COVID-19 and dementia: Analyses of risk, disparity, and outcomes from electronic health records in the US

Alzheimers Dement. 2021 Aug;17(8):1297-1306. doi: 10.1002/alz.12296. Epub 2021 Feb 9.

Abstract

Introduction: At present, there is limited data on the risks, disparity, and outcomes for COVID-19 in patients with dementia in the United States.

Methods: This is a retrospective case-control analysis of patient electronic health records (EHRs) of 61.9 million adult and senior patients (age ≥ 18 years) in the United States up to August 21, 2020.

Results: Patients with dementia were at increased risk for COVID-19 compared to patients without dementia (adjusted odds ratio [AOR]: 2.00 [95% confidence interval (CI), 1.94-2.06], P < .001), with the strongest effect for vascular dementia (AOR: 3.17 [95% CI, 2.97-3.37], P < .001), followed by presenile dementia (AOR: 2.62 [95% CI, 2.28-3.00], P < .001), Alzheimer's disease (AOR: 1.86 [95% CI, 1.77-1.96], P < .001), senile dementia (AOR: 1.99 [95% CI, 1.86-2.13], P < .001) and post-traumatic dementia (AOR: 1.67 [95% CI, 1.51-1.86] P < .001). Blacks with dementia had higher risk of COVID-19 than Whites (AOR: 2.86 [95% CI, 2.67-3.06], P < .001). The 6-month mortality and hospitalization risks in patients with dementia and COVID-19 were 20.99% and 59.26%, respectively.

Discussion: These findings highlight the need to protect patients with dementia as part of the strategy to control the COVID-19 pandemic.

Keywords: Alzheimer's disease; COVID-19; dementia; patient electronic health records.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / complications
  • Alzheimer Disease / epidemiology
  • Blacks
  • Brain Injuries, Traumatic / complications
  • Brain Injuries, Traumatic / epidemiology
  • COVID-19 / complications*
  • COVID-19 / epidemiology
  • Case-Control Studies
  • Dementia / complications*
  • Dementia / epidemiology
  • Dementia, Vascular / complications
  • Dementia, Vascular / epidemiology
  • Demography
  • Electronic Health Records
  • Female
  • Healthcare Disparities
  • Hospitalization / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Treatment Outcome
  • United States / epidemiology
  • Whites
  • Young Adult