Impact of social isolation and coping strategies in older adults with mild cognitive impairment during the covid-19 pandemic: A qualitative study

ABSTRACT

The COVID-19 pandemic imposed a psychological burden on elderly and particularly individuals with cognitive impairment and dementia. Few studies have investigated the quarantine experiences of older adults with mild cognitive impairment (MCI) during the COVID-19 pandemic.

Objectives

The objective of this study was to explore the experiences and feelings of older adults with MCI during the COVID-19 outbreak in Chile and to know what strategies they used to overcome social isolation.

Method

A qualitative design was used. Ten participants with a diagnosis of MCI took part in this study. All interviews were recorded and coded using thematic analysis.

Results

The thematic analysis identified three themes related to the quarantine experience of older adults with MCI diagnosis: (1) Effects of social isolation during the COVID-19 pandemic (2) Believes, feelings and behaviors about the SARS-CoV-2 virus (3) Coping with social isolation/response to difficulties during the pandemic. It was found that older adults with MCI have been mainly psychologically and socially affected by social distancing and isolation, particularly individuals who were alone during COVID-19 outbreak. The only physical dimension negatively affected was the level of activity. Social isolation led to a significant number of negative emotions such as anger, fear of contracting the virus or possibility of contagion for their families, worries and sadness as well as emotional loneliness. It is noteworthy that the majority of participants have used several coping strategies during this challenging time.

Conclusion

Since social isolation and a sedentary life have been associated with poorer cognition and functionality in people with MCI, a rational plan to both prevent the progression of cognitive decline and to increase social contact, is essential. Special attention must be drawn to maintaining people physically active at home and keeping their daily routine (within the possibilities) and also to ensure social connectedness through technology. Implementation of these measures could potentially reduce negative emotions during the pandemic.

KEYWORDS:

• COVID-19 pandemic
• quarantine experience
• older adults
• mild cognitive impairment
• qualitative study

Acknowledgements

The authors would like to thank to the study participants, and the direction of Hospital Clinic Universidad de Chile as well as Dr. Isabel Behrens for evaluation of patients with MCI.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Authors’ contributions

M.F is the principal investigator of this project and wrote the first draft of the manuscript; I.B is a neurologist who evaluated the patients with diagnosis of MCI. EC and SM were involved in the thematic analysis by coding the answers independently; MF and CM were involved independently to review the interview materials, summarized and extracted meaningful statements, and formulated the themes presented in this paper; and CM and GR contributed to manuscript revision. All authors have approved the final version of this manuscript.

Additional information

Funding

MF received funding from National Fund for Scientific and Technological Development, through the grant ANID FONDECYT N°3190275 as well as supported by the ANID – Millennium Science Initiative Program –ICS13_005 to perform this study. Additionally, CM received funding from ANID – Millennium Science Initiative Program – ICS2019_024 and ICS13_005 as well as ANID FONDECYT 1191726. Finally, GR received funding from ANID – Millennium Science Initiative Program – ICS13_005.