Deaths among those with dementia rose during COVID-19 pandemic, study finds

Feb. 28 (UPI) -- Older adults with Alzheimer's disease and related dementias had higher rates of death during the COVID-19 pandemic than in previous years, a study published Monday by JAMA Neurology found.

This was particularly for those of Asian, Black and Hispanic descent, as well as people who lived in nursing homes, the researchers said.

Among people age 65 years and older covered by Medicare, death rates were 26% higher for those with Alzheimer's disease and other forms of dementia in 2020 compared to 2019, the data showed.

Death rates were 12% higher in 2020 for people in this age group without dementia compared to 2019, most likely reflecting the impact of COVID-19, according to the researchers.

For people with all forms of dementia who lived in nursing homes, death rates were 14% higher in 2020 than they were in 2019, the researchers said.

Asian American, Black American and Hispanic American adults with all forms of dementia experienced an up to 40% higher rate of death in 2020 compared to 2019, the data showed.

"I think our findings highlight that as a healthcare system we really do have to think about people with cognitive limitations differently," study co-author Dr. Lauren Gray Gilstrap told UPI in an email.

"More creative solutions are needed to better serve this vulnerable segment of society," said Gilstrap, an assistant professor of medicine and health policy at Geisel School of Medicine at Dartmouth University in Lebanon, N.H.

About 6 million people in the United States have been diagnosed with dementia, or a decline in brain function that causes memory loss and other problems, with Alzheimer's disease the most common form, according to the Alzheimer's Association.

Most of those affected by dementia are age 65 and older -- a group that also has been found to be at increased risk for COVID-19 infection and severe illness from the virus, due in part to weakened immune systems, research indicates.

The immune system's ability to fight off viruses declines with age, and this also makes the COVID-19 vaccines, which are designed to strengthen the body's natural immune response, less effective, previous studies have found.

Because of these issues, nursing homes, which house people in these at-risk groups, have borne the brunt of the effects of the COVID-19 pandemic in many parts of the country.

For this study, Gilstrap and her colleagues analyzed data on nearly 27 million adults in the United States covered by Medicare, the federally funded health plan that provides benefits to those age 65 years and older.

They compared deaths rates among Medicare beneficiaries with Alzheimer's disease and other forms of dementia and those without these conditions for 2019, the year before the COVID-19 pandemic began, and 2020, when the spread of the virus was at its height, they said.

About 2.3 million of the 2020 Medicare enrollees included in the study had been diagnosed with some form of dementia compared to just over 2.4 million in 2019, the researchers said.

In 2020, 25% of the Medicare enrollees with some form of dementia died, up from just under 20% in 2019, the data showed.

Just under 3% of Medicare enrollees without dementia died in 2020, up from just under 2.5% in 2019, according to the researchers.

"This pandemic has been hard on all of us, but I think it's been especially hard on people with Alzheimer's disease and related dementias and those living in nursing homes," Gilstrap said.

"People with [dementia] are generally older, and we know older people and especially those with comorbidities were at higher risk of dying from COVID-19," she said.