People with dementia had a much higher risk of catching the coronavirus, and were far more likely to be hospitalized and die from it, than people without dementia, a new study of millions of medical records in the United States has found.
Their risk could not be fully explained by traits common to people with dementia known as risk factors for Covid-19: old age, living in a nursing home and with conditions such as obesity, asthma, diabetes and cardiovascular disease. After researchers adjusted for these factors, Americans with depression were still twice as likely to get Covid-19 at the end of last summer.
“It’s definitely suggesting that there’s something about depression that makes you more vulnerable,” said Dr. Kristine Yaffe, professor of neurology and psychiatry at the University of California, San Francisco , who were not involved in the study.
The study found that black people with dementia were almost three times as likely as white people with dementia to be infected with the virus, a finding that experts who are more likely to show that people with color in general have the injury was disproportionate during the pandemic.
“This study highlights the need to protect patients with dementia, especially those who are black,” the authors wrote.
Maria Carrillo, chief science officer at the Alzheimer’s Society, which runs the journal that published the study, Alzheimer’s and Dementia, said in an interview, “One of the things that came out of this Covid-19 condition is that we should point out these differences. “
The study was led by researchers at Case Western Reserve University who analyzed electronic health records of 61.9 million people aged 18 and over in the United States from February 1 through August 21, 2020. The data came , compiled by IBM Watson Health Explorys. from 360 hospitals and 317,000 health care providers across all 50 states and representing one-fifth of the U.S. population, the authors said.
Dr Rong Xu, professor of biochemical biology at Case Western and senior author of the study, said there had been a proliferation of people with depression being more likely to get infection and harm from Covid -19.
“We thought, ‘We have the data; we can just confirm this idea, ‘”Xu said.
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The researchers found that out of 15,770 patients with Covid-19 in the records examined, 810 of them also had depression. When the researchers adjusted for general demographic factors – age, gender and race – they found that people with dementia were more than three times more likely to get Covid-19. When they adjusted for Covid’s specific risk factors such as foster home residence and basic physical conditions, the gap closed slightly, but people with dementia were still twice as likely to be infected.
The experts and authors of the study said that the reasons for this vulnerability could include cognitive and psychological factors.
“People with dementia rely heavily on those around them to make the safety material, to wear a mask, to keep people away through social distance,” said Dr Kenneth Langa, professor of medicine at University of Michigan, which was not involved in the study. “The mental retardation and the fact that they are at risk is more social,” he said.
Yaffe said there may be a “weak element” for people with dementia, including lack of mobility and muscle tone, which can affect their susceptibility to disease.
Carrillo noted that coronavirus 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 a viral deficiency, which may be exacerbated or exacerbated by Covid-19.
In fact, the study authors divided patients according to the type of depression listed in the electronic records and found that people with dementia had a higher risk than those with Alzheimer’s disease or dementia. other types.
But Langa and Yaffe warned that there was a big overlap between types of dementia. Many patients have both Alzheimer’s pathology and vascular pathology, they said, and non-specialist physicians may not differentiate subtypes in providing codes for electronic records.
In studying hospital risk and mortality for Covid-19 patients with dementia, the researchers did not adjust for demographics such as age or whether they lived in nursing homes or had underlying health conditions. They found that Covid-19 patients with dementia were 2.6 times more likely to be hospitalized in the first six months of the pandemic than those without dementia. They were 4.4 times as likely to die.
Black people with Covid-19 and depression were significantly more likely to be hospitalized than white people with both diseases. The authors found no significant difference in mortality for black and white coronavirus patients with depression, although they wrote that the number of deaths studied, 170, may be too small for com- to give a hard conclusion about that.
Experts noted that one limitation of the study was that researchers did not have access to socioeconomic information, which could provide a greater understanding of patient risk factors.
Langa also noted that the data only showed people who have interacted with the healthcare system, so it does not include “more isolated and poorer patients who have harder time getting to doctors. ”
As a result, he said, the study could be “an estimate of the greatest Covid-19 infectious risk for those with dementia. ”