Change in modifiable dementia risk factors during COVID-19 lockdown: The experience of over 50s in Tasmania, Australia

Larissa Bartlett, James J R Brady, Maree Farrow, Sarang Kim, Aidan Bindoff, Hannah Fair, James C Vickers, Duncan Sinclair, Larissa Bartlett, James J R Brady, Maree Farrow, Sarang Kim, Aidan Bindoff, Hannah Fair, James C Vickers, Duncan Sinclair

Abstract

Introduction: Containment measures implemented to minimize the spread of coronavirus disease 2019 (COVID-19) are reported to be negatively affecting mental health, diet, and alcohol consumption. These factors, as well as poor cardiometabolic health and insufficient physical and cognitive activity, are known to increase the risk of developing dementia. COVID-19 "lockdown" measures may have exacerbated these dementia risk factors among people in mid-to-later life.

Methods: We compared longitudinal data from before (October 2019) and during (April-June 2020) the first COVID-19 lockdown period in Tasmania, Australia. Participants (n = 1671) were 50+ years of age and engaged in a public health program targeting dementia risk reduction, with one-third participating in the Preventing Dementia Massive Open Online Course (PD-MOOC). Regression models were used to assess changes in smoking, alcohol use, body mass index (BMI), diet, physical exercise, cognitive and social activity, anxiety and depression, and management of cholesterol, diabetes, and blood pressure. Where significant changes were noted, the moderating influence of being in current employment, living with others, and completing the PD-MOOC was tested.

Results: Although friend networks contracted marginally during lockdown, no detrimental effects on modifiable dementia risk factors were noted. Anxiety levels and alcohol consumption decreased, there was no change in depression scores, and small but significant improvements were observed in cognitive and physical activity, smoking, diet, and BMI. Stronger improvements in cognitive activity were observed among people who were cohabiting (not living alone) and both cognitive activity and adherence to the MIND diet (Mediterranean-DASH diet Intervention for Neurological Delay) improved more for people who participated in the PD-MOOC.

Discussion: Longitudinal data did not show widespread negative effects of COVID-19 lockdown on modifiable dementia risk factors in this sample. The results counter the dominant narratives of universal pandemic-related distress and suggest that engaging at-risk populations in proactive health promotion and education campaigns during lockdown events could be a protective public health strategy.

Keywords: COVID‐19; dementia; lockdown; longitudinal; modifiable risk‐factors.

© 2021 The Authors. Alzheimer's & Dementia: Translational Research & Clinical Interventions published by Wiley Periodicals, Inc. on behalf of Alzheimer's Association.

Figures

FIGURE 1
FIGURE 1
Standardized mean difference with 95% CI from T1 to T2 for each of the assessed variables (model 2a)
FIGURE 2
FIGURE 2
Interactions of time with PD‐MOOC exposure and cohabitation status at T2. Error bars‐ 95% CI. PD‐MOOC‐ Preventing Dementia Massive Open Online Course. Unadjusted means for Diet‐ adherence to the Mediterranean‐DASH Intervention for Neurodegenerative Delay (MIND) diet excluding wine consumption, sum of scores (0, 0.5, or 1) for each category; Cognitive activity‐ summed frequency of 11 different cognitive activities

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