key: cord-0900189-mnn4fdjf
authors: Park, Moon Ho
title: Social networks including contactless interaction and reversion in patients with mild cognitive impairment even in the era of COVID‐19
date: 2021-11-16
journal: Geriatr Gerontol Int
DOI: 10.1111/ggi.14309
sha: 0560ebb1012fe1a78893267cceada0314e8238ae
doc_id: 900189
cord_uid: mnn4fdjf

nan

Since the end of 2019, the global pandemic of coronavirus disease 2019 (COVID-19) has changed our daily life as well as our patterns of patient management. Although vaccinations and possible herd immunity have generated hope for overcoming COVID-19, social isolation including social distancing, quarantine and lockdowns will continue until therapeutics for COVID-19 are available.

Good social relationships, however, were found to have a positive effect on cardiovascular disease, psychological disease, as well as cognitive dysfunction. Although social isolation was associated with reduced COVID-19 transmission, it can affect the poor prognosis for patients with various underlying diseases, and social isolation increases the risk of deterioration of physical function and cognitive dysfunction. [1] [2] [3] [4] Mild cognitive impairment (MCI), which is known as a predementia stage, can often be reverted to normal cognition. Estimates of improvement or reversion from MCI back to normal cognition have been quite varied, ranging from 6% to 53%, depending in part on diagnostic criteria or duration of followup. 5, 6 Clinically, the identification of factors associated with reversion from MCI to normal cognition is very important. These factors include better baseline cognitive function, more mental activities, better physical condition, less brain atrophy, some MCI features and less informant-based memory complaints. 6 Although social relationships have been restricted in many ways during the COVID-19 pandemic, substitutive contactless Bold numbers indicate statistical significance (P < 0.05). a Gray rhombus and line in plot were represented as OR and 95% CI in univariable regression analysis. Because there were some missing variables, numbers of available data in univariable analysis were 251 in IQCODE, 247 in GDpS, 208 in NPI, 252 in SNI baseline, 257 in SNI f.up, and 252 in SNI change, but the number of the other variables was 10 complete datasets. b Black circle and line in plot represent OR and 95% CI in multivariable regression analysis with backward-elimination methods with probability for removal of variables with P < 0.20, which was evaluated on the complete dataset (n = 174). c Black square and line in plot represent OR and 95% CI in multivariable regression analysis on the multiple imputation process (n = 258, 10 complete datasets).

interactions are available. Thus, we evaluated the association of reversion from MCI with social networks including online and technology-assisted communications. Of the total 292 participants who were diagnosed with MCI at baseline from November 2019, we retrospectively evaluated 258 participants (43% male) aged 70.5 AE 9.7 years who were subsequently classified with either normal cognition (n = 44) or repeat diagnosis of MCI (n = 214) after about 18.0 AE 0.6 months (34 participants who progressed from MCI to dementia were excluded). The associations with reversion were investigated for baseline factors that included demographics The results of the logistic regression analyses are presented in the Fig. 1 . To increase the power to detect associations and to anticipate the likely possibility from using the partial information available, we generated 10 imputed values for each participant with missing data, yielding 10 complete datasets. With completecase and multiple imputation, both analyses revealed more likely in participants with the higher MoCA score and increased SNI score and less likely in participants with impaired IQCODE result and multiple-domain MCI.

Our results should be interpreted with caution given the disadvantages associated with retrospective analyses with a relatively small sample size. However, when social factors are considered, which is a modifiable factor, an increased social network was consistently associated with aspects of reversion from MCI as well as better baseline cognitive function, less informant-based memory complaints and less multiple impaired domains of cognition.

In conclusion, an increased social network may play important roles in reversion from MCI to normal cognition. The many limitations in social networking during the era of the COVID-19 pandemic cause decreased interactions with neighbors, relatives and acquaintances. 1 However, one of the practical recommendations for the management of cognitive dysfunction during the COVID-19 pandemics includes promotion of social networks should be continued through online and technology-assisted methods. 1,2 A social network is one of the important potential modifiable factors for the prognosis of MCI, suggesting that continuous social networking should be considered for patients with cognitive dysfunction.

The author declares no conflict of interest.

Anonymized data related to the current article are available and will be shared by request from any qualified investigator. Persons interested in obtaining access to the data should contact the corresponding author (M.H.P.).

Department of Neurology, Korea University Ansan Hospital, Ansan, South Korea

The Japan geriatrics society consensus statement "recommendations for older persons to receive the best medical and long-term care during the COVID-19 outbreak-considering the timing of advance care planning implementation

Alzheimer Europe recommendations on promoting the wellbeing of people with dementia and carers during the COVID-19 pandemic

COVID-19, loneliness, social isolation and risk of dementia in older people: a systematic review and meta-analysis of the relevant literature

Social networks, host resistance, and mortality: a nine-year follow-up study of Alameda County residents

Outcomes of mild cognitive impairment by definition: a population study

Factors predicting reversion from mild cognitive impairment to normal cognitive functioning: a population-based study