key: cord-0988817-j36biioi authors: Yoshino, Hiroshi; Takechi, Hajime title: Influences of COVID‐19 in a dementia outpatient clinic: experience from the Fujita‐Health University Hospital in Aichi, Japan date: 2021-03-18 journal: Psychogeriatrics DOI: 10.1111/psyg.12684 sha: 8f489736e089cc0c057ef0c70e5e1252821515ff doc_id: 988817 cord_uid: j36biioi nan However, the state of alarm was expanded to the entirety of Japan on April 17. April showed a 23.5% decrease in total visits to our outpatient clinic (Fig. 1) . The number of new domestic infections of COVID-19 peaked at 714 on April 12, 4 then the number of new domestic infections gradually decreased. The state of alarm was lifted on May 25, 2020. Numbers of first visits in February, March, April, May and June were 27, 18, 23, 18 and 33, respectively. Numbers of cancelled reservations or no-shows for the same periods were 13, 10, 18, 16 and six, respectively. The telemedicine consultations started in March 2020 at Fujita-Health University Hospital, with two, 12, eight and three consultations in March, April, May and June, respectively. The number of telemedicine consultations showed a marked decrease in June (Fig. 1) . Overall, total visits and first visits were trending toward the pre-outbreak baseline. Overall, numbers of first visits and total visits between February and June 2020 were 119 and 1008, respectively, compared to 160 and 1035, respectively, for the same period in 2019. Our results show that after an initial dip, activity in our outpatient clinic resumed baseline activity within 4 months. A Spanish study reported that total visits including telemedicine consultations were at 78% of visit levels before the outbreak. 5 One reason for the decrease in first visits may have been declines in referrals from general practitioners. Telemedicine is a real option for care, but the number of telemedicine consultations decreased within a short time. One reason for this may be that the state of alarm was lifted on May 25, 2020. Patients and their families may have desired face-to-face visits due to anxiety about potential deterioration of dementia. According to Japan Medical Association, medical fees in outpatient clinics of internal medicine based on year-on-year comparison in March, April, May and June 2020 were −8.0, −13.5, −17.2, and −8.9%, respectively, which indicated no difference or even faster recovery in outpatient dementia clinics than outpatient clinics of internal medicine under COVID-19 conditions. 6 Limitations of the present study were as follows. First, this detailed analysis was limited to only a single facility. Second, this study examined an extremely limited period of only 4 months. A long-term, multi-centre analysis is warranted in the future. In conclusion, we should consider that patients with dementia or their families may desire face-to-face visits. We also believe that outpatient dementia clinics represent essential resources, even under COVID-19 conditions. The authors have no potential conflicts of interest to disclose. H. Yoshino designed the study, collected the data, completed analysis and wrote the paper. H. Takechi completed analysis and reviewed the paper. COVID-19 and older adults: what we know JAGS Minister of Health, Labor and Welfare Dementia care in times of COVID-19: experience Fundació ACE in Balcelona, Spain