Online physical exercise and the neuropsychiatric symptoms in patients with dementia: a cross-sectional study during the COVID-19 pandemic

ABSTRACT. Social isolation is necessary during the COVID-19 pandemic but can be harmful to mental health, especially in people with neurocognitive disorders. Although physical exercise can alleviate neuropsychiatric symptoms and improve quality of life (QoL), sedentary behavior increased during the pandemic. Online interventions can contribute to improving physical activity and mental health. Objective: The objective of this study was to compare the neuropsychiatric symptoms and QoL of older adults with neurocognitive disorders who participated in an online physical exercise program with sedentary patients during the COVID-19 pandemic. Methods: In this cross-sectional study, 25 older patients with neurocognitive disorders (control group=11; online exercise group=14) were evaluated based on Neuropsychiatric Inventory (NPI) and the Quality of Life in Alzheimer’s Disease (QoL-AD) scale. Results: There were differences between the two groups in the total NPI (U=36.50, p=0.025) and the nighttime behavior disturbances item (U=38.00, p=0.033), both with large effect sizes (ES=-1.03, 95% confidence interval [CI]:-1.83 to -0.16 and ES=-1.06, 95%CI -1.86 to -0.19, respectively). In terms of QoL-AD, a difference was identified only in the memory subitem (U=20.00, p=0.005), with a large ES (1.59, 95%CI 0.59-2.48). Conclusions: Older adults with neurocognitive disorders who participated in an online physical exercise program, during the COVID-19 pandemic, showed fewer neuropsychiatric total symptoms, fewer nighttime disturbances episodes, and better subjective memory, compared to their physically inactive counterparts. Randomized controlled trials should be performed to better understand the effect of physical exercise in neuropsychiatric symptoms in dementia patients during periods of social isolation.

摘要。新型冠状病毒肺炎（COVID-19）大流行期间需实施社交隔离，但此举可能损害心理健康，尤其对神经认知障碍（neurocognitive disorders）人群。尽管体育锻炼可缓解神经精神症状、提升生活质量（QoL），但大流行期间民众久坐行为显著增加。线上干预措施有助于改善体育活动水平与心理健康状态。
研究目的：本研究旨在对比新型冠状病毒肺炎（COVID-19）大流行期间，参与线上体育锻炼项目的神经认知障碍老年患者与久坐患者的神经精神症状及生活质量。
研究方法：本项横断面研究共纳入25例神经认知障碍老年患者，其中对照组11例、线上锻炼组14例。采用神经精神问卷（Neuropsychiatric Inventory, NPI）及阿尔茨海默病患者生活质量量表（Quality of Life in Alzheimer’s Disease, QoL-AD）对受试者进行评估。
研究结果：两组患者的神经精神问卷总得分（U=36.50，p=0.025）及夜间行为障碍条目得分（U=38.00，p=0.033）均存在显著差异，且均具有大效应量（ES=-1.03，95%置信区间[CI]：-1.83~-0.16；ES=-1.06，95%CI：-1.86~-0.19）。在阿尔茨海默病患者生活质量量表方面，仅记忆维度条目得分存在组间差异（U=20.00，p=0.005），且效应量较大（ES=1.59，95%CI：0.59~2.48）。
研究结论：新型冠状病毒肺炎（COVID-19）大流行期间，参与线上体育锻炼项目的神经认知障碍老年患者，相较久坐不动的对照患者，其总神经精神症状更少、夜间行为障碍发作频次更低，且主观记忆水平更优。未来需开展随机对照试验，以进一步明确社交隔离期内体育锻炼对痴呆患者神经精神症状的干预效果。