People with dementia have a significantly higher risk of contracting coronovirus, and are more likely to be hospitalized and die than people without dementia, New study Millions of medical records have been found in the United States.
Their risk may not be fully explained by people with dementia in general who are known risk factors for Kovid-19: old age, living in nursing homes, and conditions such as obesity, asthma, diabetes, and heart disease. After researchers adjusted for those factors, dementia Americans were still twice as likely to receive Kovid-19 as they were last summer.
“It is very reassuring to suggest that there is something about dementia that makes you more vulnerable,” Dr. Said Christine Yaffe, a professor of neurology and psychiatry at the University of California, San Francisco, who was not involved in the study.
The study found that black people with dementia were nearly three times more likely to be infected with the virus, a finding that experts said most likely reflected the fact that people of color were exposed during the epidemic Has generally been disproportionately harmed.
“This study highlights the need to protect dementia patients, especially those who are black,” the authors write.
Alzheimer’s and Dementia, Chief Science Officer of the Alzheimer’s Association, which runs the journal that publishes the study, said in an interview, “One of the things that has come out of this Kovid situation is that we have to go towards these inequalities Should be pointing. . “
The study was led by researchers at Case Western Reserve University, who analyzed the electronic health records of 61.9 million people aged 18 and older in the United States as of August 21, 2020. Data collected by IBM Watson Health Exploit, came. The authors stated that 360 hospitals and 317,000 healthcare providers were represented in all 50 states.
Rong Xu, a professor of biomedical informatics at Case Western and senior author of the study, said that there was speculation about whether people with dementia were at greater risk of infection and harm from Kovid-19.
“We thought, ‘We have data, we can test this hypothesis,” Dr. Xu said.
Researchers found that the record analyzed 15,770 patients with Kovid-19, 810 of them with dementia. When researchers adjusted for common demographic factors – age, gender, and race – they found that people with dementia had more than three times the risk of having Kovid-19. When they adjusted for covid-specific risk factors such as nursing home residency and underlying physical conditions, the difference closed somewhat, but people with dementia were still twice as likely to become infected.
Experts and study authors stated that the causes of this vulnerability may include cognitive and physiological factors.
University of Michigan Professor of Medicine Drs. Kenneth Langa said, “People with dementia are more dependent on the people around them, so that they can remember to make safety goods, to wear masks, to keep socially distant people away.” The study was not included. “Cognitive impairment and the fact that they are socially at greater risk,” he said.
Dr. Yaff said that people with dementia may also have a “lethal element”, including loss of mobility and muscle mass, which can affect their resilience to infection.
Dr. Carrillo stated that coronovirus infection was associated with an inflammatory response that has been shown to affect blood vessels and other aspects of the circulatory system. Many people with dementia already have vascular impairment, which may be compounded or amplified by Kovid-19.
In fact, the study authors divided patients by the type of dementia listed in the electronic record and found that those designated as vascular dementia were at greater risk for infection than those with Alzheimer’s disease or other types.
But Dr. Langa and Dr. Yaffe warned that there was significant overlap between types of dementia. Many patients have both Alzheimer’s pathology and vascular pathology, he said, and physicians who are not specialists cannot subdivide in providing codes for electronic records.
In examining the risk of hospitalization and death for Kovid patients with dementia, the researchers did not adjust for age-like demographics or whether they lived in nursing homes or had underlying medical conditions. They found that Kovid patients with dementia were 2.6 times more likely to be hospitalized during the first six months of dementia than those without dementia. He was 4.4 times likely to die.
Black people with Kovid-19 and dementia were more likely to be hospitalized as white than people who had both illnesses. The authors did not find any significant difference in mortality rates for black and white coronavirus patients with dementia, although they wrote that the number of deaths analyzed to 170 may be too small to provide convincing conclusions about that.
Experts said a limitation in the study was that researchers did not have access to socioeconomic information, which could provide an increased understanding of patients’ risk factors.
Dr. Langa also noted that the data only reflect those who have interacted with the health care system, so it does not include “more isolated and poorer patients who have a harder time working for doctors.”
As a result, he said, the study “may be an estimate of the risk of greater Kovid infection for people suffering from dementia.”