The Protective Impact of Telemedicine on Persons With Dementia and Their Caregivers During the COVID-19 Pandemic

Am J Geriatr Psychiatry. 2020 Nov;28(11):1175-1184. doi: 10.1016/j.jagp.2020.07.019. Epub 2020 Aug 8.


Objectives: Social distancing under the COVID-19 pandemic has restricted access to community services for older adults with neurocognitive disorder (NCD) and their caregivers. Telehealth is a viable alternative to face-to-face service delivery. Telephone calls alone, however, may be insufficient. Here, we evaluated whether supplementary telehealth via video-conferencing platforms could bring additional benefits to care-recipient with NCD and their spousal caregivers at home.

Participants: Sixty older adults NCD-and-caregiver dyads were recruited through an activity center.

Design, intervention: The impact of additional services delivered to both care-recipient and caregiver through video conference (n = 30) was compared with telehealth targeted at caregivers by telephone only (n = 30), over 4 weeks in a pretest-post-test design. Interviews and questionnaires were conducted at baseline and study's end.

Measurements, results: Supplementary telemedicine had averted the deterioration in the Montreal Cognitive Assessment evident in the telephone-only group (ηp2 = 0.50). It also reversed the falling trend in quality of life observed in the telephone only group (QoL-AD, ηp2 = 0.23). Varying degrees of improvements in physical and mental health (Short-Form 36 v2), perceived burden (Zarit Burden Interview Scale) and self-efficacy (Revised Caregiving Self-Efficacy Scale) were observed among caregivers in the video-conferencing group, which were absent in the telephone-only group (ηp2 = 0.23-0.51).

Conclusion: Telemedicine by video conference was associated with improved resilience and wellbeing to both people with NCD and their caregivers at home. The benefits were visible already after 4 weeks and unmatched by telephone alone. Video conference as the modus operandi of telehmedicine beyond the context of pandemic-related social distancing should be considered.

Keywords: COVID-19 pandemic; Caregiver; dementia; telehealth.

MeSH terms

  • Aged
  • Betacoronavirus
  • COVID-19
  • Caregivers / psychology*
  • Coronavirus Infections* / epidemiology
  • Coronavirus Infections* / psychology
  • Dementia* / epidemiology
  • Dementia* / therapy
  • Dementia* / virology
  • Female
  • Home Care Services / trends
  • Hong Kong / epidemiology
  • Humans
  • Independent Living / psychology
  • Male
  • Mental Health
  • Pandemics*
  • Patient Care Management / methods
  • Patient Care Management / trends
  • Pneumonia, Viral* / epidemiology
  • Pneumonia, Viral* / psychology
  • Protective Factors
  • Quality of Life*
  • SARS-CoV-2
  • Telemedicine / methods*
  • Videoconferencing*