Dementia patients more at risk for coronavirus infection, hospitalization, study finds

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Dementia patients are at an increased risk of contracting the novel coronavirus, suggests the findings of a new, large study that also determined those who suffer from the cognitive condition are more likely to be hospitalized due to a COVID-19 infection. 

For the study published Tuesday in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, researchers from Case Western University analyzed electronic health record data from nearly 62 million adult Americans between February and August 2020. Of the 15,770 patients with COVID-19, 810 of them also had dementia, according to the study. 

"This study highlights the need to protect patients with dementia, especially those who are Black, as part of the strategy to control the pandemic," the researchers concluded. (iStock)

After adjusting for several factors, such as age, sex, and race, the researchers determined those who suffer from dementia were twice as likely to contract the novel disease than those who do not suffer from it. Dementia patients were also more likely to be hospitalized due to COVID-19, and were found to be more likely to die from it, the researchers concluded. 

More specifically, the hospitalization risk for dementia patients was about 59%, more than double when compared to those who do not suffer from the condition. Meanwhile, the overall mortality risk in the study was about 5% but jumped to 20% for dementia patients. 

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The study also found that Black patients with dementia were even more likely to be hospitalized or die from COVID-19 when compared to white dementia patients. About 73% of Black dementia patients were hospitalized due to COVID-19 over the study period, compared to 53% for white patients. 

Additionally, during the study period, about 23% of Black patients with dementia died, while 19% of white patients with dementia died. 

"This study highlights the need to protect patients with dementia, especially those who are Black, as part of the strategy to control the pandemic," the researchers concluded. 

"Comparing the odds of COVID‐19 in patients with dementia before and after adjusting COVID-19 risk factors, it is clear that these factors, many of which are also risk factors for dementia (e.g., cardiovascular diseases, type 2 diabetes, obesity, asthma, chronic kidney disease) indeed contributed to the high risk for COVID‐19 in patients with dementia," they continued.

"Although a higher proportion of patients with dementia may reside in nursing homes and chronic care facilities, and close encounters predispose to transmission of the virus, the impact of dementia on the risk for SARS-CoV-2 infection persists after controlling for nursing home care," they wrote. "Yet," they noted, "even after adjusting for these risk factors, patients with dementia still had high risk for COVID-19 compared to patients without dementia."

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"Reasons for this observed high risk for viral infection are the following: first, certain residual and unmeasured confounding factors (e.g., socioeconomic determinants, behavioral factors, lifestyle) may have contributed to the increased risk for COVID-19 in patients with dementia. For example, patients with dementia may be particularly prone to SARS-CoV-2 infection because their impaired memory limits their ability to comply with recommendations for social distancing, mask-wearing, or hand washing," they said of one possibility. 

Overall, more research is needed to understand the reasoning why dementia patients are more at risk for COVID-19 and severe outcomes, the researchers said, noting, however, that their findings "can serve as a baseline study of initial COVID‐19 risk, racial disparity, and outcomes observations in patients with dementia across the United States."