muscles, they are going to waste away. That happens to younger people as well. If you think about it, if you are not doing anything for a long period of time, the first time you do exercise you're pained up. But older people don't have a lot of reserves, so they are sort of going along at an all right level, but anything that is going to upset that all right level is going to cause them to get weak, and the sitting around doing nothing and not going anywhere is causing muscles to weaken. They are losing muscle tissue and that is why we are seeing the increased frailty,” Eldemire Shearer said.
She added: “With frailty comes the increased risk of fall, it worsens the social isolation because if you're afraid that you're going to fall or that you're weak, then you are not going to try it. It's something younger people need to address — to have it checked out, to find out if anything clinical is contributing to it and to therapy, exercises. They are now doing exercises by Zoom. Little groups are getting together so it's about making sure that the older people remain as active as possible.”
Meanwhile, Professor Eldemire Shearer said, in order to improve brain health, people have to use their brain and encourage older folks to do the same.
“You have to use your brain and how you use your brain is going to depend on what you like. The only way you're going to do something is if you enjoy it. For some people it is craft and although eyesight can be a problem with embroidery, a lot of older people still crotchet, a lot of older people make items and they still do their cookies and their tamarind balls.
“There are word puzzles, which you can now download onto their device. There are jigsaw puzzles and that's a very good way of trying to keep your mind active — by matching those pieces and, of course, talking. Don't sit and do stagnant things that don't need interaction.
“You need to use your brain. Have a good argument, have a good discussion. Grandchildren — helping with homework is great stimulation. We have about 20 per cent of our older population either living alone or with a relative, so it's challenging to get the stimulation that you need. But we have to or we are going to see more dementia.”