LAUSR

The novel coronavirus (Covid-19) that emerged in Wuhan, China, in December 2019 rapidly spread within Hubei province, and by January 30, 2020 had extended to up to 20 countries. Highly contagious and dangerous, Covid-19 quickly impacted governments and public health systems, so that almost the entire world had to adopt the clinical and social tools that had previously been successfully deployed on a massive and unprecedented scale in China. Quarantine, social distancing, and community containment are the public health measures that have recently, as in the past, been taken to separate people to interrupt transmission and thereby prevent person-to-person spread of this disease [1]. However, quarantine brings with it also important psychological sequelae, as recently reported in the general Chinese population [2], so that the World Health Organization (WHO) promptly provided guidelines for dealing with this problem. An increasing amount of data is becoming available on the psychological and social problems resulting from Covid-19 and the interventions to tackle them in the general population [3]; yet little attention is being paid to elderly population and, in particular, to a frail subgroup of this age: individuals with neurocognitive disorders. The “stayhome” disposition and the sudden upheaval of daily life routines are in themselves difficult to tolerate by healthy and/or younger people, but can become even more burdensome for older persons with diseases that involve cognitive impairments, no less. For them, a daily routine is fundamental as a behavioral therapeutic approach to control the typical Behavioral and Psychological Symptoms of Dementia (BPSD) of disease, as psychomotor agitation, wandering and aggression. The opportunity to leave the house and to go out is a great source of indirect cognitive stimulation, thanks to the variety of environmental stimuli and the multiple possible chances of social exchange. Finally, also the possible motor impairments associated to quarantine should not be underestimated: a forced reduction of motor/physical activity can cause, particularly in older individuals with neurocognitive disorders, a progressive loss of personal and instrumental autonomy, as well as a possible worsening of other agingrelated clinical problems, as sarcopenia, with a consequent increased risk of falls, and subsequent medical geriatrics complications. With this background, the present Point of View paper aims to focus on a particularly frail population, namely on individuals with neurocognitive disorders, that have been relatively neglected up to now by the literature on the Covid19 pandemic. To do that, on a first section, this paper puts forward research topics aimed at deeper investigation of the indirect cognitive and psycho-affective effects of Covid-19 quarantine on individuals with neurocognitive disorders. Beyond providing selected points for discussion and highlighting some open issues, this paper suggests to consider remote assessment tools to be implemented not just during extraordinary periods, such as that of Covid-19, but also as a future and possible method of clinical practice. In the second section, “remote interventions” (RI) are proposed to be validated to provide neuropsychological assistance to persons with neurocognitive disorders, but also psychological and psychoeducational support for their caregivers during the pandemic but also for the next future. * Maria Devita [email protected]