Dementia patients are twice as likely to contract COVID-19, African-Americans face greater risks

CLEVELAND, Ohio — For people battling dementia, every day can be a struggle to do and remember simple tasks. A new study finds their daily challenges are being compounded even further by the coronavirus pandemic. Researchers from Case Western Reserve University say patients with dementia are twice as likely to become infected with COVID-19. Those risks are dramatically higher for African-Americans with the disease.

The study examined the health records of nearly 62 million adults throughout the United States. The six-month report covers a timeframe stretching from the beginning of the pandemic through late August 2020. While all dementia patients face increased risk of contracting the virus, the results reveal Black dementia patients are three times more likely than Caucasians to get sick.

Study authors add that people with any form of this neurological condition are also more likely to die or need hospitalization for COVID symptoms. While the overall death rate during the study came in at 5.64 percent, one in five dementia patients (20.99%) with the virus died. That number jumped to 23 percent among Blacks with dementia.

“Our results emphasize how important it is to protect those with dementia from acquiring SARS-CoV2, for they are at higher risk for severe disease than those without dementia,” says study co-author Pamela Davis, dean emerita of the Case Western Reserve School of Medicine, in a university release. “These patients may constitute another vulnerable category. However, more work is required to understand the mechanism by which this occurs.”

What makes someone with dementia more vulnerable to COVID?

Researchers theorized that several factors come into play which make Alzheimer’s or other dementia patients more vulnerable during the pandemic. One of the key problems, study authors say, may be the damage in the blood-brain barrier which prevents certain viruses and bacteria from reaching the brain.

Dementia can also hinder a person from wearing a mask or remembering to wear one, properly social distancing, and washing hands regularly. The study notes that heart disease, diabetes, obesity, and high blood pressure are all risk factors for both dementia and COVID-19. They can also lead to worse outcomes and more severe infections during the pandemic.

“On behalf of the millions of people living with Alzheimer’s and other dementia that we represent, these preliminary findings suggest a frightening reality of the vulnerabilities associated with dementia,” says Maria Carrillo, PhD, chief science officer of the Alzheimer’s Association. “It is critical we develop and implement strategies that strike a balance between keeping people, especially long-term care residents, safe from COVID-19 but also protecting them from health-related harms associated with social isolation.”

To study these risks, researchers gathered data from 360 hospitals and 317,000 providers nationally. The 61.9 million people that information covers represents about 20 percent of the United States population. From that group, over one million have dementia, 15,770 had a case of COVID-19, and 810 had both.

“The availability of such a large de-identified database of patient electronic health records analyzed by modern informatics techniques gave our study great power to detect vulnerabilities in patient disease groupings,” principal investigator Rong Xu says.

Some dementia patients face greater risks than others

After adjusting for factors including age, gender, race, and other health issues, the results uncovered the link between COVID and dementia. This risk, however, can be higher depending on the form of dementia a patient has.

Researchers find people with vascular dementia have the highest risk of contracting the virus, with odds more than three times higher than normal. This particular group is followed by patients with presenile dementia, senile dementia, Alzheimer’s disease, and post-traumatic dementia.

While study authors say there’s a clear difference between Black and white dementia patients, the results do not find any added risk based on age or gender.

During the six months, the overall risk for patients needing hospitalization from COVID was 25.17 percent. For those battling dementia, the risk skyrocketed to 59.26 percent, with a staggering 73 percent hospitalization rate among African-Americans.

The Alzheimer’s Association says there are approximately 5.8 million Americans over 65 living with some form of dementia. Around 50 million people deal with cognitive decline globally.

The study appears in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association.

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