For People with Dementia, More Cases and Worse Outcomes

Image of a hand holding another hand with COVID-19 viruses surrounding themImage: WildPixel/Stock/Getty Images Plus

A Case Western Reserve-led research team reviewed electronic health records of nearly 62 million adults in the United States to investigate vulnerabilities to COVID-19, and the results were troubling.

The risk of contracting COVID-19 was twice as high for patients with dementia than for those without itwhile among those with dementia, African Americans were close to three times more likely to be infected than were Caucasians.

In addition, patients with dementia who contracted COVID-19 had significantly worse outcomes in terms of hospitalizations and deaths than those who had COVID-19 but not dementia.

The study was published earlier this year by the peer-reviewed Alzheimer's & Dementia: The Journal of the Alzheimer’s Association.

"Our results emphasize how important it is to protect those with dementia from acquiring SARS-CoV-2 [the virus that causes COVID-19], for they are at higher risk for severe disease than those without dementia," said study co-author Pamela Davis, MD, PhD, professor of general medical sciences in the Center for Community Health Integration at the School of Medicine.

Rong Xu, PhD, a professor of biomedical informatics at the medical school and director of its Center for Artificial Intelligence in Drug Discovery, was the principal investigator.

The research records were stripped of identifying information. Of the 61.9 million adults included, more than 1 million had dementia, 15,770 had COVID-19 and 810 had both.

The researchers hypothesized the risk would be greater for patients with dementia for several reasons. Damage to the blood-brain barrier can allow certain viruses and bacteria to more easily reach the brain and may make these patients more susceptible.

Dementia also may interfere with wearing a mask, physically distancing from others or frequently cleaning hands. And conditions such as cardiovascular diseases, diabetes, obesity and hypertension are risk factors for dementia and COVID-19, and are associated with worse COVID-19 outcomes.