Severe dementia, older age raise COVID-19 death risk in nursing homes

Severe dementia, older age raise COVID-19 death risk in nursing homes
Age and dementia increase the risk for COVID-19 death among nursing home residents, a new study has found. File photo by Ken Cedeno/UPI | License Photo

March 31 (UPI) -- Nursing home residents age 90 and older in the United States are nearly three times as likely to die from COVID-19 as those age 65 to 70, a study published Wednesday by JAMA Network Open found.

In addition, those with severe dementia, regardless of age, had up to a 90% higher risk for death from the virus compared to those with no cognitive impairment, the data showed.


The researchers noted, however, that over the course of the pandemic, from the initial start of its spread in March 2019 through the rest of the year, the overall risk of death among nursing home residents declined significantly.

"Among nursing home residents who were infected, risk of death was associated with the same types of factors that have been found among [the general population]," study co-author Dr. James Goodwin told UPI in an email.

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"Increased age, dementia, impaired physical function and male sex all were associated with increased risk of death," said Goodwin, a professor of medicine at the University of Texas Medical Branch in Galveston.

About 81% of the people who died from COVID-19 in the United States in 2020 were age 65 and older, according to figures released Wednesday by the U.S. Centers for Disease Control and Prevention.


Nursing home residents accounted for 22% of all virus-related deaths last year, the agency estimated.

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For this study, Goodwin and his colleagues analyzed data on more than 482,000 Medicare beneficiaries age 65 years and older who resided in more than 15,000 nursing homes nationally.

The analysis covered the period between April 1 and Sept. 30 of last year, which encompassed both the first and second waves of the pandemic in the United States.

Of the nursing home residents included in the analysis, 28% tested positive for the virus and 21% required hospital treatment.

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Just over 19% died as a result of infection, the researchers said.

Nursing home residents who were obese had a 19% higher risk for infection and a 40% risk for hospitalization compared to those with a healthy body weight.

Male nursing home residents had a 32% higher risk for hospitalization due to COVID-19 compared to female residents, while those with kidney disease and diabetes, regardless of gender, had about a 20% higher risk for hospitalization.

Only age -- being 90 years old or older -- and suffering from severe dementia increased the risk for death from COVID-19 among nursing home residents.

Although many regions of the country reported large numbers of virus-related deaths among nursing home residents last spring at the start of the pandemic, rates began to drop as facilities instituted infection control measures, such as mask-wearing and social distancing.


"Most nursing home residents with COVID-19 survived, and survival after infection improved substantially over time," Goodwin said.

"From early in the pandemic, the spring of 2019, until last fall, the mortality of nursing home residents diagnosed with COVID-19 dropped by 70%," he said.

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